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Skin Health

Lecturer - Istanbul Kent University, Health Services Vocational School and Faculty of Pharmacy

"Healthy skin is an important indicator that reflects our general body health."

Cilt Sağlığı

What is skin?

The skin is a complex organ that maintains critical functions such as preventing body fluid loss and regulating temperature, creating a physical barrier by protecting the body against external factors such as harmful pathogens, pollution, and ultraviolet (UV) radiation, and mediating the sensation of touch and pain sensation. It also has an immunological* structure that is vital for maintaining tissue homeostasis, defense, and repair.

*Immunology: The sub-discipline of science that deals with immunity and the immune systems of different organisms.

Structure of the skin

Human skin consists of three main layers: epidermis (upper layer), dermis (middle layer), and hypodermis (lower layer). The epidermis is the outermost layer of the skin; It is pided into stratum corneum, stratum lucidum, stratum granulosum, and stratum basale. It protects against external factors. The stratum corneum has a prominent role as a waterproof, relatively impermeable barrier that is key to preventing the entry of various xenobiotics*. The stratum basale determines skin color by producing pigment through cells called melanocytes. The dermis contains blood vessels, nerve endings, and collagen fibers that facilitate the transport of nutrients, which determines the strength and elasticity of the skin. Both dermal layers host immune cells such as fibroblasts, macrophages, lymphocytes, and mast cells. The hypodermis is a layer of fat and connective tissue located under the dermis that regulates body temperature. Skin adipose tissue functions as an important organ for glucose homeostasis and lipid metabolism by storing energy in the form of fatty acids. This layer also produces various mediators such as growth factors and contains many immune cells. In addition, since subcutaneous fat has low thermal conductivity, it acts as an insulation layer for the body ​homeostasis is the state of steady internal physical and chemical conditions maintained by living systems.

Xenobiotics: Xenobiotics are substances other than nutrients that our body interacts with during life.

Homeostasis: A state of stable internal physical and chemical conditions maintained by living systems.

Lipid: One of the basic organic compounds found in the structure of all living organisms. Lipids are pided into saturated and unsaturated fats.

Skin microbiome

Did you know that human skin, which serves as our body's physical barrier and largest organ, hosts millions of bacteria, fungi, and viruses that make up the "skin microbiome"?

These microorganisms and the environment surrounding them are the microbiome. There is no single definition of a balanced skin microbiome. The microbial balance for each inpidual is dynamic and unique. Microbiota colonization begins at birth and matures with us as we grow and navigate the environments around us. Its composition is determined by various internal factors such as skin area, inpidual differences, ethnicity, gender, and age, as well as external factors such as lifestyle, hygiene habits, use of cosmetics, antibiotics, diet, obesity, geographical location, climate, and season.

Skin microbiome; It has important roles in maintaining skin homeostasis, protection against invading pathogens*, and modulation of the immune system and gene expression. Disturbance of balance can lead to pathophysiological* problems, triggering skin conditions such as infections, allergic diseases, and autoimmune disorders.

*Pathogen: A pathogen is defined as an organism causing disease to its host.​

*Pathophysiology: The study of disturbances in normal mechanical, physical, and biochemical functions caused by abnormal syndromes or conditions that cannot be called a disease or illness.

What is dysbiosis?

Dysbiosis refers to a lack of balance between microbial communities in certain areas of the body. Various skin diseases such as atopic dermatitis*, seborrheic dermatitis**, acne, alopecia***, and psoriasis*** can be caused by dysbiosis.

*Atopic dermatitis: A chronic skin condition that causes dry, scaly patchy lesions on the skin and intense itching.

**Seborrheic dermatitis: A common skin condition that mainly affects the scalp. It causes scaly patches, reddening of the skin, and persistent dandruff.

***Alopecia: Hair loss.

****Psoriasis: A skin condition that causes skin cells to proliferate faster than normal, resulting in raised, scaly patches on the skin.

What is skin health?

Your skin shows the world how healthy you are and how old you are. Skin health means that the skin is in optimal condition and functions effectively. Skin health depends on various factors such as genetics, environmental influences, and personal care habits. Healthy skin should be moist, elastic, and smooth. This is important in terms of appearance, health, self-confidence, and communication.

Regular cleansing and moisturizing are essential for your skin to stay healthy. Additionally, adopting a healthy lifestyle that focuses on our overall health, such as eating a balanced diet, drinking enough water, and exercising regularly, also affects skin health.

Ways to protect skin health

The key to maintaining skin health is regular care, proper nutrition, and paying attention to daily habits. The first tip for flawless skin, one of the most universally desired features, is to protect yourself from the sun's harmful ultraviolet (UV) rays, which can cause premature aging of the skin and serious problems such as skin cancer. For this purpose, it is important to take sun protection measures by using sunscreen with a sun protection factor (SPF) of at least 30, avoiding long periods outdoors during peak sun hours, and wearing wide-brimmed hats and appropriate clothing.

Another way to maintain skin health is to have a balanced diet containing sufficient amounts of vitamins, minerals, and antioxidants. Antioxidants, omega-3 fatty acids, and vitamins C and E can help keep skin young and glowing. A rich diet containing fish, nuts, colorful vegetables, and fruits supports skin health.

Consuming adequate amounts of water is critical for the body to maintain the skin's moisture balance. Water helps cleanse the body of toxins* and prevents dryness and cracks by increasing the elasticity of the skin.

Stress can have a negative impact on skin health. Avoiding stress or developing ways to manage stress is important to maintain overall skin health. Yoga, meditation, and various hobbies can be effective in managing stress.

Even though it is neglected, regular and quality sleep is an important part of protecting skin health.

*Toxin: Toxic substances secreted by microorganisms.

Skincare and cleaning

Skincare is a set of measures to support skin health, improve appearance, and reduce skin imperfections.

By washing your face regularly, you can remove dead skin cells and accumulated sebum and prevent pores from clogging. Thus, the formation of problems such as acne can be prevented. However, over-cleansing can strip your skin of its natural oils. That's why it's important to use mild cleaning products and deep clean regularly. Additionally, makeup needs to be removed before going to sleep to keep your skin healthy.

It is important to regularly use a moisturizer suitable for your skin type to maintain the moisture balance of your skin. Moisturizers increase skin elasticity and prevent dryness and flaking. Especially in winter months, your skin needs more moisture due to cold weather.

Skin types and the importance of skin care appropriate for skin type

Skin types generally include oily, dry, combination, normal and sensitive skin. Oily skin is characterized by a shiny appearance, large pores, and often blackheads. It should be aimed at maintaining oil balance by using light, water-based products. Since dry skin lacks moisture and natural oils, it has a flaky and tense structure. It should be aimed at nourishing the skin with intense moisturizing products and gentle cleansers. In combination skin type, especially the T-zone is oily and the cheeks are dry or a normal combination prevails. A balanced care routine should be preferred with oil control products and moisturizers specific to the T zone. Normal skin is said to be balanced, smooth, and generally free of problems. General skin health is maintained with regular cleaning. Sensitive skin, on the other hand, shows characteristics such as redness, irritation, and susceptibility to allergic reactions. It is necessary to protect the skin with gentle care using fragrance-free products.

Knowing your skin type is an essential step to applying proper skin care. However, it should not be forgotten that skin type may change over time depending on many factors such as environmental factors, age, and lifestyle. Therefore, it is important for skin health to check the skin type at regular intervals and apply the appropriate care routine.

Commonly known mistakes

There is no need to use sunscreen in winter or if the weather is not sunny.

Even if the sky is cloudy and the sun's rays do not shine directly on your face, you should protect your skin every day with sunscreen suitable for your skin, as the skin is exposed to UVA and UVB rays.

If you have oily skin, you do not need to use moisturizer.

All skin types, including oily skin, need moisturizing. Moisturization balances skin sebum, keeping the skin moist and healthy.

Dark skin needs less sunscreen.

The sun's UV rays interact with skin the same way they interact with fair skin. Dark skin may not sunburn as easily, but it doesn't change the fact that dark skin is also at risk of skin cancer.

Expensive skin care products always offer better care.

The price of a product does not always mean that it is of high quality and effective. Therefore, it is important to focus on its content rather than its price. Instead of products containing synthetic chemicals, natural, vegan, and sustainable products should be preferred.

Diet has nothing to do with skincare.

Components in eaten foods, like hormones, can affect the skin at the cellular level. For example, pieces of bread, pasta, and potatoes with a high glycemic index can promote the destruction of collagen and elastin fibers.

1.         Carmona-Cruz S, Orozco-Covarrubias L, and Sáez-de-Ocariz M, The Human Skin Microbiome in Selected Cutaneous Diseases. (2022).

https://pubmed.ncbi.nlm.nih.gov/35321316/

2.         Chen Y, Knight R, and Gallo RL, Evolving approaches to profiling the microbiome in skin disease. (2023).

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10110978/

3.         Dréno B, et al., The Skin Microbiome: A New Actor in Inflammatory Acne. (2020).

https://pubmed.ncbi.nlm.nih.gov/32910436/

4.         Humphrey S, et al., Defining Skin Quality: Clinical Relevance, Terminology, and Assessment. (2021).

https://pubmed.ncbi.nlm.nih.gov/34148998/

5.         Lee HJ and Kim M, Skin Barrier Function and the Microbiome. (2022).

https://pubmed.ncbi.nlm.nih.gov/36361857/

6.         Lee J, et al., Hair-bearing human skin generated entirely from pluripotent stem cells. (2020).

https://www.nature.com/articles/s41586-020-2352-3

7.         Meléndez-Martínez AJ, Stinco CM, and Mapelli-Brahm P, Skin Carotenoids in Public Health and Nutricosmetics: The Emerging Roles and Applications of the UV Radiation-Absorbing Colourless Carotenoids Phytoene and Phytofluene. (2019).

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6566388/

8.         Nguyen AV and Soulika AM, The Dynamics of the Skin's Immune System. (2019).

https://pubmed.ncbi.nlm.nih.gov/31013709/

9.         Pangestuti R, Shin KH, and Kim SK, Anti-Photoaging and Potential Skin Health Benefits of Seaweeds. (2021).

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8004118/

10.       Townsend EC and Kalan LR, The dynamic balance of the skin microbiome across the lifespan. (2023).

https://pubmed.ncbi.nlm.nih.gov/36606709/

11.       Xu H and Li H, Acne, the Skin Microbiome, and Antibiotic Treatment. (2019).

https://pubmed.ncbi.nlm.nih.gov/30632097/

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