Introduction
The skin is the largest and one of the most complex organs of the human body, playing
a crucial role not only in physical health but also in psychological well-being. For a
psychology student, understanding the intricacies of the skin can provide valuable
insights into psychosomatic relationships, body image, and the social implications of
various skin conditions .The skin covers the entire external surface of the human body
and is the principal site of interaction with the surrounding world. It serves as a
protective barrier that prevents internal tissues from exposure to trauma, ultraviolet
(UV) radiation, temperature extremes, toxins, and bacteria. Other important functions
include sensory perception, immunologic surveillance, thermoregulation, and control of
insensible fluid loss.
The integument consists of three mutually dependent layers, the epidermis, dermis and
hypodermis.
Diagram of the Human skin
The Epidermis
The epidermis is the outermost layer of the skin, and it is composed of several
sublayers. Here is the structure of the epidermis:
1. Stratum Corneum (SC): The outermost sublayer of the epidermis, composed of dead
skin cells that are held together by lipids. The SC provides a waterproof barrier that
prevents water loss from the body.
2. Stratum Lucidum (SL): A thin, transparent sublayer of the epidermis, located just
beneath the SC. The SL is composed of dead skin cells that are compacted together.
3. Stratum Granulosum (SG): A sublayer of the epidermis, located just beneath the SL.
The SG is composed of skin cells that are in the process of dying and becoming
compacted together.
4. Stratum Spinosum (SS): A sublayer of the epidermis, located just beneath the SG. The
SS is composed of skin cells that are held together by desmosomes.
5. Stratum Basale (SB): The innermost sublayer of the epidermis, located just above the
dermis. The SB is composed of a single layer of skin cells that are responsible for
producing new skin cells through cell division.
The epidermis is composed of several types of skin cells, including:
- Keratinocytes: The main type of skin cell in the epidermis, responsible for producing
keratin.
- Melanocytes: Skin cells that produce melanin, responsible for skin pigmentation.
- Langerhans cells: Immune cells that play a role in the immune response.
- Merkel cells: Skin cells that play a role in touch sensation.
The functions of the epidermis
The epidermis is the outermost layer of the skin, and it serves several essential
functions for the body, including:
1. Protection: Acts as a barrier against environmental hazards such as bacteria, viruses,
chemicals, and physical injury.
Protects against harmful UV radiation with the help of melanocytes, which produce
melanin.
2. Waterproofing and Hydration: Prevents water loss through the skin due to the
presence of keratin and lipids, maintaining the body's hydration.
3. Sensation: Contains sensory nerve endings that detect touch, pressure, pain, and
temperature, helping the body respond to environmental stimuli.
4. Thermoregulation: While most temperature regulation occurs in the dermis, the
epidermis plays a role by limiting water loss and providing insulation.
5. Immune Defense: Contains specialized immune cells, like Langerhans cells, which
help detect and fight pathogens.
6. Vitamin D Synthesis: In response to sunlight (UVB rays), the epidermis helps
synthesize vitamin D, which is crucial for bone health and immune function.
7. Skin Regeneration: Continuously sheds dead skin cells (stratum corneum) and
replaces them with new cells from the basal layer, ensuring the skin remains healthy
and intact.
The Dermis
The dermis is the middle layer of skin and is made up of connective tissue, blood
vessels, nerves, glands, and hair follicles. It has two layers: the papillary dermis and the
reticular dermis.
1. Papillary dermis:The top layer of the dermis
Made up of loose connective tissue
Contains collagen fibers, fibroblast cells, fat cells, blood vessels, nerve fibers, and touch
receptors
2. Reticular dermis: The thicker, inner sublayer, which contains a denser network of
collagen and elastin fibers.
Components
The dermis is composed of the following
1. Collagen fibers: Provide strength, structure, and elasticity to the skin.
2. Elastin fibers: Allow the skin to snap back into place after stretching.
3. Fibroblasts: Cells that produce collagen and elastin fibers.
4. Macrophages: Immune cells that help defend against infections.
5. Blood vessels: Supply oxygen and nutrients to the skin.
6. Sebaceous glands: Produce sebum, an oily substance that helps moisturize the skin.
7. Sweat glands: Produce sweat, which helps regulate body temperature.
The dermis could have several effects on our behavior which could be stated as follows;
1. Pain perception: The dermis contains nerve endings that transmit pain signals to the
brain. Pain can influence behavior, such as avoiding certain activities or seeking relief.
2. Touch and tactile sensations: The dermis is responsible for transmitting touch and
tactile sensations, which can affect behavior, such as responding to social touch or
exploring one's environment.
3. Temperature regulation: The dermis plays a role in regulating body temperature,
which can impact behavior, such as seeking shade or adjusting clothing.
4. Sensory integration: The dermis, along with other sensory receptors, contributes to
sensory integration, which is the process of combining multiple sensory inputs to
understand the environment. This can influence behavior, such as responding to threats
or navigating through spaces.
5. Emotional responses: The dermis can be involved in emotional responses, such as the
sensation of goosebumps or the feeling of tension in the skin.
6. Social behavior: The appearance and health of the skin can affect social behavior,
such as self-esteem, confidence, and social interactions.
7. Neurological connections: Research suggests that the dermis may have connections
to the nervous system, which could potentially influence behavior, although more
research is needed to fully understand this relationship.
Functions of the Dermis
The dermis is the middle layer of the skin plays a vital role in maintaining skin structure
and function. And they are as follows:
1. Provides Structural Support
The dermis is rich in collagen and elastin fibers, which provide strength, elasticity, and
flexibility to the skin. These fibers help the skin maintain its shape and resist
deformation from external forces, such as stretching or compression.
Example: When you stretch your skin, like when you lift something heavy or bend, the
dermis allows the skin to return to its original shape without damage.
2. Regulates Temperature (Thermoregulation)
The dermis plays a key role in temperature regulation through its blood vessels. When
you're hot, blood vessels in the dermis expand (vasodilation), allowing more blood to
flow near the skin's surface to release heat. When you're cold, blood vessels constrict
(vasoconstriction) to retain heat.
Example: If you’re exposed to cold weather, you may notice your skin turning pale
because blood flow is reduced to preserve body heat.
3. Facilitates Sensation: The dermis contains numerous sensory receptors that detect
stimuli such as touch, pressure, pain, and temperature. These receptors help the body
respond to its environment and are crucial for protective reflexes.
Example: If you touch something hot, sensory receptors in the dermis send signals to
your brain to prompt you to pull away quickly to prevent injury.
4. Supports Hair Follicles and Sweat glands: The dermis houses the hair follicles, which
are responsible for the growth of hair, and the sweat glands, which help regulate body
temperature and excrete waste products. These structures are essential for skin
function and homeostasis.
Example: Sweat glands help cool the body by secreting sweat, and the hair follicles
allow for hair growth, which can provide protection from UV radiation and help with
temperature regulation.
5. Houses the Lymphatic and Blood Vessels: The dermis contains a network of blood
vessels that supply oxygen and nutrients to the skin and deeper tissues, while also
removing waste products. Additionally, lymphatic vessels help in immune responses
and the removal of excess fluid and toxins.
Example: When the skin is injured, blood vessels in the dermis help deliver nutrients
needed for tissue repair, while the lymphatic vessels help clear out waste products from
the injury site.
6. Stores Nutrients and Water: The dermis acts as a storage site for important nutrients,
including water, electrolytes, and fats, that support skin health and function. This water
reservoir helps maintain skin hydration and ensures that skin cells receive the nutrients
they need.
Example: In times of dehydration, the dermis helps retain water in the skin, which can
prevent excessive dryness and improve the skin’s appearance.
7. Facilitates wound healing:The dermis contains fibroblasts, which are specialized cells
responsible for producing collagen and other extracellular matrix components that aid
in wound healing. When the skin is damaged, fibroblasts are activated to repair the
tissue.
Example: After an injury, you may notice scarring or healing in the skin as the dermis
regenerates new tissue to close up wounds and restore the skin's integrity.
Contributions of Epidermis and Dermis to somatic perception
The skin is equipped with nociceptors that allow for the sensation of touch, heat, cold,
and pain, facilitating interaction with the environment. The skin's sensory roles are
essential for an individual's movement, protection, and interaction with the
environment.
The somatic sensory system transmits pain (nociception), temperature, light touch,
discriminative touch, vibration, pressure, and proprioception sensations to the central
nervous system. Specialized cutaneous receptors and end organs mediate perception,
including Merkel disks and Pacinian, Meissner, and Ruffini corpuscles.
Recall that the epidermis is the outermost layer of skin in mammals. It is relatively thin,
is composed of keratin-filled cells, and has no blood supply. The epidermis serves as a
barrier to water and to invasion by pathogens. Below this, the much thicker dermis
contains blood vessels, sweat glands, hair follicles, lymph vessels, and lipid-secreting
sebaceous glands. Below the epidermis and dermis is the subcutaneous tissue, or
hypodermis, the fatty layer that contains blood vessels, connective tissue, and the
axons of sensory neurons. The hypodermis, which holds about 50 percent of the body’s
fat, attaches the dermis to the bone and muscle, and supplies nerves and blood vessels
to the dermis.
Sensory receptors are classified into five categories: mechanoreceptors,
thermoreceptors, proprioceptors, pain receptors, and chemoreceptors. These categories
are based on the nature of stimuli each receptor class transduces. What is commonly
referred to as “touch” involves more than one kind of stimulus and more than one kind
of receptor.
• MECHANORECEPTORS in the skin are described as encapsulated (that is, surrounded
by a capsule) or unencapsulated (a group that includes free nerve endings). A free
nerve ending, as its name implies, is an unencapsulated dendrite of a sensory neuron.
Free nerve endings are the most common nerve endings in skin, and they extend into
the middle of the epidermis. Free nerve endings are sensitive to painful stimuli, to hot
and cold, and to light touch. They are slow to adjust to a stimulus and so are less
sensitive to abrupt changes in stimulation. Mechanoreceptors sense stimuli due to
physical deformation of their plasma membranes. They contain mechanically gated ion
channels whose gates open or close in response to pressure, touch, stretching, and
sound.”
Psychologically, mechanoreceptors play a crucial role in our sense of touch and spatial
awareness, influencing our perception of the environment and our bodily position.
Examples include:
- Reaching out to touch a soft toy
- Holding a cup without dropping it
- Walking on uneven terrain without losing balance
• THERMORECEPTORS: They detect changes in temperature, allowing us to perceive
heat, cold, and warmth. Thermoreceptors influence our emotional and behavioral
responses to temperature changes, such as seeking comfort or avoiding pain.
Thermoreceptors contribute to our ability to perceive and regulate our body
temperature, which is essential for maintaining homeostasis. For example, in response
to heat, one may seek shade on a hot day or avoid touching hot surfaces.
• PROPRIOCEPTORS: In proprioception, proprioceptive and kinesthetic signals travel
through myelinated afferent neurons running from the spinal cord to the medulla.
Neurons are not physically connected, but communicate via neurotransmitters secreted
into synapses or “gaps” between communicating neurons. Once in the medulla, the
neurons continue carrying the signals to the thalamus.
This receptor detects changes in muscle length, tension, and joint position, enabling us
to sense our bodily position and movement. Proprioceptors play a crucial role in our
sense of self and body awareness, influencing our perception of our bodily position and
movement. Proprioceptors contribute to our ability to perceive our bodily position,
movement, and balance, enabling us to maintain posture, coordinate movements, and
navigate our environment. E.g Maintaining balance while walking on a narrow beam or
performing complex movements like dancing or playing a musical instrument.
• PAIN RECEPTORS (NOCICEPTORS): Pain receptors detect tissue damage or potential
damage, triggering pain perception. Pain receptors play a crucial role in our emotional
and behavioral responses to pain, influencing our perception of threat, anxiety, and
stress. Pain receptors contribute to our ability to perceive and respond to tissue
damage, protecting us from harm and promoting healing. For instance,
- Withdrawing a hand from a hot surface
- Guarding a injured limb to avoid further pain
- Seeking medical attention for persistent pain
• CHEMORECEPTORS: They detect changes in chemical composition, such as oxygen
and carbon dioxide levels, pH, and other chemicals. Chemoreceptors influence our
respiratory and cardiovascular responses, which can impact our emotional state,
cognitive function, and behavior. Chemoreceptors contribute to our ability to perceive
changes in our internal environment, regulating our respiratory and cardiovascular
systems to maintain homeostasis. An example where this receptor is activated is
increasing breathing rate due to intense excerise or responding to the smell of food or
danger.
. NOCICEPTION : is the neural process of detecting and transmitting information about
noxious (potentially harmful) stimuli, serving as a critical component of the body’s
defense mechanism. It involves specialized sensory receptors called nociceptors that
respond to mechanical, thermal, or chemical threats, initiating signals that travel
through the peripheral and central nervous systems. This process enables the
perception of pain, prompting protective responses to prevent or minimize tissue
damage. Nociception specifically contributes to the pain aspect of somatic perception
by detecting harmful stimuli and conveying this information to the brain, where it is
interpreted as pain. This perception not only alerts individuals to potential injury but
also facilitates appropriate reactions, such as withdrawal from the harmful source,
thereby playing a vital role in injury prevention and survival.
It’s important to note that while nociception involves the detection of harmful stimuli,
the actual experience of pain is a complex interplay of sensory input and emotional
context. This means that nociceptive signals can lead to the perception of pain, but the
intensity and quality of pain experienced can be influenced by various factors, including
psychological and environmental contexts.
how properly functioning skin (dermis and epidermis) contributes to proper somatic
perception and psychological well being.
Somatic Perception
Somatic perception refers to how individuals perceive bodily sensations, including
touch, pain, temperature, and pressure. The skin is equipped with a wide array of
sensory receptors (mechanoreceptors, thermoreceptors, nociceptors, etc.) that relay
information to the brain, thus influencing overall body awareness and emotional
responses.
Role of the Epidermis: The epidermis contains nerve endings that respond to touch,
which play an essential role in somatic perception. Research indicates that tactile
interactions can enhance body image and self-perception (Gallace & Spence, 2005).
Feeling textures and temperatures helps people interpret their environment, which is
foundational for healthy psychological functioning.
Role of the Dermis: The dermis includes deeper sensory receptors that inform the brain
about pressure and vibration (Ackerley et al., 2014). These sensations influence mood
and emotional states—positive tactile experiences, like a comforting touch or a
massage, have been linked to reduced anxiety and improved mental health.
Influence on Psychological Well-Being
A properly functioning skin not only enhances sensory perception but also directly
impacts psychological well-being. Several studies suggest the following:
Skin and Stress Response: The skin is involved in the body's stress response. According
to resourceful research published in the journal Frontiers in Psychology, when the skin
barrier is compromised, it can lead to skin conditions like eczema, which are linked to
stress, anxiety, and depression (Schoch et al., 2019). This illustrates how skin health
can reflect and influence mental health.
Body Image and Self-Esteem: Research highlights the connection between skin health
and self-esteem. Individuals with skin conditions often experience societal stigma,
which can lead to anxiety and depression (Harrison et al., 2018). A healthy skin
appearance can promote positive body image and social interactions, vital components
of psychological well-being.
Touch and Emotional Regulation: Positive tactile experiences (e.g., hugging, massage)
stimulate the release of oxytocin, often referred to as the “love hormone.” This
hormone helps reduce stress and promotes bonding, showing that healthy skin capable
of safe physical contact is essential for emotional health (Field, 2015).
Statistics and Case Studies
A study conducted by the Journal of Investigative Dermatology reported that 1 in 4
people with chronic skin conditions experience clinical levels of depression (Kreatsoulas
et al., 2013). This statistic underscores the link between skin health and mental health.
what happens if there is a wrong sensation or wrong perception from the skin . And
disorders that are associated with it.
Sensation and Perception: A Brief Overview
Sensation refers to the process by which our sensory receptors and nervous system
receive and represent stimulus energies from our environment. In contrast, perception
is the process by which the brain organizes and interprets these sensory inputs,
enabling us to recognize meaningful objects and events. The skin contains various
receptors that can detect touch, temperature, and pain, which are integral for our
interaction with our environment.
Wrong Sensation or Perception
When we talk about "wrong sensations," we typically refer to conditions in which the
sensory input from the skin is altered or misinterpreted. Similarly, "wrong perception"
indicates a failure in the brain’s ability to interpret sensory information correctly. Both
can result from a variety of causes, including psychological disorders, neurological
conditions, or peripheral nerve issues.
Associated Disorders
1. Somatoform Disorders: Somatoform disorders, such as Somatic Symptom Disorder
(SSD), often involve patients reporting physical symptoms without a clear medical basis.
For instance, a person may experience sensations of pain, numbness, or tingling that do
not correlate with any identifiable physiological condition. According to the American
Psychiatric Association (2013), SSD prevalence in the general population ranges from
5% to 7%.
Example: A study by Tyrer et al. (2000) in the British Journal of Psychiatry highlighted
how patients with SSD might misinterpret normal bodily sensations as signs of serious
illness, leading to excessive health anxiety.
Phantom Limb Syndrome: Individuals who have lost a limb often continue to feel
sensations in the amputated limb, such as itching or pain. This phenomenon is known as
phantom limb syndrome (PLS). Research shows that about 60-80% of amputees
experience phantom sensations (Koo et al., 2013).
Case Study: A notable case reported by Richardson (1995) in the Journal of Pain and
Symptom Management described an amputee who frequently felt sensations of warmth
in his phantom limb despite no physical presence of the limb, indicating that the brain
retains a "mental map" of the body, influencing sensations even after limb loss.
2. Neuropathic Pain: This type of pain arises from damage to the nervous system itself,
rather than from a direct injury. Conditions like diabetic neuropathy or postherpetic
neuralgia fall under this category. Research indicates that around 30% of diabetes
patients may experience diabetic neuropathy, leading to false sensations of burning or
tingling in the extremities (Wahab et al., 2019).
3. Sensory Processing Disorder (SPD): SPD encompasses difficulties in processing
sensory information, leading to confusion and sometimes distress in interpreting
sensory experiences. Children and adults with SPD might either be overly sensitive or
under-responsive to sensory input, affecting daily life.
4. Psychotic Disorders: Disorders such as schizophrenia can also present with altered
perceptions. Affected individuals may experience tactile hallucinations, where they
perceive sensations that are not present, such as bugs crawling on their skin.
Distorted Somatic Perception and Psychological Disorders
1. Body Dysmorphic Disorder (BDD): Body Dysmorphic Disorder is characterized by an
obsessive focus on perceived flaws in physical appearance, which often includes the
skin. Individuals suffering from BDD may see minor imperfections as significant defects,
leading to feelings of shame, anxiety, and avoidance of social situations. According to a
study published in the Journal of the American Academy of Dermatology, about 9-15%
of patients seeking dermatological treatment may meet the criteria for BDD (Rumsey,
2013).
Case Study Example: Consider a case where an individual, let's call her Mary, is
preoccupied with what she believes to be a severe blemish on her cheek. To Mary, this
small imperfection is magnified to a point where it consumes her daily thoughts,
impacting her social life and mental health. Research shows that individuals like Mary
often engage in compulsive behaviors such as excessive grooming, frequent seeking of
reassurance, or even surgical interventions to correct what they perceive as
imperfections (Phillips & Pagano, 2000).
2. Somatic Symptom Disorder (SSD): Somatic Symptom Disorder involves the presence
of one or more distressing somatic symptoms accompanied by excessive thoughts,
feelings, or behaviors related to the symptoms. In this case, the somatic perception can
often be tied to the skin. For instance, an individual may experience chronic pain or
fatigue but may predominately focus their concerns on their skin's appearance or
sensations. The American Psychiatric Association notes that SSD can significantly impair
day-to-day functioning (APA, 2013).
Statistics: Approximately 5-7% of adults may experience SSD in their lifetime, with
women more frequently affected than men (Gureje et al., 2008). In Nigeria, cultural
factors often interplay with symptom expression, sometimes complicating diagnostic
clarity, which demonstrates a need for culturally competent approaches in assessment
and treatment.
3. Psychodermatological Disorders: These disorders highlight the close connection
between psychological states and dermatological health. Conditions like eczema,
psoriasis, and acne can be exacerbated by psychological stress. Research indicates that
approximately 30% of patients with psoriasis experience significant psychological
distress (Menter et al., 2019).
Case Example: An illustrative case here could be Michael, who has been living with acne
for years. His persistent acne has affected his self-esteem, leading him to isolate
himself socially and develop depressive symptoms. Studies show individuals with skin
conditions like acne often report lower quality of life and increased levels of social
anxiety (McDaniel et al., 2011).
Aging affects both the structure of the skin and sensory perception in several ways due
to physiological changes over time.
Impact on Skin Structure:
1. Thinning of the Epidermis & Dermis – The outer layer (epidermis) becomes thinner,
making the skin more fragile. The dermis loses collagen and elastin, leading to reduced
strength and elasticity.
2. Decreased Collagen & Elastin Production – Collagen provides firmness, while elastin
allows skin to stretch and return to its original form. Their decline results in wrinkles and
sagging.
3. Reduced Hydration & Oil Production – Sebaceous (oil) glands produce less sebum,
leading to dryness and increased susceptibility to irritation.
4. Slower Wound Healing – Cell turnover slows down, making it harder for the skin to
repair itself after injuries.
5. Reduced Blood Supply – Fewer capillaries in the skin mean less oxygen and nutrients,
contributing to dull, thin skin.
6. Hyperpigmentation & Age Spots – Uneven melanin distribution leads to dark spots,
commonly called liver spots.
Impact on Sensory Perception:
1. Decreased Sensitivity to Touch – Reduced Meissner’s corpuscles (touch receptors)
lead to a decline in tactile perception, making it harder to sense light touches.
2. Reduced Pain Sensation – A decrease in nerve endings and slower nerve conduction
can make older adults less sensitive to pain, increasing the risk of unnoticed injuries.
3. Impaired Temperature Regulation – Sweat glands become less active, and blood
circulation decreases, making it harder to regulate body temperature and perceive
extreme heat or cold.
4. Decline in Proprioception – Aging affects mechanoreceptors responsible for body
awareness, increasing the risk of falls and balance issues.
Overall, these changes make aging skin more prone to damage, slower to heal, and less
effective in perceiving sensory stimuli.
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