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How The Skin Works For skin therapists, the skin is the most important organ in the body. The study of the skin is essential in making a correct diagnosis, thus enabling the appropriate treatment to be given. Next to the brain, the skin is the most complex organ of the body. The skin has 6 functions in the body: 1.Sensation Because the skin contains so many tactile nerve endings, the brain can be made aware of the stimuli of pain, heat, and cold in any part of the body. 2.Heat Regulation Controls our body temperature so that it maintains our internal heat regardless of environmental climate. It does this through the excretion of sweat from the sudoriferous glands, and the dilation of the blood vessels in the dermis. 3.Absorption The skin is able to absorb some oil or fat-based substances on a topical level, but deeper penetration is confined to either medication or application of a water-based substance by means of galvanic current. Penetration of cosmetic preparations is restricted to the epidermal layers only. 4.Protection Through the fat cells in the subcutaneous tissue, the skin protects the body against blows and falls. The Stratum Corneum acts as a barrier against bacterial invasion. The Stratum Germinativum produces melanin pigment as a natural protection from ultraviolet light. 5.Excretion The eccrine and apocrine glands excrete perspiration and sweat for temperature regulation. 6.Secretion Sebum is secreted by the sebaceous glands and is a complex mixture of lipids and fatty acids. Adult sebum is fungicidal, germicidal and inhibits the growth of skin surface bacteria. Sebum plays an important part in maintaining the surface of the skin intact. 1. The Epidermis consists of keratinized surface layers. 2. The Dermis is made up primarily of collagen (80%) & elastin (3%) (connective tissue) with sebaceous glands, apocrine glands, eccrine glands and hair follicles; ground substance, nerves, blood supply -living layer because anything that penetrates the dermis is absorbed into the blood and lymph supply. 3. The Hypodermis or Subcutaneous Tissue is made up of loose connective tissue mostly adipose (fat) & blood vessels. The Epidermis: Stratum Basal or Germinativum: Produces keratinocyte and melanocyte cells. Keratinocytes transport cholesterol to the stratum corneum to form a part of the Natural Moisturizing Factor. 1 in 10 cells is a melanocyte. Skin renews at the rate of 1 million cells per minute in youth. This is the layer involved in basal cell carcinoma. Stratum Spinosum: These are cells with 'tonofibrils' extending from the membrane, hence the layer is referred to as the 'filamentosum.‟ This is the first epidermal layer involved in allergic response, blistering and squamous cell carcinoma. Stratum Granulosum: Cells contain granules of 'keratohyalin,‟ which hardens to form keratin protein. Nuclei is broken down by lamellar bodies within the cell, which then breaks down to form lipids. Lipids pass through the membrane along with the lamellar bodies, to form the Natural Moisturizing Factor. Stratum Lucidum: Translucent and flat cells which are present only in the palms and soles. Cells are filled with densely packed filaments called 'eleidin' (the horny pads). Stratum Corneum: Cells are almost devoid of water (6%-9%). Made up of hard 'corneocytes.‟ Lamellar bodies' function to regulate the Natural Moisturizing Factor and cell thickness, thus regulating absorption in the epidermis. Stratum Disjunctum: The outer few 'shell' layers of dead epidermal cells. This is the layer we exfoliate. The journey from the Stratum Germinativum to the Stratum Corneum during puberty takes between 12-19 days, mid-life 28-35 days, and up to 90 days at maturity. Acidic Environment: The pH of the environment is controlled in part by the acid mantle which is now referred to as the hydrolipid film. The hydrolipid film has a pH of 4.0-6.0 (in healthy people)and supports the formation and maturation of epidermal lipids; it is often said that it helps maintain the barrier function of the skin. It also provides indirect protection against invasion by microorganisms and provides direct protection against alkaline substances with its alkali neutralizing capacity. If the hydrolipid film becomes disrupted, damaged, or loses its acidity, the skin is more prone to damage and infection. In essence, the pH gradient in the Stratum Corneum has a multitude of benefits that help maintain the epidermis in optimal condition. The Dermis: The dermal layer of the skin has been called the "action" layer and is regarded as the "true" skin. The dermis is made up of connective tissue proteins namely collagen and elastin, which lend support to the epidermis and give the skin both its moisture retaining properties and its elastic quality. It is in this layer that the skin’s major aging processes take place. Being a condensed connective tissue, the dermis is unstable and undergoes changes, breakdown and renewal. The dermis also contains blood vessels, lymphatics, nerves, tactile corpuscles, sebaceous glands, sudoriferous glands, and hair follicles. The dermis has a superficial papillary layer, and a deep reticular layer. For growth, the skin requires amino acids, vitamins, trace elements, and essential fatty acids. Mitosis (cell renewal) in the Stratum Germinativum gets the necessary energy from the nutrition supplied by the blood supply in the dermis. Action in the dermis will ultimately affect the appearance of the epidermis either obviously, as in a blush due to capillary dilation, or progressively, such as over or under activity of the primary glands. The sudoriferous or sweat glands, secrete a weak salt solution that varies in amount according to our activity and body temperature. They consist of a coiled base and a tube-like duct which opens on the surface of the skin, forming a pore. There are two types of sudoriferous glands; apocrine glands, connected with hair follicles and stimulated by emotions, and eccrine glands, situated all over the body and stimulated by heat. The sebaceous glands are sac-like glands attached to hair follicles. These glands are 2-3 times more numerous around vellus hairs (facial area, upper chest and back). The sebaceous glands manufacture sebum and it travels upward through the hair follicles to the surface of the skin opening in an ostea (not a pore). Sebum, which is a complex secretion with a high percentage of fatty acids and lipids, then mixes with the perspiration from the eccrine glands and forms the skin‟s "acid mantle.” It is this layer of oil and water, together with the N.M.F., that keeps the epidermis smooth and prevents bacterial invasion. The Subcutaneous Tissue: The subcutaneous tissue is a deeper layer of connective tissue and separates the dermis from the underlying muscle. An ample supply of blood and lymph vessels, nerve endings, and fat cells are found here. The fat cells act as a storage depot and helps reduce heat loss, and also as a shock absorber to protect the bones and internal organs. The adipose fat cells contain carotene, a yellowish pigment, which lends a "buttery" look to the human fat cell. It is in the adipose fatty tissue of the subcutaneous layer that we also find the toxic stubborn cellulite tissue.