Physiology of the skin

Introduction

The skin is the main interface between the individual and the environment. It therefore has
essential physiological functions which allow the individual to live safely, even under
changing external conditions which might pose potential threats. The most important
physiological function of the skin is protection against various forms of noxious stimuli
including physical and chemical trauma, micro-organisms and radiation. The skin and its
appendages such as hair are also vital for thermoregulation. Several modalities of sensation
are mediated via the skin allowing the individual to recognize the context of their relationship
to the environment. The skin is a significant water storage organ, particularly in
the hypodermis layer. Although it mainly acts as a barrier, the skin does have some ability to
absorb various substances, particularly lipophilic compounds. Emotions such as fright, anger
or joy can be expressed via the skin, due to changes in blood supply, the position of hairs, or
movements of those muscles which insert directly into the skin. Synthesis of vitamin
D occurs in sun-exposed skin and is the major site of production in normal health. respond to
traumatic or surgical injury.
The skin is one of the largest and most important organs in the body and comprises
approximately 16% of the human body weight. The skin is continuous with the membranes
lining the body orifices and in certain areas contains accessory structures such as glands, hair
and nails. The skin is the interface between the body and the environment. It has a number of
physiological functions that are essential to maintaining homeostasis, protection and social
interaction. Its main roles include:
 Protection
 Thermoregulation
 Sensation
 Water storage
 Absorption
 Expression
 Synthesis of vitamin D.

The mobility and elasticity of the skin are crucial for normal movement of joints and the
strength of the skin is essential in places such as the hand and feet that are exposed to regular
minor trauma. In addition to this, the skin overlying each area of the body has specific
adaptions for particular purposes; the skin of the fingertip is thick, sensitive and moist to
make it ideal for gripping, while the thin and flexible skin of the eyelid is very mobile and
also provides good protection for the globe. Infant skin, particularly in premature neonates, is
relatively thin, more prone to water loss and with weaker barrier functions against infections
and other noxious stimuli. As the infant matures, these functions also develop and in healthy
individuals skin physiology provides optimum protection from environmental insults.

Ageing has a marked effect on the human skin. As time progresses, there is less cell division
in the germinative layer of the epidermis leading to a gradual thinning of the skin. This
usually starts happening after the third decade of life. In addition, there is a decrease in the
collagen content of the dermis of approximately 1% per annum. This is due to a reduction in
collagen synthesis leading to reduced elasticity of the dermis which causes wrinkling and
sagging of the skin. This process is not dependent on UVR, since collagen loss with age also
occurs in non-exposed areas, but is increased by persistent exposure to high levels of UVR
from sunlight.

Protection

The skin protects the body by forming a waterproof layer which protects the deeper structures
and prevents dehydration from loss of water. This is due to the keratinized epithelium in the
epidermis. The skin also forms a barrier from:

 Physical trauma
 Chemical trauma
 Micro-organisms
 Radiation (for example UV light).

Thermoregulation

The human body is kept at a remarkably stable core temperature even in extremes of heat
through a negative feedback system involving the skin, skeletal muscles, sweat glands and
the hypothalamus. This ensures that the body temperature is maintained around 37°C and
provides an optimum environment for enzyme mediated components of metabolism. If the
core body temperature drops, the hypothalamus sends impulses to the skin that constrict
arterioles to minimize heat loss and stimulates skeletal

Sensation

The skin is the main interface between the body and the environment. As such, it has
numerous sensory receptors which allow the individual to perceive environmental stimuli
across a range of modalities. The high number of sensory nerve endings in the skin also
provide immediate sensory feedback from the environment to the sensory cerebral cortex.
This leads to reflex actions such as withdrawing from a hot object to prevent injury. Certain
areas of the body have an increased number of sensory

Water storage

The barrier function of the skin is essential for not only protection but also for maintaining
normal volumes of water and electrolytes in the human body. The skin contains 18–20% of
the body's total water content. The ability of the skin to retain water is also important in
enhancing the protective functions. When the skin loses water, it leads to cracks and
chapping, thus breaching the skin's contiguous line of defence and allowing noxious stimuli
to enter the skin

Absorption

Although the skin acts as a barrier between the organism and the environment, water and
some water-soluble compounds can also be absorbed through the skin. The skin, however,
has a greater capacity to absorb lipophilic rather than hydrophilic substances. This principle is
utilized in the application of transdermal patches or creams to achieve systemic
administration of various drugs. Absorption is increased in conditions of skin damage where
the barrier function is reduced by trauma or disease.

Expression
The skin, especially over the face, is an essential part of social interaction, attracting attention
for social and sexual purposes and is therefore essential to the survival of the species. Facial
expression is a dynamic tool used by humans to transmit information to others. These can be
either innate or learned expressions and can express a wide range of emotions, behaviours
and communications.

Synthesis of vitamin D

In addition to the synthesis of melanin, ultraviolet light also converts 7-dehydrocholesterol to

cholecalciferol (vitamin D3) in the skin. This process is essential to the production and
maintenance of bone by osteoblasts. In normal adults, considerably more cholecalciferol is
produced in the skin than derived from food. However, dietary sources are relatively more
important during pregnancy, in those confined indoors and in the elderly. With age, the
process of vitamin D