SKIN 101

I have some high school and college students who are among the many readers of this blog, and I am sure that the last thing they want to be reminded about right is class.  Therefore, I was a little reluctant to name this week’s entry “SKIN 101”.  However, while the title may harken unwelcome images of sitting in a classroom, I chose it because it is succinct and to the point.  It also tells you (hopefully) that the information I am giving you is useful, but digestible.  In short, the more you know about your skin, the better you will be able to take care of it.

Your skin is your body’s largest organ, and arguably the most important.  We actually cannot live without healthy skin, as it protects us from hostile environments and is the first line of defense against toxins and bacteria.  The skin keeps you hydrated, and plays a vital role in your immune system.

The skin heals its own wounds, controls loss of heat, cools the body when necessary, and produces vitamin D for your bones.  Glands within the skin produce oil that keeps the skin moist.  The outer layer of the skin, the epidermis, consists of millions of epithelial cells in many layers.  New epithelial cells are formed every day in the deeper layers of the epidermis, and then they grow upwards to the surface to replace the older cells.  However, not all those cells get removed.  As they accumulate, the skin gradually looks older over time.

Anti-aging and skin-resurfacing technologies, such as Fraxel, remove the top layer of damaged older epithelial cells that are not replaced naturally.  Because the deeper, newer and healthier epithelial cells look better, the resurfaced skin has a healthy fresh glow.  The epidermis is a living and growing layer which can regenerate and renew itself, but applying topical products and laser technology to it regularly can help prevent and correct aging changes.

The next layer of skin beneath the epidermis is called the dermis.  The dermis is the pink layer of the skin that carries the blood vessels and provides the structural support for the outer layers.  The support structure consists of collagen, elastin, and hyaluronic acid.  Collagen and elastin are produced by special cells within the dermis called fibroblasts.  These cells are stimulated by Fraxel and other deeply penetrating lasers to produce more collagen.  Fibroblasts slow down in their production of collagen with age and when damaged by smoking and ultraviolet radiation.

A damaged dermis can cause striking changes associated with aging, especially on the face.  The loss of the skin’s basic foundation layer results in the wrinkling and sagging commonly attributed to the aging process.  Stimulating the fibroblasts to produce more collagen and replacing the foundation with hyaluronic acid fillers (Restylane, Juvederm) can start the process of reversing the damage.  As I frequently say to patients, we can turn back the clock on your appearance, although we still cannot stop the clock of aging.

I hope this basic outline of the skin structure does not conjure up images of a classroom, but rather helps you better understand how the skin works and how the latest technology can help undo some of the damage caused by the sun and the aging process.  In the future, I will try to fill in some other details about the structure and mechanics of the skin.

But for now, class is dismissed!

About Dr. John Burke

John Burke M.D. has practiced medicine for over 25 years, and is the founding partner of MidMaine Internal Medicine. He established Maine Laser Skin Care in 2004 after devoting years to learning the latest in laser and dermatologic technology. Dr. Burke has treated patients from all over the United States. He is one of Maine's busiest practitioners in laser treatments, and in the use of Botox for upper facial lines and excessive sweating.
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