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CHAPTER 3 skin, lymph, and energy pathways
beauty is more than skin deep

Your face is made of many separate elements that fit together like a jigsaw to make up the face you see in the mirror. As you’ve already seen, the facial muscles play a vital part, and later on we will consider the role of the lymph system and also the energy pathways that, in all Eastern therapies, are considered crucial to your appearance and good health.

Nevertheless, the skin is also important and by learning how and why the skin changes with the passing years you’ll start to appreciate why it is necessary to take good care of this vital organ. In the process, you’ll discover new ways to delay, or reverse, the ravages of time and keep a youthful appearance for longer.

why skin is important

When you look at your reflection in the mirror usually the first thing you notice is the condition of your skin. You may have spent so long looking at your skin from a cosmetic point of view that you find it hard to think of the skin as a living organ. But the skin isn’t there just to cover you up and make you look good. It has many vital functions that protect you and keep you alive. It is also a pretty accurate indicator of your state of health. When you feel dreadful, your skin usually looks off color. Healthy-looking skin is a sign of good physical health – and good mental health, too. Once you study the skin in detail, you’ll begin to appreciate how complicated it is.

The skin is the body’s largest organ. Spread out, it would cover about two square metres. It is constantly renewing itself, producing fresh cells and shedding dead ones as, for example, your clothes brush against your skin or you dry yourself with a towel. It is said that people shed what amounts to the entire surface of their skin once a week – no wonder that 80 percent of household dust is made up of human skin! If dead cells are allowed to accumulate they give the skin a dull, scaly appearance. So this is just one reason why a regular skin care regime, including exfoliation (see page 123), is important.

the role of the skin

The skin is highly intricate. Each tiny section of skin is packed with cells, nerves, blood vessels, hairs, sensory cells, and oil and sweat glands. The skin varies in thickness from only ¹/₅ in (0.5mm) around the eyes to ¹/₄ in (6mm) or more on the soles of the feet, where it has to cope with the increased wear and tear of walking. It also thickens anywhere on the body where extra protection is needed, such as on the hands of manual workers. But the basic functions of the skin are the same wherever it is. These are: to regulate body temperature, protect against damage and disease, remove waste products, monitor your surroundings, and produce vitamin D.

temperature regulation

The skin plays a key role in regulating your temperature. If you get too hot, perhaps because you’ve just entered a warm environment or have been exercising hard, the blood vessels in the skin dilate to allow more blood to pass through them. This allows excess heat to escape from the surface of the body through convection and radiation. It is the increased flow of blood through the skin that makes you look flushed. As an extra measure against overheating, the sweat glands produce perspiration that seeps on to the surface of the skin through tiny pores. The perspiration absorbs heat as it evaporates and so helps to lower your temperature.

In cold weather, blood vessels in your skin contract to reduce the amount of blood flowing near the surface of your body and so conserve your heat. This is why some people look pale or almost blue when they’re cold. In addition, the hairs on the skin stand up and this traps a layer of warm air around the body to provide extra insulation. When this happens, small bumps called goose pimples appear on the skin as tiny muscles pull the hairs upright.

protection

The skin covers virtually the entire body, providing a barrier that protects the underlying tissues from dehydration, friction, physical and chemical damage, and invasion by harmful organisms. The skin is relatively waterproof, although some moisture is absorbed when you take a bath – this causes the skin to swell, producing the wrinkling we notice after a long soak. The skin also contains sebaceous glands that produce an oily substance called sebum. This keeps the skin supple and lubricated and helps protect against moisture loss. The skin still loses some moisture, however, especially in the dry atmosphere of a modern centrally heated home or office, which is why you should apply moisturizer regularly to keep the skin supple. Sweat glands have an important defensive role, too. Sweat is slightly acidic and combines with sebum to produce a protective layer called the acid mantle that guards against bacteria and fungi. Sweat also contains an enzyme, lysozyme, that can destroy bacteria. In response to sunlight, some skin cells produce a dark-brown pigment, melanin, which blocks damaging ultraviolet radiation.

waste removal

Sweat glands not only help to control body temperature, they also excrete water, salts, and organic waste products in the sweat, so helping to regulate the body’s salt and water levels and remove toxic substances. Regular exercise increases perspiration and so helps to flush out these toxins and prevent a harmful build-up.

environmental monitor

The skin is not only a barrier but also the main link between the body and the outside world, so its ability to monitor environmental conditions is of great importance. The skin houses nerve endings and receptors that detect stimuli related to temperature, touch, pressure, and damage. These nerve endings trigger impulses that travel to the central nervous system (CNS) to keep the brain informed about your surroundings, so you can make the appropriate response, such as pulling your hand away from a hot object. The connections between the skin and the nervous system are especially important during a massage. Even the lightest of touches is registered by the brain and has a direct and immediate influence on your state of mind and emotions; a pampering touch has a calming, soothing effect, while a firmer massage will leave you stimulated and invigorated.

production of vitamin d

Vitamin D is obtained from some foods, such as meat and fish, and is also formed in the body by the action of sunlight on the skin. This vitamin aids the absorption of calcium from the gut and so is needed for healthy teeth, bones, and nerves. Although you must protect the skin from the damaging effects of excessive ultraviolet radiation (see Chapter 8), regular moderate exposure to sunshine is vital to ensure an adequate intake of vitamin D.

skin structure

Bearing in mind just how important the skin is, it should come as no surprise to learn that this organ is not a shapeless mass of cells but has a complicated structure. The skin consists of two main layers; the outer one is the epidermis and the inner one is the dermis. The main function of the epidermis is to form a tough barrier against the outside world, while the dermis is a soft, thick cushion of connective tissue that lies directly below the epidermis and largely determines the way the skin looks. Both layers are constantly repairing and renewing themselves, but the dermis does so more slowly than the epidermis. Under the dermis is a layer of fat cells, known as adipose tissue or subcutaneous (below the skin) fat, which provides insulation and protective padding as well as a store of energy.

Just as the thickness of the skin varies slightly throughout the body, so does the structure. For example, you do not find hairs on the palms of the hands or the soles of the feet. Generally, though, the skin is pretty similar all over the body. If you examine the skin in more detail you can see what an amazing job it does.

The epidermis

The epidermis is sub-divided into four distinct layers: the basal, spinous, granular, and cornified layers.

Basal layer: Cells here are attached to the basement membrane, which separates the epidermis from the dermis. Basal cells continually divide and grow to produce new cells that gradually move up through the epidermal layers to the surface. The basal layer also contains special cells, called melanocytes, that produce the pigment melanin. Melanin not only acts as a sunscreen against ultraviolet light but it also determines normal skin color, being naturally more prevalent in darker-skinned people.

Spinous layer: Here, cells rising up from the basal layer start to flatten out and produce a tough protein, keratin, to protect the body from harm.

Granular layer: In this layer, the still-living cells continue to flatten and fill with keratin but then gradually lose their nuclei to become dead cells.

Cornified layer: This is the outermost layer of the epidermis where the scale-like cells are made up almost entirely of keratin. These cells are all dead and are constantly being worn away and replaced by cells from below.

The dermis

The dermis is thicker than the epidermis. It consists mainly of connective tissue, which is made up of fibers of the proteins collagen and elastin and a non-fibrous gelatin-like material called ground substance or extracellular matrix (ECM) that fills spaces between the fibers. Moving through the matrix and among the fibers are fibroblast cells that manufacture the protein fibers and weave them together to form a web-like structure. These fibers often occur in bundles, made up of many fibrils lying parallel to one another, and they are very strong. They are found in all types of connective tissue such as bone, cartilage, tendon, and ligament.

The dermis contains blood vessels, which supply oxygen and nutrients to the skin and remove waste products, as well as special skin structures such as sensory receptors, nerve endings, sweat glands, and hair follicles – the deep pits that house the hairs. Each hair grows from the papilla, an area at the bottom of the follicle. Like skin, hair is made up mostly of keratin and is dead, except at its base, where new hair is constantly being formed. Each hair grows for about four years and then falls out and a new period of hair growth begins. Each follicle is surrounded by nerve endings that respond to the movement of the hair and can detect, for example, a light touch or a gentle breeze.

why does your skin age?

As we have already said, the dermis is mainly comprised of connective tissue so, to understand what happens to our skin as we get older, we need to look at this complex material in more detail. Connective tissue gives protection and support and is the most widely distributed material in the body. Under a microscope, the connective tissue of the dermis looks like a loose tangle of fibers. The main fibers are made up of the structural protein collagen and have great strength and suppleness. Collagen is the most abundant protein in the body and makes up about 70 percent of connective tissue. Collagen fibers are very tough and highly resistant to pulling forces although they do allow plenty of flexibility in the tissue.

Mixed up with the bundles of collagen fibers are thinner, more elastic fibers formed from a protein called elastin that increases the strength and flexibility of the connective tissue. Elastin fibers are smaller than collagen fibers and make up 5 percent of the dermis. They can be stretched by up to 150 percent of their relaxed length without breaking, which allows people to put on weight or expand during pregnancy without their skin tearing. Together, the two types of fibers give structure and suppleness to the skin, keeping the flesh smooth and taut.

Collagen and elastin bundles run in specific directions in different parts of the body. To discover the direction, pinch an area of skin and see which way it folds most easily into wrinkles. After a certain age, no pinching may be necessary as the wrinkles remain. A cut in the skin that separates parallel bundles of collagen fibers without damaging them heals with a fine line. But any injury that damages the fiber bundles forms a broad scar.

Although skin ages at a constant rate, the most noticeable effects occur from the late forties onwards. There are several reasons for this. When we are young the collagen and elastin fibers have tremendous strength and flexibility, but this gradually decreases. Over time, the fibroblast cells that produce collagen and elastin start to decline, so reducing the number of fibers present. Those fibers that are left may break apart while others can develop cross-links that bind them and lock them into place to form a shapeless matted tangle. This blocks the flow of fluid through the dermis, reducing its suppleness and preventing the fibers stretching and moving so freely with the muscles of the face.

Elastin fibers normally spring back into place when they’ve been stretched, which maintains skin tone. But with age they lose some of their elasticity, thicken into clumps, and become frayed. Once these fibers have hardened and shrunk, the skin tends to sag. Years of muscle action such as smiling and frowning can become imprinted on the skin as creases and wrinkles, especially on the forehead and around the eyes and mouth.

Another cause of skin aging on the face is a stiffening of the gelatin-like ground substance. The chains of protein molecules that make up this material get bound together, further reducing the skin’s suppleness. As if that wasn’t enough, the connective tissue of the dermis can glue the skin to the tissues surrounding the muscles and bones. This makes the face look drawn in, tight, and pinched. Other effects also occur over time. The layer of fat just below the surface of the skin gets thinner, underlying muscles start to shrink, and the water content of the skin declines, giving the rather loose and dry texture of aging skin. In addition, dead skin cells may not be replaced so uniformly when they are shed, giving an uneven appearance to the outer skin.

These age-related changes can’t be prevented indefinitely. But there is much you can do to resist them. Facial exercises and massage (Chapters 4 & 5), coupled with a good skin care regime (Chapter 6), and sun protection (Chapter 8), help to keep the skin fibers supple for longer. A healthy diet (Chapter 7) ensures that the dermis gets all the nutrients it needs to build new fibers.

Underlying factors

Age-related changes to the skin are triggered by several factors including excessive sun exposure; a build-up of harmful atoms called free radicals; poor diet, such as excess sugar consumption; and, in women in later life, a fall in the level of the hormone oestrogen.

Sun exposure: Ultraviolet rays penetrate deep into the skin, drying the tissues and weakening the fibers, so accelerating their disintegration.

Free radicals: These are unstable and highly destructive atoms. They are a by-product of the normal chemical reactions in the cells that release energy and are also produced by smoking, sunbathing, fried foods, and industrial and traffic pollution. Although short-lived, free radicals destabilize the molecules around them, causing damage to living cells, especially in the skin, and leading to premature aging.

Excess sugar: This leads to sudden, steep rises in blood glucose levels that can disrupt glucose regulation systems. The excess glucose binds to proteins, in a process known as protein glycation, causing irreversible structural changes to the skin, such as the cross-linking of collagen fibers and other connective tissue damage associated with aging. Protein glycation is a major problem for diabetics, but also occurs in non-diabetics, underlining the importance of a healthy diet.

Oestrogen: In women, the disintegration of the skin fibers is accelerated in later life by a decline in oestrogen. Collagen in the skin can fall by 30 percent during the first 10 years after menopause.