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Elias and Williams: The Inside-Out of Skin by dermatologists and skin researchers Peter M. Elias, M.D. and Mary L. Williams, M.D.

The Inside-Out of Skin

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WELCOME TO ELIAS & WILLIAMS

Are you curious about skin - how it works or what it does? Have you wondered why some people have strong and healthy skin, while other people’s skin is easily irritated and prone to rashes?

Peter M. Elias, M.D. and Mary L. Williams, M.D., dermatology experts on the Inside-Out of Skin

We, Peter M. Elias, M.D. and Mary L. Williams, M.D., are professors of dermatology and skin scientists who have spent our careers learning how the skin works in our laboratory and treating children and adults with skin disorders in our clinics. Here, we offer up to date and scientifically sound information about skin and how it works everyday – quietly and efficiently - to keep us well, and what is happening in our skin, when it is unwell.

We believe that, just as there is more to owning and operating a car then simply filling the gas tank and turning on the ignition, so, too, if we understand how the skin operates, this knowledge will make us better stewards of its health and beauty.

We provide both in-depth articles based upon the latest scientific understanding and research, as well as answers to some of the most commonly asked questions about skin. Whether you are just a curious person, or a parent with a child suffering from a skin disorder, or a practitioner in the skin-care industry, or a health care provider, we believe you will find here new and surprising information.


Taking Good Care of Your Skin Cover | Free Guide by Peter M. Elias, M.D. and Mary L. Williams, M.D.

We offer our Special Report: Taking Good Care of Your Skin

This booklet offers up-to-date scientific information on how the skin works to keep us well and what we can do to maintain its health and beauty.

Yes, Send Me the Guide

Featured Article

The Skin’s Many Barriers and Climate Change

October 9, 2020 By Mary L Williams, M.D.

Ancient Fishapods, the earliest vertebrates to leave the seas for life on dry land, can teach us about the evolution of skin's many barriers, especially our waterproofing barrier that prevents the loss of water from our cells to the dry atmosphere. (Tiktaalik roseae by Zina Deretsky, Courtesy: National Science Foundation)
Fishapods – fish-like creatures using fins as legs – were the earliest vertebrates to attempt life on dry land. Drawing of Tiktaalik roseae by Zina Deretsky, courtesy: National Science Foundation

Skin’s Many Barriers And How Climate Change May Affect Them

Skin has many barriers: it keeps us waterproof, it holds back invading microorganisms, and it protects us from mechanical injury, from toxic rays of sunlight and foreign chemicals in our environment. Each of skin’s many barriers may be impacted as our environment changes as a result of global warming. To understand how skin will have to adapt to climate change we need to consider how these barrier’s work to keep us well.

The Skin’s Water Barrier Came First

Life on our planet began in its seas – a warm womb with a salinity that is close to that of a cell’s interior. But upon leaving the osmotic neutrality of the seas for life on land, our fish-like ancestors, the fishapods, suddenly would have encountered an entirely different world. There they faced a steep osmotic gradient between the much drier air outside and their water-based interior. They now required a water-proof covering to prevent the otherwise inevitable dehydration.

With that first step onto dry land – dawned a new evolutionary imperative, for them and for all their progeny who would follow.  They required a means to prevent the loss of water from their cells into the arid atmosphere that now surrounded them. 

Thus, before the grand experiment of terrestrial life could truly begin, this imperative – the need for a water barrier – had to be solved.

Indeed, all land dwelling species have had to evolve a water barrier on their external coverings (or ‘integuments’) – from the cuticles coating the leaves of plants, to the exoskeletons of insects, or to the scales of reptiles and to our human skin – in order to maintain their water-based way of life in a dry world. 

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INSIDE THE SKIN BARRIER

The Skin Microbiome: Good Bugs And The Bugs That Bug Us by Peter M. Elias, MD, dermatologist and skin scientist | EliasandWilliams.com

The Skin Microbiome: Good Bugs And The Bugs That Bug Us

By Peter M. Elias, M.D.

We hear a lot about the multitude and diversity the micro-organisms – especially the bacteria - that populate our stomach and intestines. We learn that these bugs living on and in us account for a …

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REPAIRING THE SKIN BARRIER

The How and Why of Sensitive Skin | Dermatologists and skin researchers, Peter M. Elias, M.D. and Mary L. Williams, M.D.

The How and Why of Sensitive Skin

By Peter M. Elias, M.D.

An alarming percentage (about 60%) of normal adults, mostly women, self-report that they regularly experience ‘sensitive skin’. Most perceive ‘sensitive skin’ as various amounts of stinging, burning, …

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SKIN DISORDERS

Dry Skin: Who Is At Risk and What Can Be Done About it? by Peter M. Elias, MD, dermatologist and skin scientist | EliasandWilliams.com

Dry Skin: Who Is At Risk and What Can Be Done About It?

By Peter M. Elias, M.D.

Who is at risk? Many people are prone to develop dry skin. Examples include those who have or have in the past had atopic dermatitis. This is a common form of eczema that affects up to 20% of the …

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MORE FROM SKIN DISORDERS

CLIMATE AND THE SKIN

COVID-19, Climate Change and The Skin: Q&A with Mary L. Williams, M.D. Dermatologist and Skin Scientist | Mary L Williams MD | EliasandWilliams.com

Q&A: COVID 19, Climate Change, And The Skin

By Mary L Williams, M.D.

Q: COVID-19, climate change and skin? Are they related to each other, and if so how and why? A: Let's look first at COVID-19 and climate change, and see how they are and are not …

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Q&A

Q&A: Preventing Dry Skin From COVID-19 Hand Washing And Toxic Hand Sanitizers | Mary L. Williams, MD, UCSF skin scientist and dermatologist | EliasandWilliams.com

Q& A: Preventing Dry Skin From COVID-19 Hand Washing And Toxic Hand Sanitizers

By Peter M. Elias, M.D. & Mary L. Williams, M.D.

Q: I have developed dry skin from COVID-19 because I have to wash my hands so often. Hand sanitizers are even worse in drying out my skin and, anyway, I’m afraid to use them because I’ve heard they’re …

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FOR PROFESSIONALS

Top 5 Discoveries about Skin of this Decade | Peter M. Elias, MD and Mary L. Williams, MD | EliasandWilliams.com

Top 5 Scientific Discoveries About Skin Of The Decade

By Peter M. Elias, M.D. & Mary L. Williams, M.D.

We have learned a lot about skin and its permeability barrier in recent years.  Here are our picks for the top 5 discoveries about skin of the past decade.  Some of these arose from work in …

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MORE FROM FOR PROFESSIONALS

THE STORY OF EPICERAM®

EpiCeram® a barroer repair treatment for atopic dermatitis

What Is EpiCeram®? EpiCeram® emulsion is a barrier-repair formulation, which is available by prescription only. It offers a unique, cortisone-free, topical therapy for patients with eczema and atopic dermatitis. EpiCeram® was developed based upon research from the Elias laboratory. Our research group has been concerned for many years with uncovering the means whereby skin prevents water from escaping out of the body – its permeability barrier. The Science Behind …

LEARN MORE about The Story of EpiCeram®
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