DERMATOLOGY

NUTRITION

By Kajal Gupta

Be Medic Academy
Module 2: Skin Anatomy and Physiology
The skin is the largest organ in the body,
covering its outer surface of the body. Skin
and its derivative hair, nails, sweat and oil

What do we know
glands all together makes up the
Integumentary system.

about our Skin?

The skin's structure comprises an intricate
network that serves as the body's initial
barrier against pathogens, ultraviolet (UV)
light, chemicals, and mechanical injury.

The skin has 3 layers—

the epidermis, dermis, and hypodermis, all
three layers have different anatomy and
structures.
A few points to know about the skin.

- Skin thickness varies by body region and is influenced by the thickness of

the epidermal and dermal layers.
- Hairless skin in the palms of the hands and soles of the feet is the thickest
due to the presence of the stratum lucidum, an extra layer in the epidermis.
Regions lacking this extra layer are considered thin skin. Of these regions,
the back has the thickest skin because it has a thick epidermis.
- The skin's barrier function makes it susceptible to various inflammatory and
infectious conditions.
- Understanding the skin's anatomy and function is crucial for managing
conditions across all medical fields.
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Functions of Skin
1. Regulate body temperature - When the skin is
exposed to a cold temperature, the blood vessels in
the dermis constrict. This allows the blood, which is
warm, to bypass the skin. And the skin then
becomes the temperature of the cold it is exposed
to. Body heat is conserved since the blood vessels
are not diverting heat to the skin anymore.

2. Protective barriers- It acts as a protective

barriers and acts as one of the first defence system
of the body such as water loss, invasion of germs
and bacteria, UV ray protein, physical injuries to
internal body and chemical damage
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Functions of Skin
3. Sensory organ- It is one the sensory organ and
has sensors which detects the touch, temperature
pain

4. Production of Vitamin D- When skin is exposed

to sunlight and UV rays fall on it and pre Vitamin D3
is produced in the epidermis layer of skin.
Previtamin D3 is then metabolized in the liver and
kidneys to produce the active form of vitamin D.
LAYERS AND STRUCTURE
OF SKIN
Skin is made up of Water, protein, fat, minerals.

A. EPIDERMIS
It is the outermost layer of the skin. It is made up
of a stratified squamous epithelium, primarily
comprising keratinocytes.
Keratinocytes which produce keratin protein and it
is the most common type of skin cells and act as a
building block of epidermis.

- As the epidermis is avascular (contains no blood

vessels), it is entirely dependent on the layer
below it i.e. dermis for nutrient transfer and waste
disposal through the basement membrane.
Keratinocytes - Keratinocytes are formed by division in the stratum basale. As they move up through the
two upper layers.
The outermost layer of skin is the Stratum corneum which has flattened dead skin cells (they have lost their
nucleus) called Corneocytes.
These cells fall off the skin by the process of Desquamation, this process takes about 28 days.
As corneocytes contain a water-retaining substance – a natural moisturising factor – these attract and hold
water. This process of holding and retaining water is pliable and elastic and reduces cracks and dryness.
The hydration of skin is maintained by the Stratum corneum. The hydration is affected by environmental
changes and hydration. And the medication can only penetrate inside the Stratum corneum layer of skin.
Melanocytes. Melanocytes are found in the
stratum basale. They produce the pigment
melanin, manufactured from an amino acid
Tyrosine, packaged into cellular vesicles called
melanosomes, and transported and delivered
into the cytoplasm of the keratinocytes. These
cells absorb harmful UV rays and protect skin
from harmful rays.

Skin colour is determined by the amount of

melanin produced by the melanocytes and taken
up by Keratinocytes.

Skin colour depends on UV radiation, genetic

factors and hormonal influences
Langerhans cells- These cells are found in
stratum spinosum. These are part of the body's
immune system and protect the body from the
antigens.

Merkel cells- These cells are only present in very

small numbers in the stratum basale. These are
close to nerves and feels the sensation e.g; palms,
soles and genitalia

So, what role it plays:

- Acts as protective barrier
- Generate new cells
- Protects body, from antigens
- Provide colour to skin
B. DERMIS
It is the middle layer in the skin present between the
basement membrane and subcutaneous membrane. The
main role of Dermis is to provide support and sustain the
epidermis.
This layer is responsible for wrinkles. It has Collagen and
Elastic, two important components of skin. It has fibroblast
cells which connect these two. It has nerves on it which
sense pain, touch, temperature.

Function of Dermis:
Protection;
Cushioning the deeper structures from mechanical
injury;
Providing nourishment to the epidermis;
Playing an important role in wound healing
Dermis is made up of Two layers:

The more superficial papillary dermis - It is a thin layer which has capillaries, elastic fibres
and some collagen.
The deeper reticular dermis - It is thick and has more dense collagen

So, what role it plays:

- Constitute Collagen and elastin
- Grows hair
- Sensory feels due to presence of nerves
- Produce oil and sweat from oil glands &
sweat glands
- Supply blood and nutrients to Epidermis
C. HYPODERMIS

It is the bottom layer of the skin and. It's

made up of fat cells, connective tissue,
and blood vessels. Connects the skin to
the fibrous tissues of bone and muscles

It functions as a fat layer, cushioning, and

storage.
FUNCTIONS OF COLLAGEN, ELASTIN AND SKIN
CELLS
1. COLLAGEN
Collagen is the most abundant protein in the body.
Collagen is the primary building block of the skin,
muscles, bones, tendons and ligaments, and other
connective tissues.
It’s also found in organs, blood vessels and
intestinal lining.

Collagen is made from 3 amino acids :

Proline
Glycine and
Hydroxyproline
These amino acids group together to form helix
structure. As shown in the img;
Micronutrients like Copper, Zinc, Vitamin C and Manganese are required to support triple
helix structure.

Function of Collagen

● Helping fibroblasts form in the dermis (middle skin layer), which helps in growth of
new cells.
● Playing a role in replacing dead skin cells.
● Providing a protective covering for organs.
● Giving structure, strength and elasticity to the skin.
● Helps in blood clotting
2. ELASTIN

It is made of random structure of polypeptide chain made of

the amino acids that make up elastin are proline, glycine,
desmosine and isodesmosine. It is found in the dermis layer
of the skin.
Elastin main function is to allow tissues in the body to
stretch out and shrink back.

Function of Elastin

Elasticity: Elastin gives tissues elasticity, allowing them to

stretch and recoil.
Energy storage: Elastin stores potential energy created by
tissue contraction, which is then released when the tissue
relaxes.
Reversible extensibility: Elastin allows tissues to be fully
extended and then return to their original shape.
A QUICK EXPERIMENT
As you age, the elastin in your skin decreases. For example, hold one of your hands in front of your
body, palm-side down. Pinch the skin on the back of your outstretched hand and hold it for several
seconds with your other hand.

Elastin allows you to stretch your skin. If you have a lot of elastin in your skin, the skin on the back of
your hand will shrink back into place very quickly once you stop pinching. If you don’t have a lot of
elastin in your skin, it may take several seconds for your skin to shrink back into place.
SKIN AGEING PROCESS & FACTORS AFFECTING SKIN
HEALTH
What Kind of changes appear when skin is ageing
- Skin becomes rougher. Skin develops lesions such as benign tumors.
- Skin becomes slack. The loss of the elastic tissue (elastin) in the skin with age
causes the skin to hang loosely.
- Skin becomes more transparent. This is caused by thinning of the epidermis
(surface layer of the skin).
- Skin becomes more fragile. This is caused by a flattening of the area where the
epidermis and dermis come together.
- Skin becomes more easily bruised. This is due to thinner blood vessel walls.
- Aged skin tends to develop a variety of benign neoplasms, such as sebaceous
hyperplasia and cherry angiomas.
- Skin cancers are less common in intrinsically aged skin than in extrinsically
aged skin
External factors that affect skin:
1. Climate
Sustained exposure to the sun triggers the formation of free
radicals.The weather can have a significant impact on skin
condition:
The sun’s rays affect skin in different ways:
- UVB rays are responsible for sunburn. And linked to DNA
damage which can cause skin cancer.
- Both UVA rays and HEV Light can cause skin to age
prematurely (photoage)
Sun allergies are mainly triggered by UVA rays but can also
be provoked by UVB.
- UVA, UVB and HEV Light rays can induce
hyperpigmentation and may contribute to conditions such
as age spots (also known as sun spots) and melasma.
2. Temperature
Extreme temperatures, and the speed of change between them, impact on skin skin.
- In cold conditions skin reacts by narrowing the blood vessels to protect the body from losing too
much heat. Sustained cold temperatures reduce sebaceous gland secretion and cause skin to dry
out. Rosea like condition also triggered in heat
- In hot and humid conditions (for example tropical countries or a sauna) sweat glands produce
more sweat, leaving the skin moist and shiny and, in some cases, prone to acne. Low humidity, as
found in aeroplane cabins and even caused by central heating, can cause skin to become
dehydrated and lead to increased sensitivity.
-
3. Aggressive products
- Skin is naturally mildly acidic, with a pH of between 4.7 and 5.75. Aggressive cleansers and
moisturising products with an alkaline pH overtax skin’s natural neutralising capability, damage cell
structure and impair the barrier function of the outermost layer of the epidermis. As a result, skin can dry
out and become sensitive or even hypersensitive.
- When skin is sensitive it is susceptible to skin infections and flare-ups of diseases such as Atopic
Dermatitis or Rosacea
- Certain chemical peels can have a similar effect
Some people are particularly affected by aggressive products:
- Small children and the elderly: Young and old skin is less resistant because skin barrier function is
either not yet fully developed or is on the decline. Read more in skin in different ages.
- Those exposed to chemicals in the workplace: Professionals such as hairdressers, masons and
industrial workers are in regular contact with detergents, solvents, lacquers and paints - all
substances that are harmful to the skin.
Those with hypersensitive skin
Hypersensitive skin is characterised by a compromised skin barrier and hyper-reactive nerve fibres in
the epidermis
4. Washing too frequently 5. Nutrition
- Showering or bathing too frequently, for too long A balanced diet will help to keep skin
and with water that is too hot leads to a loss of healthy.
skin’s natural moisturising factors and surface -A diet high in fast food, sugar,
lipids. saturated fats deteriorate the skin
- The pH of skin is mildly acidic, and frequent health
washing with tap water - that ranges from
neutral to mildly alkaline impair its protective
barrier function.
6. Medication 7. Lifestyles factors

- Smoking - generates free radical

Certain medicines (e.g. chemotherapy,
which causes early signs of ageing
diuretics, laxatives and the lipid-lowering drugs
- Poor sleep, effects the skin's
and medical procedures
hydration, elasticity, and collagen
(e.g. radiotherapy and dialysis) can make skin
production
more sensitive and prone to dryness.
Common skin types
& their
characteristics
Normal Skin

‘Normal’ is a term widely used to refer to well-balanced

skin. The scientific term for well-balanced skin is
eudermic. The T-zone (forehead, chin and nose) may
be a bit oily, but overall sebum and moisture is
balanced and the skin is neither too oily nor too dry.

How to identify:
Fine pores
Good blood circulation
A velvety, soft and smooth texture
A fresh, rosy colour uniform transparency
No blemishes
Not prone to sensitivity
Dry Skin

‘Dry’ is used to describe a skin type that produces less

sebum than normal skin. As a result of the lack of
sebum, dry skin lacks the lipids that it needs to retain
moisture and build a protective shield against external
influences. This leads to an impaired barrier function.

How to identify:
Mildly dry skin can feel tight, brittle and rough and look
dull. Skin elasticity is also low.
Very dry skin
If the dryness is not treated, skin may develop:
mild scaling or flakiness in patches
a rough and blotchy appearance (sometimes it appears to be prematurely aged)
a feeling of tightness
possible itchiness

It is also more sensitive to irritation, redness and the risk of infection.

Extremely dry skin

Certain areas of the body – particularly hands, feet, elbows and knees – are prone to:
Roughness
chapping with a tendency to form rhagades (cracks)
Calluses
Scaling
frequent itchiness

Extremely dry skin is most commonly found on the elderly or on severely dehydrated hands. Read more
in rough and cracked body skin
Oily Skin
Oily’ is used to describe a skin type with heightened
sebum production. This over production is known as
seborrhea.

How to identify:
Oily skin can be characterized by enlarged and visible
pores.
Acne concerns often appear in the T-zone, especially
during puberty.
Oily Skin
Oily skin is characterised by:

Enlarged, clearly visible pores

A glossy shine
Thicker, pale skin: blood vessels may not be visible
Oily skin is prone to comedones (blackheads and whiteheads)
and to the varying forms of acne.
With mild acne, a significant number of comedones appear on
the face and frequently on the neck, shoulders, back and
chest too.
In moderate and severe cases, papules (small bumps with no
visible white or black head) and pustules (medium sized
bumps with a noticeable white or yellow dot at the centre)
appear and the skin becomes red and inflamed.
Combination Skin
In combination skin the skin types vary in the T-zone and
the cheeks. The so-called T-zone can differ substantially
– from a very slim zone to an extended area.

How to identify:

an oily T-zone (forehead, chin and nose)

enlarged pores in this area perhaps with some impurities
normal to dry cheeks
Analyse different
skin types & their
nutritional needs
Nutrition for Dry Skin type

WHAT TO EAT WHAT TO AVOID

Water Avoid dehydrating food e.g; Coffee and Tea
Food with high water content- Cucumber, Energy drinks
Watermelon, Strawberries, Oranges, Peaches
Avocado
Salmon
Olive oil
Vitamin A (Carrot, Papaya, Orange )
Vitamin C rich food (Citrus fruits, Bell pepper)
Coconut water
Nutrition for Oily Skin type

WHAT TO EAT WHAT TO AVOID

Add anti inflammatory oils (avocado, olive, fish, Oily,
flaxseed) Ultra-processed foods - made with refined carbs
Fish and sugar
B2 rich foods (may also disrupt healthy sebum
production and lead to oily skin). Like avocado,
egg yolk, mushroom, spinach, tofu
B complex
Omega 3
Vitamin E
Hyaluronic rich foods
Nutrition for Combination Skin type

WHAT TO EAT WHAT TO AVOID

Vitamin C Do not need to ditch carbs entirely
Vitamin A (Helps in skin turnover)
Healthy Fats - Monounsaturated and
Polyunsaturated
Nutrition for Acne- prone Skin type

WHAT TO EAT WHAT TO AVOID

Milk and its products
Greek yogurt
Sugar
Refined flour
Unhealthy fat
Nutrition for Dull/ Ageing Skin type

WHAT TO EAT WHAT TO AVOID

Lycopene rich food Fast food
Tomato Smoking
Guava
Papaya
Red pepper
Cocoa
Egg
Fish
Lean meat
Vitamin C rich food
ACTIVITY
1. Which layer of skin has cells without nucleus ?
A. Dermis
B. Epidermis
C. Hypodermis
D. None of the above
1. The lesser the number of melanocytes capsule stored in
keratinocytes the ______ the colour of the skin
A. Dark
B. Normal
C. Light
E. All the above
3. What is the name of the layer shown in the picture?

A.Epidermis
B. Hypodermis
C. Dermis
D. None of the above
?
1. Are environmental factors the major factor causing skin
ageing in the 20's age group?

A. Yes
B. No
5. What form of Vitamin D is made underneath the skin?

A. Vitamin D1
B. VItamin D2
C. Vitamin D3
D. Vitamin D
THANK YOU