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Skin Is the Mirror of Internal Body and Mind | What does your reflection say?

Skin, the largest organ of our body, is the mirror and a reflection of what is going inside of you, in your body and your mind. A lot has been written and discussed about how skin being the outer layer of the body is in constant contact with the environment, bearing the brunt of weather, water temperature, pollution, dust, sand, sea, air, etc. Today let us look at skin as the line between the body, mind and the environment & the constant dialogue that happens between the two.

I often explain to my patients how beautifully nature has given us our skin, hair, and nails, that sometimes up to 10-20yrs prior start giving us signals that something is not right with our body, and that we should do course correction. So many diseases give their first signals via the skin, for example Heart Attack, Kidney or Gall Bladder Stones indicators show on some part of the skin, or change in the shape, color, or size of a mole on skin could point towards impending Cancer. Here are some commonly seen skin issues which act as first signals to future conditions: 

1. Hormonal Acne, Hirsutism & Early Hereditary Balding

There is an epidemic of hormonal imbalance around the world due to our drastically changed lifestyle. Acne is common in teenage, but we are increasingly seeing stubborn and painful acne, on the lower part of the face & neck, and acne starting for the first time at 30-40yrs of age in many patients. Besides acne, Hirsutism (growth of terminal hair in females in areas like beard, moustache, and mid riff) is also being seen. Also, commonly seen is hereditary patterned baldness (side receding, thinning front and vertex hair) on the scalp) in not just males but females too! Unfortunately, we are seeing them in as early as 20s, and in few cases of boys, before puberty as well. 

2. Acanthosis Nigricans

The thick dark skin with crisscross lines along the neck (commonly assumed to be from rubbing of necklace/chain, accumulation of dirt, that doesn’t fade with scrubbing or rubbing or facials), underarms, sides of the eyes, inner thighs, knuckles, elbow folds, etc. is called ‘Acanthosis Nigricans’. It is commonly accompanied by skin tags in the same area and stretch marks along the shoulders, calves, waistline, and thighs, This is the first marker of Insulin Resistance; a very important causative feature of Metabolic syndrome (a group of lifestyle diseases commonly attributed to western affluent/ rich lifestyle). Acanthosis Nigricans is commonly seen as early as 6-7yrs of age, so is Obesity, type 2 Diabetes, fat induced Liver problems, etc. 

3. Xanthelasma Palpebrum or Cholesterol Spots

Yellow colored spots around eyelids are linked to deranged lipid profile which can be one of the causes of high blood pressure, Heart Attack, Brain Stroke, clots in legs, etc. in future. Only cosmetic removal of these spots (with surgery or chemical peels) would be insufficient treatment if the underlying root cause is not identified and treated. 

4. Psoriasis

Psoriasis is a skin disease where skin turnover happens in 4-5 days instead of 2 months, which is the normal turnover time. Just like snakeskin, patches of skin shed at a go leaving behind red irritated patches with cuts and fissures topped with silvery white scales of dead skin. Psoriasis is a marker of Metabolic Syndrome. Patients with Psoriasis are more likely to have high cholesterol levels, high chances of Heart Disease.

5. Atopic Dermatitis

It is a type of Eczema which runs in family. If a family member has Asthma, dust allergy, Allergic Sinusitis, teary eyes (Conjunctivitis) etc., it is called atopy. Atopy can manifest on skin as itchy irritated Eczema patches on body fold areas, knee & elbow folds, and cheeks in infants, and sometimes involve the whole skin. Skin allergy has close link to gut health, just like Psoriasis, Acne and other diseases are interlinked with hormonal imbalance.

6. Urticaria (Hives)

Urticaria is called as ‘pitta’ in Hindi. We Indians commonly attribute Urticaria or hives to poor gut health and science is now confirming it. The mosquito bite-like big itchy rashes which subside in 24 hours on their own, or with consumption of antihistamines, point to poor gut health. Commonly the person suffers from constipation, bloating, acidity, etc., where their gut is not able to process proteins from allergens like dust, Eggs, cow milk, seafood, nuts, viruses, vaccines, etc.; this protein enters the blood and creates allergies. Sometimes, Urticaria can be autoimmune; especially if a person has other autoimmune diseases like Hypothyroidism, he can manifest Urticaria. 

7. Alopecia Areata

Alopecia Areata has been in news since past few days because Jada Smith has been trying to create awareness about her condition. Here, patches of baldness on the scalp which can sometimes extend to whole scalp going bald, and loss of eyebrows, eyelashes, and even body hair, is an autoimmune condition. Conditions such as this can manifest alongside other autoimmune conditions like Thyroid, Diabetes, etc. later in life or as allergies. 

8. Herpes Zoster/shingles

We all get Chicken Pox once in lifetime, and its virus lays sleeping in our nerves for life. Once in lifetime it comes out as Herpes Zoster along the area of nerve supply with painful fluid-filled vesicles on skin. Herpes Zoster usually manifests when one’s immunity is low, usually at 60-70yrs of age. In past 2yrs of the COVID19 pandemic, we Dermatologists have seen Shingles in otherwise healthy people in their 30-40s. When discussed in detail, they were experiencing tough times professionally or personally; their mental stress was the cause of lowered immunity. 

9. Recurrent Infections

Skin-like fungal infection, Candida (in genitals and body folds), and recurrent painful boils needing antibiotic therapies can be first marker of Diabetes. More sugar in your skin causes bacteria, viruses, and fungi to grow rapidly. 

10. Hair Fall (With No Balding)

It is commonly linked to nutritional deficiencies, Anemia, mental stress, disturbed sleep, or late-night sleeping (also leading to early greying of hair), vitamin or trace element deficiency, Thyroid etc.

So, it’s time we start by listening to the smallest signals that our skin gives us and begin focusing on the root cause of the problem. Listen to your skin, it is the report card of your body and mind! 

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