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Photo by Ravi Patel from Unsplash

Years may wrinkle the skin, but to give up interest wrinkles the soul. ~ Douglas MacArthur

People who know me have heard me say in several media interviews, “One cannot have bad health and good skin.” As a skin doctor, I have a personal, clinical and research interest in our largest organ.

A few years ago, I developed the concept of biodynamic skin tension lines (BEST lines) that not only help surgeons plan surgery with less scarring, but this research opened my eyes into how skin tension affected so many aspects of health, including mental health. For example, in studying scalp hair-whorl patterns, I found that abnormal patterns indicated suboptimal brain expansion in the womb and could be a predictor of schizophrenia. Therefore, if wrinkles predict ill health, does the reverse apply i.e., can bad skin health indicate underlying disease? It is as if, from a philosophical view, skin decided to reverse the equation on us.

From an applied physics point of view, skin is an elastic solid. If human skin is viewed such a physical membrane, wrinkles fundamentally occur because a keratinocyte-stiffened epidermis (top layer of skin) drapes a softer and thicker dermis (bottom layer of skin). Of course, anatomical sites like knees and elbows have wrinkles that are ‘tension’ wrinkles (two-dimensional, due to geometry and joint action) and in other areas like forehead, muscle action causes ‘compression’ wrinkles (one- dimensional due to muscle action such as frowning). My research into skin lines and wrinkles ended up with a commercial application: Notox, a non-toxin-based skincare range of wrinkle-reducing products.

Tybjærg-Hansen and others studied over 10,000 people in Denmark and found that skin creases in certain locations like ear lobes indicated the body’s biological age and was an indicator for heart disease. My studies also showed that under each new wrinkle we develop (within ±1 mm) lies a lymphatic vessel and its surrounding tube of adipose tissue. So the development of new skin lines many also mean changes beneath. We are only now beginning to understand what this means. This finding fitted in with my original theory of skin merely reflecting what happens underneath, within our body’s organs and metabolic systems. It also mirrored what I see in clinical practice. For example, shingles in older people may indicate health risks beyond what we see on skin. In fact, research shows that for 3–12 months following an attack of shingles that is seen on skin, people older than 50 have a higher risk for stroke or heart attacks.

We know the most common cause of sun damage, especially in New Zealand and Australia is UV damage from the sun. But now we know that sun damage decreases hippocampal neurogenesis i.e., new nerve cell production which in turn increases the risk of dementias such as Alzheimer’s disease.

As we age, our skin develops more senescent cells. This shortened lifespan of skin cells is a preventive mechanism to protect us from cell overgrowths that can end up as skin cancer. But as more of these types of skin cells are produced, they end up affecting adjacent cells metabolically by secreting factors known as the senescence-associated secretory phenotype (SASP). These have paracrine actions i.e., affect adjacent cells as opposed to endocrine actions that affect distant organs via the blood stream.

New research from a group in Portugal led by Cláudia Cavadas suggests that these senescent skin cells can induce or accelerate the age-related dysfunction of other nearby cells irrespective of their different origins. These cells induce changes that cause organ and immune systems to make the whole body age. Therefore, not only does bad health cause aging, but aging skin can cause problems in other organs also. This is an area of research interest for me, but from a practical point of view, it means taking care of one’s skin health is important. My research lab-based skincare company is aptly named the Healthy Skin Lab, and for those interested you can find cleansers, sunscreens, serums, and oils for all your skin’s needs.

As I finish writing this piece, I run my hands on my skin. What I feel is a time machine that has somehow transported ancient biological signals to our messy and vain human bodies that never seem satisfied.

THE END

Note: This blog is about science-communication, education, interesting science, and new medical research to do with (mostly) health and skin. It is not individual one-on-one medical advice. Please do not stop any medications without consulting your own doctor.