SKIN: FUNCTIONAL AS WELL AS ORNAMENTAL

Unless wounded or suffering a rash or whatever, I venture to suggest that people mostly attend to how skin looks. It’s only logical, given that it’s exposed to public view—more or less, depending on culture, sex, age, season, and occasion!

Putting Your Best Face Forward

The good news is this: skin is constantly renewing itself, shedding dead cells and producing new ones. On average, we lose about 30,000 to 40,000 skin cells per minute. You may not see the dead, dull skin flaking off your face and body, but it is, and it contributes significantly to household dust!

It takes about a month for newly formed skin cells to make their way to the surface. The bad news is that renewal takes longer with age: turnover can take as much as six to eight weeks in someone in their 60s or 70s.

A buildup of dead skin cells can make your complexion appear duller and drier.

Like your body’s overall metabolism, the skin’s metabolic processes also lag with age and exposure to environmental aggressors.

The skin’s metabolism controls the production and breakdown of collagen and elastin. It also affects how well your skin renews its cells, repairs its damage, and even how it responds to topical products you use.

Giving Nature a Helping Hand

You can speed up the process of skin renewal (at any age) with topical products that contains retinoids, which promote new cell growth, or alpha hydroxy acids, including glycolic acid. These loosen up the intercellular glue-like substance that holds skin cells together on the surface, allowing them to slough off sooner. You can find these ingredients in cleansers, serums, lotions, or creams.

An alternative is the judicious use of skin exfoliants. Harsh or excessive exfoliation can cause small tears, which allow water to escape and potential irritants to pass into your skin, making it feel dry and sensitive.

Heads up: the molecules in most cosmetic compounds are too large to be absorbed, so be suspicious of claims about absorption.

Even molecules in some anti-aging skin-care products are too large to pass through skin’s outermost layer.

When the skin’s barrier gets damaged (from UV exposure, harsh cleansers, over-exfoliating, etc.), microscopic tears form.

Sunscreen keeps skin’s surface safe from sunburns and its cells protected from UV damage. My dermatologist recommends a lotion with SPF 35 on the face, every day, year-round, and something stronger for extended exposure, for example when sailing.

The road to healthy, radiant skin is paved with blood vessels. Skin contains 11 miles of blood vessels. Each square inch contains 20 blood vessels.

Gilding the Lily

Nanaia Mahuta, former Foreign Minister of New Zealand

One’s skin is an expansive canvas. The average adult has 2,800 square inches—about 22 square feet—of skin, and people have painted on it for more than 6,000 years, when ancient Egyptians (both women and men) used makeup to enhance their appearance and display their wealth. Now the beauty industry is a key driver of the U.S. economy, generating approximately $94.36 billion in cosmetics and beauty sales in 2023. Enough said about that.

Over time and around the world, for the sake of appearances, skin has been tattooed, pierced, and scarred, kept pale or tanned vigorously. Standards of beauty vary greatly from culture to culture.

But beyond its ornamental value, skin is incredibly useful!

The Real Skinny on Skin

Next time you step on the scale, remember that skin is the heaviest of all your organs. The average adult body can have 20 pounds of skin alone, making up 10-15% of body weight. That 10-15% is composed of water, oils, fats, nutrients, hair follicles, blood and lymph vessels, collagen, and living and dead cells.

Cross-section of human skin

Within one square inch of skin, there are 19 million skin cells of various types, each with its own specific job.

That square inch includes about 60,000 melanocytes, cells that produce melanin pigment, which gives skin its color. All humans have melanocytes (with the exception of some people born with albinism).

The majority of skin cells are keratinocytes. These include basal and squamous cells, the two types from which the most common skin cancers can arise.

Skin Hard at Work

According to the Cleveland Clinic, a square inch of skin also contains 300 sweat glands—for better or worse!

Skin helps regulate body temperature by sweating, but also by dilating blood vessels. Blood vessels bring oxygen and nutrients to your cells, remove waste, and help regulate your skin’s temperature. When the skin gets warm, your blood vessels dilate, allowing heat to escape to the outside air. When it’s cold outside, they constrict, keeping the heat in your skin.

Skin is a sensory organ, each square inch containing 1,000 nerve endings, allowing us to feel touch, temperature, pain, pressure, and vibration.

Skin is also highly reactive to emotional stress. Research has shown that skin inflammations such as eczema, psoriasis, and acne often flare during stressful times.

Stressful situations can also trigger sweating, itching and hives.

Experts have found the connection between stress and skin is bidirectional: stress can exacerbate skin issues, but skin can also send signals to the brain, triggering a stress response.

Skin is the protective barrier against external threats, such as UV rays, bacteria, and infections.

Under the Surface

Skin has a microbiome, with trillions of microorganisms such as bacteria, viruses and fungi that help in fighting infection, controlling inflammation and helping your immune system recognize possible threats. Researchers are working on treatments to manipulate the bacteria on the skin’s surface to treat inflammatory skin conditions such as atopic dermatitis, acne, and diseases including skin cancer.

Researchers have discovered that skin has a circadian rhythm. During daylight hours, skin is in protective mode, trying to shield cells from UV light, free radicals, pollution, etc. Research shows that repair peaks at night. Both temperature and permeability increase at night, making skin more receptive to topical ingredients. Also at night, more water escapes from the skin. So, before bed, it’s prime time to apply moisturizer.

The thickest skin grows on the soles of the feet and palms of the hands, while the thinnest grows on the eyelids.

When exposed to sunlight, skin produces vitamin D, which is essential for bone health.

Your skin can flex. There are tiny muscles within the skin called the arrector pili muscles, located inside your hair follicles. It’s these muscles that make your body hairs stand straight up when you get goosebumps.

Medical Uses of Skin

My guess is that when people sign their organ donor cards, very few are thinking “skin.” Heart, liver, kidney, lungs…sure. In fact, skin is the largest organ in (on?) the human body. And skin donations are sorely needed.

Each year, approximately 58,000 tissue donors provide lifesaving and healing tissue for transplant. A single tissue donor can heal up to 75 lives. That’s why surgeons can perform approximately 2.5 million tissue transplants each year in the U.S.

Three-quarters of skin transplants are used in life-saving circumstances, such as severe burns. Doctors also use skin grafts in various surgeries, including open heart and post-mastectomy breast reconstruction. Experts estimate that another 500,000 patients would have shortened wound-healing time if enough skin were available.

Should you need a skin transplant, the preferred source would be you! Doctors usually take skin from the patient’s back, buttocks, and the backs of the thighs. These are highly effective, successful over 90% of the time. Skin donations from another person (living or dead) or from an animal, such as a pig or a fish, are stop-gap measures, to minimize infection and maximize fluid retention till you are able to repair yourself. “Foreign” skin is nearly always rejected long term.

Bottom Line: The title says it all. Skin is useful as well as ornamental

PSA: CLOTHING CAN BE HAZARDOUS TO YOUR HEALTH!

And you don’t have to take my word for it. Whole books have been written on the subject!

But in case you don’t want to read three books—or even one—here are some highlights.

Undergarments

Bras

Underwire bras can kill you by acting as conductor if you are struck by lightning. Not likely, but possible. On the other hand, underwires digging into your body is common, and can be painful, cause skin irritation, even bruising.

Regularly wearing a push-up or padded bras, on the other hand, constantly pull the breast against gravity and put pressure on the delicate tissues of the lower breast. If these tissues separate from the main body tissues, it causes sagging.

Ill-fitting bras, especially for the well-endowed, can lead to pain in the neck, shoulders, back, and chest. Research by Rouillon on women 18-35 showed that women who did not wear bras developed more muscle tissue to provide natural support. Hmm… One study in 1991 suggested that premenopausal women who went bra-less had half the risk of breast cancer.

Thongs/ G-Strings

To avoid another embarrassment, remember that UNDERwear is meant to be worn UNDER.

Thong panties increases the likelihood of getting urinary tract infections. Thongs that have a tendency to slide forward transfer bacteria to the genitals. And these panties have been linked to the development of hemorrhoids. (To avoid embarrassing confusion, remember that “thongs” in Australia are flip-flop shoes. Scanty panties are called “G-strings.”)

Boxers or Briefs?

In 2018, NPR reported on research that showed that men who wear tight-fitting briefs had sperm counts 17% lower than boxer wearers. This is probably an effect of heat: men’s testicles hanging below the torso stay cooler by 4-6 degrees. By extension, should men who want to father children wear no pants at all? Kilts or kimonos?

Corsets

Available in Maternity and Children’s Sizes!

“Corset” probably brings to mind the lace-up garment of the 1890s, in ads that claimed they could reduce a 27-inch waist to 18 inches. The resulting displacement of internal organs caused constipation and weakened a woman’s back muscles, sometimes to the point of being unable to remain upright without the support of the corset.

This style of corsets today are mostly relegated to dress-up, sex play, or limited to occasional use.

A modern version would be shape wear. When worn daily, it puts unwanted and unnecessary pressure on internal organs, resulting in acid reflux because of pressure on the stomach, and possible nerve damage by constricting your sides and thighs.

As an interesting historical side note, both lace-up and compression corsets have been marketed to men as well as women.

Petticoats and Slips

Even back then, people thought they were silly.

In addition to trying to shrink their waists, American and European women wore big cage-like devices under their skirts to make their waists look even smaller. The hoop skirt (aka, a cage crinoline) was made of a fabric petticoat with channels to hold thin strips of wood, whalebone, or other stiffenings, and a tie to secure it at the waist.

The bigger the hoop, the more it inhibited women’s mobility. In addition, they were very flammable, making them particularly dangerous around candles, lanterns, fireplaces, and all those other commonly burning things found in the average 19th Century household. In England in the 1860s, as many as 300 women a year died this way.

Bathing Suits

By exposing large amounts of skin to sunlight, a bathing suit can contribute to some types of skin cancers.

For women, the lack of support in bathing suit tops can contribute to the same problems as ill-fitting bras.

Sitting around in a wet bathing suit for hours on end may lead to a yeast infection or UTI, plus anything associated with bacteria in the water.

Advice: change out of wet suits ASAP and use plenty of sunscreen. Swimsuits with long sleeves or pants provide better sun protection but increase the risk of fabric filled with bacteria.

Yoga Pants

For all that they are comfortable and versatile, yoga pants are susceptible to all the problems listed for compression clothing. You might get chaffing from running, inflamed hair follicles (from bacteria) or ingrown hairs (from compression), as well as fungal infections.

Shoes

High Shoes

High heels misalign one’s posture, often leading to long-term damage to knees, spine, hips, and leg muscles. They also increase the risk of tripping, falling, and rolling one’s ankles, sometimes with fatal results. Wearing designer shoes (e.g., Jimmy Choo, Manolo Blahnik, or Christian Lououtin) that cost a fortune still inhibit a woman’s mobility.

Chopines

In 16th century Italy, aristocratic women wore tall platforms called chopines, made of wood, covered in leather, and decorated. The women were essentially walking on short, fat, stilts and unable to move freely. But then, there were few occasions for them to go out, unless it was to display the wealth of the family.

Tengu Geta
British wooden pattens

Similar footwear has been worn for practical or ornamental purposes in many areas. Variations of Japanese geta kept fancy aristocrats and peasant farmers out of mud and snow. Sudanese Nuba wooden sandals, Dutch klompen, Korean namakshin, Cantabrian Spanish albarcas, and British pattens were all variations of risers worn over or clipped to the shoe.

Platform shoes are still with us.

Low Shoes

Flip-flops have been linked to foot, ankle, and knee pain. In addition, the exposed foot is vulnerable to falling objects, getting stepped on or rolled over, an well as tripping  or hitting one’s toes into whatever is around.

Crocs, rubber slip-on shoes, are very popular at the moment but with their own dangers. According to the Consumer Product Safety Commission, nearly 200 wearers (mostly kids) have been injured when their Crocs were snagged between the moving treads of an escalator.

Flat shoes that don’t offer proper support can cause abnormalities in how one walks and runs. 

Small Shoes

Marathon Feet

Shoes that are too small in any way are likely to cause discomfort, even if only worn briefly. Wearing shoes that are too small for extended periods of time can cause serious damage to feet. Marathon runners are advised to buy shoes one to one-and-a-half sizes larger than normal to account for swelling caused by hours of pounding the pavement. Not doing so is likely to cause ingrown toenails, lost toenails, cysts on top of the foot, and nerve damage in the toes and arches.

Pointy-toe shoes harm feet by squeezing and molding the foot into an unnatural shape. They distort individual toes, and swelling between toes three and four can pinch a nerve most painfully. 

Pointe shoes
Kabuki dancer wearing tabi

Dancers frequently suffer foot problems caused by shoes. Some dancers deliberately wear shoes slightly too small to allow for better grip with the floor or so the material conforms better to the shape of the foot. Tabi (somewhere between shoes and socks) worn by traditional Japanese dancers and ghillies (soft shoes) worn by Irish dancers are often worn a half size too small. Ballet pointe shoes, no matter how well fitted, force the foot into a cramped position while dancers balance their entire weight on their toes.

Bleeding through your socks is always a good sign

The Chinese practice of foot-binding is the most extreme example of shoes mangling women’s feet. Lotus feet were highly valued. For one thing it denoted wealth: the woman didn’t have to work in the fields and/or being carried everywhere implied she would always be rich enough for such service. Walking at all involved a sway of the hips that was thought to be sexy.

No toddlers were harmed in the making of this image. This is a display from the Foot-Binding Museum in Wuzhen.

Foot binding began in infancy or toddlerhood. It was painful at best, and if the feet became infected, could cause septic shock. The last factory producing lotus shoes didn’t close until 1999.

Accessories

Jewelry

Big, heavy earrings may lead to inadvertently stretching or tearing one’s earlobes. They can get hooked onto objects or clothing, and even tear the earlobe.

Nickel allergy rash

Chunky, heavy necklaces and chains put pressure on your neck, back, and chest.

Oversized bracelets can cause wrist, arm, hand, and finger pain.
Avoid nickel, found in many pieces of clothing and accessories: it is the cause of one of the most common allergic reactions. Stick with stainless steel, silver, gold, or platinum, depending on your taste and budget.

Hats

Not the proper way to wear a helmet

Wearing a hat per se probably doesn’t cause hair loss, but any tight headgear could break hair follicles, creating bald patches known as friction alopecia. Wearing a hat while sweating can irritate your scalp.

Nothing says high fashion like a boat on your head.

In 1600s France, aristocratic women wore a “pouf,” something between a hat and a hairstyle. Elaborate piles of flowers, feather, ribbons, gauze, or whatever. At least one woman died when her enormously tall pouf hit a candle in a chandelier and caught fire.

Not exactly a hat, but a headpiece nonetheless, in the 1800s men shaved their heads and wore perukes. The lice lived in the wig rather than on the body, and the wig could be sent to the wigmaker to be boiled and deloused.

Neckware

Isadora Duncan, shown here before her scarf got caught in the wheel of her car. The after-photos aren’t quite so graceful.

Wearing scares may lead to strangulation, either intentional or accidental. (Think Isadora Duncan.) Thirty-five people a year are choked to death by their own scarves.

Edwardian dandies

Around the turn of the 20th century, men wore stiffly starched collars that were nicknamed “father killers.” They were so high and stiffly starched that if a man passed out wearing one, it would cut of his air supply.

Neckties are to men what scarves are to women, only less so: ten deaths per year are attributable to neckties.

Bags

On the other hand, a heavy purse can be very useful for beating up neo-Nazis, as photographer Hans Runesson showed in 1985. Beware the wrath of little old Polish grandmothers with very heavy handbags!

Heavy shoulder bags, handbags, and purses are typically carried on the same shoulder or arm, causing neck, shoulder, and back pain as well as throwing the body out of balance, forcing the other side to compensate, leading to all-over discomfort. 

Heavy backpacks without a waist strap and book bags can also cause neck, shoulder, and back strain, as well as long-term damage to one’s posture. Advice: lighten the load!

General Hazards in Clothing

Skin-tight clothing —everything from skinny jeans to shape wear and compression clothing—has been linked to all sorts of health problems: heartburn/acid reflux, testicular damage, and compartment syndrome (in which pressure builds up in constricted muscles, potentially life-threatening), and nerve damage. Such clothes can cause tingling in and numbness in feet and legs.

Any clothing that is excessively large presents a danger. A train on a skirt can be caught under bystanders’ feet, wrapped around wheels, or snagged by anything on the ground. Trailing sleeves have a tendency to knock things over or catch any open flames. Extra padding anywhere can put uneven weight on the body or cause the wearer to bump into things. Trouser legs or skirts that are too long are a tripping hazard. Tails always seem to have a tendency to be caught in doors.

Fabrics (including shoes) that don’t breathe often cause general discomfort, as well as dermatitis and fungal overgrowth (e.g., athlete’s foot). Stiff fabrics or scratchy ornamentation can cause chafing and abrasions.

Chemicals in Clothing

Skin is the largest organ of the body, and it’s capable of absorbing substances—not only from skincare products and makeup, but also from clothing. Chemicals absorbed through the skin go into the blood stream, which has access to all the internal organs. 

This isn’t the woman in the story. This is Jenny Buckleff, a bride who made quite an entrance at her wedding. (Don’t worry: everyone survived for the reception.)

Warning: the following story is disgusting on many levels. A woman bought a black dress at an upscale shop in Fredericksburg, but returned it a few days later. Another woman bought the dress, and developed such serious health problems that she nearly died. It turns out that the first woman’s mother had died and the black dress was put on her for her viewing. It was thoroughly contaminated with formaldehyde.  Formaldehyde and p-Phenylenediamide (in black clothing and leather dies) are in the products of 14 big-brand clothing manufacturers.

Daldykan River in Siberia after an apparent chemical leak from a textile factory

Formaldehyde—used to prevent mildew growth and inhibit wrinkling—is particularly harmful, and the U.S. does not restrict its use. (Sri Lanka and China two of the worst offenders, and major sources of inexpensive clothing.) Formaldehyde has been linked to an increase in lung cancer, difficulty breathing, and itchy eyes/nose/throat.

Ouxia Clothing Co recalled school uniforms made with carcinogens.

Side effects run from mild dermatitis to disruption of the endocrine system to cancer.  However, different chemicals can affect different organs.

Green dye, made with lead and mixed with arsenic

The U.S. doesn’t require disclosure of any of the chemicals used during production even though, according to Emma Loewe of MindBodyGreen, (How Worried Should You Be About Chemicals in Your Clothes), “…by some estimates there are upward of 250 ‘restricted substances’ used in textile manufacturing that pose potential health concerns.’”

Avoid Being Poisoned by Your Clothes

Be especially careful of irritating or poisonous chemicals in children’s clothing.
  • Because synthetics carry a heavier load of harmful chemicals, necessary to produce them, choose organic, natural fibers such as cotton, linen, jute, silk, and hemp.
  • Also avoid clothing labeled flame retardant or as wrinkle, stain, odor, or water resistant because these effects are achieved through chemical additives.
  • If you need synthetics, choose brands that use “rPet” or recycled polyester (e.g., Adidas and Athleta do this).
  • Choose clothes colored with natural dyes. If you don’t know, go for lighter colors, which contain less dye.
  • Wash before wearing to remove any surface chemicals picked up during packaging and shipping.
  • If you notice any kind of reaction to your clothing, discontinue wearing and consult a medical professional as warranted.
  • And last but not least: don’t wear anything that makes you feel self-conscious or nervous just because it is “in.”

Writers Note: Surely at least some of your characters make hazardous clothing choices!

  • A cunning murderer who makes it look like an accidental suffocation or poisoning
  • An advocate on behalf of someone who has suffered long-term effects of harmful dyes or chemicals
  • A character knowingly wearing harmful clothing in an effort to look fashionable
  • A character who refuses to wear harmful clothing and is shunned
  • A lower-class or impoverished character without the money to wear organically made or custom fitted clothing