It's Only Skin Deep

But it's deeper than you think

Skin is something more than a sack full of a person's parts. It is a reactive and vital organ, with a number of essential functions beyond simple containment.

In the news recently was a story about our youngsters' not getting enough exposure to sunlight to make vitamin D work properly. Indeed, kids spend lots of time indoors (computing, video game playing, TV watching) and when they do venture out, their concerned parents lard them up with sunscreen. Preventing UV light exposure interrupts the complex relationship between vitamin D, calcium, and bone health. Kids with osteoporosis, would you believe?

The pediatric endocrinologists now say an hour a day in the sun is needed (two hours for deeply pigmented skin which absorbs UV light poorly). Dermatologists are already in something of a stew. Balance is the solution - just a bit of sun, but not too much.

Interestingly enough, this bit about sun and vitamin D came to our attention shortly after word got around that people (kids, mostly) were not using sun-screen properly or adequately, and thus were at risk for multiple skin cancers in future years. Ok, what now?

There still exists widespread accord that risk for skin cancer is variable, based on skin and hair coloration. Deeply pigmented skin is less susceptible to all forms of cancer for obvious reasons - it doesn't absorb as much UV light. Persons of northern European ancestry, particularly those with red hair and freckles, are at high risk for all forms of skin cancer. Doesn't matter what the endocrinologists say, there is little reason to subject Little Orphan Annie types to sunlight deliberately. Extra intake of vitamin D and calcium should keep them from the consequences of osteoporosis.

Something else happens to skin fairly commonly as a result of sunlight combining with certain medicines. Some antibiotics and sulfas as well as drugs for diabetes and hypertension will in many patients produce skin rashes, redness, or hives, if the victim is exposed to UV light. The reaction may occur rapidly, after only a few doses, and it will last until well after the drug is stopped (perhaps a few weeks).

Some drugs have a long life in the human body - they just hang around and hang around - and if there is a skin reaction, it won't subside rapidly. It also won't get much better with creams and / or ointments. The reaction is a systemic process, and the only cures are time and, for severe cases, cortisone type agents. (A problem with using cortisone is that it will make diabetes worse, and for many infections being treated with antibiotics, might obscure developing complications and delay proper management.)

Young skin is tough, elastic, heals quickly, and functions admirably under a variety of circumstances. Old skin is --- well, you know, not quite so admirable.