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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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Q&A

While we strive to reply to queries posted to us, we may not be able to answer all individually. Many of the questions you pose may be of general interest to our readers and will be addressed here.

Q: What Are the Layers of Skin? Why are they important?

January 31, 2019 By Mary L Williams, M.D. Leave a Comment

A: You are right: skin is indeed made up of 3 distinct layers, each with strikingly different characteristics and functions.

These layers are: epidermis, dermis, and subcutaneous fat. Skin diseases often primarily localize to one of these layers, which can be important for their diagnosis. Understanding the structure of skin also helps us to take better care of it.

Diagram illustrating the 3 layers of skin.
The 3 layers of skin are the outermost layer, or epidermis, the supporting layer, or dermis, and the subcutanous fat.
[Read more…] about Q: What Are the Layers of Skin? Why are they important?

Q: What Is Dermatitis? Is it The Same As Eczema?

January 15, 2019 By Mary L Williams, M.D. Leave a Comment

Q&A What is Dermatitis? It it the Same as Eczema? Answered by Peter M. Elias, M.D. & Mary L. Williams, M.D.

A: ‘Dermatitis’ vs. ‘Eczema’. Lets take these words one at a time.

Dermatitis.

‘Dermatitis’ is a non-specific term. It refers to many inflammatory skin conditions, but especially to those diseases that affect the outer compartment of skin, the ‘epidermis’. One very common type of dermatitis is atopic dermatitis, which affects ~20% of infants and children and often occurs in otherwise “allergic” individuals, who have or later on develop asthma and/or hay fever.

[Read more…] about Q: What Is Dermatitis? Is it The Same As Eczema?

5 Things To Help Sensitive Skin

November 22, 2018 By Peter M. Elias, M.D. & Mary L. Williams, M.D. Leave a Comment

Like babies, many of us have sensitive skin.
Detail of G. Bellini’s Madonna and Child in the Brera Pinacoteca, Milan, Italy. Like babies, many of us have sensitive skin. Photo by Mary L Williams.

Q: My skin seems to reactive to every skin care product I use? What should I do?

A: Here are 5 things people with sensitive skin can do to avoid problems with skin care products.

1. Caveat emptor. Remain skeptical of the marketing claims about the benefits for the skin that are promoted in advertisements. These are designed to sell you their products – not to accurately and objectively report upon their effects on skin.

2. Start Slow. Test a new product before applying it widely to your skin, particularly to your face. [Read more…] about 5 Things To Help Sensitive Skin

Q: How do I know if I have “sensitive skin”

May 28, 2018 By Peter M. Elias, M.D. & Mary L. Williams, M.D. Leave a Comment

Elias and Williams Q&A: How do I know if I have "sensitive skin"?

A: People who have “sensitive skin” are more likely to experience rashes or itching with the use of skin care products, cosmetics and soaps.

Sensitive skin means that the skin’s barrier is compromised, allowing irritating chemicals to more easily penetrate into the skin and cause reactions.

You may have “sensitive” skin if:
1. You have or have ever been told you have atopic dermatitis (AD) (“eczema”). Essentially all sufferers of AD have “sensitive skin”, even when their rash is in remission.

2. You have or have ever had respiratory allergies, like asthma or hay fever (“allergic rhinitis”). Many people with respiratory allergies have sensitive skin, even if they have never had outbreaks of atopic dermatitis.

3. Your hands are very sensitive to soaps and detergents, the skin easily becoming dry, red and even cracked.

4. Your skin is generally very dry and often itchy, especially in the winter.

5. You are 65 years or older. Beginning at age 50, skin becomes less effective in repairing its barrier after routine injuries (like those from over-bathing). As this age-related decline in function progresses, people may notice their skin is drier, more itchy – and more “sensitive”

6. If you have found that many lotions, cosmetics and other skin care products irritate your skin.

7. If you have red hair or are very pale and sun-sensitive. Because melanin pigmentation is protective to the skin barrier, people who have less melanin or the “wrong” kind of melanin (“pheomelanin”) are at greater risk for sensitive skin issues.

8.  If you are taking a statin because of high cholesterol in your blood.  Statins interfere with the body’s ability to manufacture cholesterol.  Skin uses cholesterol to form its barrier.  It makes its own cholesterol for this purpose, rather than use the cholesterol in blood.  Indeed, we demonstrated many years ago that statins can interfere with the ability of skin to manufacture cholesterol.  Although not all statins seem to be a problem for skin when taken by most patients – largely because statins exert their effect on the liver and little of the drug reaches the general circulation – in some people, sufficient quantities may reach the skin to produce dermatitis.

 

Q: Do the pores on my skin need to breathe?

May 10, 2018 By Peter M. Elias, M.D. Leave a Comment

A: There are many skin pores, but they are not for breathing – our lungs take care of that need.  The pores we see on our skin represent the openings of hair follicles and sweat ducts.  It can help to keep these skin pores open.  Sweat gland openings can become obstructed – for example, by wearing skin tight clothing when we exercise. This can result in an itchy heat rash, or ‘miliaria’,  Hence, it is advisable to avoid overdressing in hot climates, and to remove sweaty clothing and shower after exercising.

If sweat gland are obstructed over most of the body, this can  result in heat intolerance – with the risk of heat stroke. Individuals who have one of the skin disorders called ichthyosis, where the stratum corneum is too thick over most or all of their body, often experience overheating, because their sweat ducts are obstructed by the scales.

Similarly, when the pores of oil or ‘sebaceous’ glands on the face, chest and back become plugged with sebum and keratinous debri, we develop comedones or blackheads. These are often an early sign of acne. More than a few blackheads can be a sign that it’s time for a visit to our dermatologist.

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Elias and Williams Taking Good Care of Your Skin Guide logo

Image: "Taking Good Care of Your Skin" Special Report by Peter M. Elias, M.D. and Mary L. Williams, M.D.

This booklet offers up-to-date scientific information on how the skin works to keep us healthy and what we can do to keep our skin healthy and beautiful.

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INSIDE THE SKIN BARRIER

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

January 7, 2020 By Peter M. Elias, M.D.

We hear a lot about the multitude and diversity the micro-organisms – especially the bacteria - that … Read More...

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SKIN DISORDERS

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

December 1, 2019 By Peter M. Elias, M.D. Leave a Comment

Who is at risk? Many people are prone to develop dry skin. Examples include those who have or … Read More...

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REPAIRING THE SKIN BARRIER

The How and Why of Sensitive Skin

November 1, 2018 By Peter M. Elias, M.D. 1 Comment

An alarming percentage (about 60%) of normal adults, mostly women, self-report that they regularly … Read More...

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CLIMATE AND THE SKIN

The Skin’s Many Barriers and Climate Change

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

Skin's Many Barriers And How Climate Change May Affect Them Skin has many barriers: it keeps us … Read More...

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Q & A

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

December 1, 2020 By Peter M. Elias, M.D. & Mary L. Williams, M.D. Leave a Comment

Q: I have developed dry skin from COVID-19 because I have to wash my hands so often. Hand sanitizers … Read More...

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Research: From The Elias Lab

Top 5 Scientific Discoveries About Skin Of The Decade

December 26, 2019 By Peter M. Elias, M.D. & Mary L. Williams, M.D. Leave a Comment

We have learned a lot about skin and its permeability barrier in recent years.  Here are our … Read More...

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Research: From Labs Around the World

Top 5 Scientific Discoveries About Skin Of The Decade

December 26, 2019 By Peter M. Elias, M.D. & Mary L. Williams, M.D. Leave a Comment

We have learned a lot about skin and its permeability barrier in recent years.  Here are our … Read More...

MORE FROM RESEARCH AROUND THE WORLD >>

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