The skin is the body’s largest organ. It consisting of a thin outer layer
called the epidermis, and a much thicker inner layer called the dermis.
Beneath the dermis is a layer consisting of little lobes of fat bound together
by tough fibers extending down from the dermis. Between the epidermis and
dermis is the basement membrane, to which both layers are attached.
It is this characteristic layering of cells, segueing from the live and
actively replicating cells of the stratum germinatum to the dead flakes
on the surface, that provides the unique setting for the skin diseases.
Please review the relevant anatomy and physiology, but here is a listing
of the main functions fulfilled by skin.
- It is the interface between the body’s internal structures and the environment,
serving as a protective coat against mechanical injury and attack by bacteria,
fungi, viruses, and parasites, while melanin protects against ultraviolet
radiation.
- It is a major organ of elimination
- In various ways the skin plays a vital role in temperature regulation.
Variable amounts of heat are lost through the skin by transfer from the
dermis capillaries to the cooler epidermal cells, the amounts varying through
constriction or dilation of the dermal blood cells. Sweating cools the epidermis
by evaporation. The amount of heat conducted from the depths of the body
is modified by the layer of insulating fat.
- The five sensations arising from stimulation of skin nerves include
touch, pain, heat, cold, and pressure. Other skin sensations, such as vibration,
are composites of these basic sensations. In hairy skin the only nerve endings
are simple, threadlike, naked terminals. In non-hairy skin, there are also
several types of specialized nerve endings. Although they appear the same,
each nerve ending is capable of responding to only one of the five basic
types of sensation.
- A number of immunological responses occur in the skin.
- It is the interface between the individuals consciousness and the world,
being the vehicle through which we express, communicate and perceive. Thus
the psychological and spiritual aspects of an individual will impact and
be impacted by the skin.
This array of functions highlights the complexity of relationships between
the skin, internal organs and psychology. An important therapaeutic insight
arises from this:
Effective phytotherapeutic treatments of skin disease is mediated through
internal medication and not topical applications.
Treatment should take into account the whole panoply of issues involved.
Similarly, the widely held view that many skin problems are caused by `nerves’
is not very helpful. There is a deep and complex relationship between the
epidermis and the nervous system. For example consider these factors:
- Developmentally they derive from the same tissue in the human embryo,
- The close functional relationship between skin and nervous system facilitates
many aspects of homeostasis, e.g. control of body temperature.
- Psychological relationships are deep and complex. An individual expresses
and experiences much of their self-image through the skin. Perception of
the world and communication to the world are vital functions.
Concluding that there is a simple causal relationship ignores all of the
insights gained through the holistic perspective. Anyone with such obvious
skin conditions may well become stressed, developing psychological coping
mechanisms that appear to be ‘nerves’. Which came first?
In the following section the phytotherapeutic approach to a representative selection
of skin conditions will be reviewed.