Read an Excerpt
Skin 101: The Basics
These days, the subject of skin is definitely in. If you doubt it, just surf the channels on your cable TV or scan the pages of nearly any popular magazine. Our guess is that you'll catch everything from glossy cosmetics ads and dire skin cancer warnings to intricately tattooed torsos and piercings in places no woman has dared to pierce before. Here in America, especially, it seems obvious that we're showing more skin, decorating it more elaborately, and-in some extreme cases-stretching it to the absolute limit for the purposes of beauty and self-expression.
Now, on a certain level, none of this should come as too huge a shock to anyone. After all, people throughout history and across cultures have always preoccupied themselves with the appearance of their skin. We understand almost intuitively that what others see first is neither our warm heart nor our razor-sharp mind but our skin. Skin is a badge we wear day in and day out: It delivers telltale messages about our overall health, acts as a pipeline for all of our senses, protects us against the elements, and influences profoundly not only how others perceive us but also how we perceive ourselves. To that extent, our timeless fascination with skin (and skin care!) is both natural and healthy.
This book tells you how to achieve great-looking skin. Despite the old saying that "beauty is only skin deep," we assume that most people would like to look great-or, at a minimum, better than they did the day before. So we've combined the medical expertise and technical knowledge of a leading dermatologist (Mitch) with the aesthetic sense and beauty savvy of a professional model and actress(Dianne) to put you on the path to skin nirvana.
Some of the ideas we'll share with you have been around for ages. Others are the product of the most recent scientific research. Some of the topics we'll cover are chiefly medical in nature. Others deal with strictly cosmetic issues. But no matter what the content of a specific section or chapter, our objective throughout is to present the kind of balanced, in-depth advice that will help you enjoy beautiful skin now, and for years to come. Step one in that process is to learn more about how our skin is constructed and how it functions in the human body.
An Overview of the Skin
Among the most commonly asked "trick" questions used on television game shows and in biology pop quizzes is this little gem: What is the largest organ of the human body? The answer, as you might have guessed, is the skin. The question often stumps people because when we think of bodily organs we tend to picture the dramatic action of, say, the heart pumping blood or the lungs processing oxygen. The skin, in comparison, appears to be nothing more than a protective wrapper for all the important work being done by the "real" organs inside.
Of course, it's true that protection of internal organs is a key function of the skin. But this passive view of how it works couldn't be further removed from reality. Just like other major bodily organs, our skin operates nonstop in an active, dynamic fashion. It helps keep us properly hydrated by regulating retention of salt and water through the sweat glands. It assists in flushing impurities from our system through the action of the blood vessels, oil glands, sweat glands, and pores. It constantly renews itself by sloughing off dead cells and manufacturing new ones. It filters the sun's UV light rays so we don't get cooked like a burger on the grill. It reacts and adjusts to changes in temperature and humidity, acting as a thermostat for the body to cool us down when it's hot and warm us up when it's not. It . . . Well, we could go on and on about all the crucial tasks the skin performs-and we will discuss some of them in more detail later-but we think you probably have the big picture for now: The skin is one busy organ, despite what outward appearances seem to suggest!
The Layers of the Skin
The skin has three principal layers,each with a name more imposing than the last: subcutaneous, dermis, epidermis. (Couldn't they have gone with, oh, bottom, middle, and top? Naw, too easy; everyone would remember those!) But tongue-twisting terms notwithstanding, let's examine each layer, one by one, to gain a fuller understanding of how the entire apparatus goes about its business. Once we've done that, we'll have a sound basis for making smarter, better informed skin-care decisions across the board.
Since so many of the skin's most vital chores happen below the surface, it's instructive to take a bottoms-up look at its construction. The analogy we like to make, though it's admittedly imperfect, is to compare the skin to a carpet.
At the bottom, or base, of the carpet lies the padding, which provides cushioning and insulation to the layers immediately above and below. In the skin, we refer to this padding as the subcutaneous layer, which is simply a specialized way of saying that it lies under the dermis (or middle layer, which we will deal with shortly). The subcutaneous layer is composed primarily of fat, and its main mission in life is to protect our tender internal organs by dampening the effect of both external shocks-someone, heaven forbid, slaps you, or you fall on your butt Rollerblading-and exposure to the cold. Ask any frostbite victim, and our bet is that they'll tell you a tad too much subcutaneous fat is preferable to not enough, which should be food for thought the next time you want to diet down to a smaller dress size!
The middle and thickest layer of the skin, the dermis, roughly corresponds to the backing on a carpet. Like carpet backing-and like other types of connective tissue in the body-the dermis is composed of very durable, resilient, fibrous material, and its principal function is to provide shape and support to the outermost layer everyone else sees, much in the manner that the bones provide a framework for our muscles. Significantly, this layer also houses our sweat and oil glands, the skin's blood vessels, hair roots, and more nerve endings than you could count in a lifetime (which is why you get "gooseflesh" when you're chilly or when the right person smiles at you). Without the dermis, the skin could not receive vital nutrients and oxygen or dispose of poisonous waste products.
Because of its structural and vascular (or blood-supplying) functions, the overall vitality of the dermis greatly impacts the outward appearance of our skin's surface. Two of its more noteworthy components in this regard, which you may have read or heard about before, are collagen and elastin. Both are fibrous proteins, and each plays an essential role in skin health. Collagen fibers keep the skin firm, while elastin fibers, as the name implies, keep skin tight by giving it the capacity to spring back into shape when we "pinch an inch." If your skin completely lacked these crucial fibers, do you know what would happen if someone poked a finger into your stomach? The indent made by their fingertip would stay there until you physically pulled the skin back out. Bizarre, but true!
In real life, something not too awfully different from this example occurs. As we age, and more important, as our skin is exposed to sunlight, our collagen and elastin fibers loosen and ultimately are destroyed. The result: wrinkles. Look at any of the older women around you-your mother, your grandmothers, aunts, teachers, whomever-and you will see that they have wrinkles to one degree or another. And, if you check with them, we have few doubts that the ones with the most wrinkles are those who got the most sun and spent the most time outdoors when they were your age. So while you may have no wrinkles today, you'll need to make the right lifestyle choices and take appropriate protective measures now to prevent them from developing in the future.
Throughout this book, we intend to show you ways to preserve your smooth, tight, wrinkle-free skin-especially in the chapter on tanning, which is must reading for all young women who enjoy water sports, laying out, or just being in the great outdoors. For the present, however, let's move on to the final and outermost layer of the skin.
At last, we've reached the carpet's surface, the part we want to be as smooth, unblemished, and aesthetically appealing as possible-the epidermis. Special skin cells called keratinocytes make up most of this layer, which varies greatly in thickness depending on the particular area of the body in question. In the eyelids, for instance, the epidermis is only about as thick as a sheet of ordinary writing paper. But in the soles of our feet it widens to the approximate thickness of the leather used in a wallet or a purse.
Skin thickness is an important factor to consider when we do scads of everyday things like washing, moisturizing, using makeup, and applying sunscreen. The skin around our eyes, for example, is extremely thin and therefore very sensitive to chemicals. So common sense dictates that we use only the gentlest soaps and purest moisturizers there. Conversely, the layer of epidermis covering our hands, feet, and back is fairly thick and tough. Here it's OK-and even preferable-to take advantage of the greater cleansing power and hydrating action offered, respectively, by stronger soaps and thicker moisturizers. How do we know when we've applied the wrong product to a specific area of the skin? Simple: Our epidermis tells us so by developing a red, scaly rash. When you see this kind of rash, check your toiletries and try to identify the offending item or items. Then substitute with something gentler.
Besides the keratinocytes noted earlier, the epidermis also contains melanocytes, more commonly known as pigment cells. These generate melanin, a brownish-black pigment contained in the tissue of many animals, including us humans. When melanocytes are stimulated by sunlight or by our body's own hormones, they swing into action, producing melanin and pumping it up to cells near the skin's surface through tentacle-like appendages called dendrites. Generally speaking, the more melanocytes we possess and the more densely melanin is packed within our pigment cells, the darker our skin, hair, and eye color will tend to be. Also, certain types of melanocytes are notably more active than others, which likewise contributes to a relatively darker complexion in people who have them. Since melanin partially filters and thereby lessens the damage caused by UV light, a person's capacity to produce it will, to a great degree, determine his or her ability to safely withstand the sun's harmful rays. This explains why darker skinned people are typically less susceptible, though certainly not immune, to sunburn than lighter skinned folks are. However, black skin is much more prone to turn dark after injuries such as cuts, sunburn, acne, or rashes.
Individual variation in the number, type, and capacity of our melanocytes, then, accounts for the fact that while human skin comes in a few basic colors (pale, tan, yellow, brown, etc.), it exhibits an astounding range of hues and shades within each group-so many, in fact, that even the most gifted painter would have a hard time reproducing a fraction of them precisely. Our attitude is that any color is great; the key is for the color to be uniform. Blotchy color indicates that the pigment cells we've been talking about are either irritated or damaged, a subject we'll cover at greater length when we discuss sun damage and other skin problems.
Finally, it's worth noting that some types of spots, such as freckles, birthmarks, and most moles, are perfectly natural in healthy skin. If you wish to cover them up or make them appear more even, a few well-placed dabs of concealer will usually do the trick. But if not, that's fine too; after all, Cindy Crawford seems to cope quite well with her mole, and we've all known a cute guy or two with freckles. Let your comfort level be your guide.