Intelligent, sensitive, emotional, capable of expressing itself, of adapting to its environment, endowed with a cellular memory and neurons...Skin is more than just an envelope. But what do we really know about it?
AT ONCE SOLID AND FRAGILE, WATERPROOF AND PERMEABLE, A BORDER BETWEEN THE INTERNAL AND THE EXTERNAL WORLD. For a long time skin has been considered a mere hide, a bodily suit designed to protect our vital organs, to register epidermic sensations and arouse sins of the flesh. Human, all too human, this secretive, contagious skin, the seat of cutaneous humours and ailments, a hive of bacteria, inhabited by more than 60 species of microscopic creatures, (yeast, fungi, arthropods). Shameful or sacred, since time immemorial it has been exhibited politically or hidden religiously. We care for it, embellish it, caress it, we examine it from every angle and dissect it to understand its underlying mechanisms. This skin that we experience, that we endure, which we have long considered a simple organ of touch, is in reality a much more intelligent and sophisticated envelope than it appears. Able to protect itself against attack, to repair itself, to adapt to its environment, to grow (and even to be replicated in 3D printing). It’s enough to make any superhero jealous. Today we are beginning to discover that it is replete with neurons and endowed with a cerebral sensitivity that is far more than skin deep.
“THE DEEPEST THING IN MAN IS THE SKIN”, PAUL VALÉRY. This sensitive tissue with a total surface area of 2m2 is a ramified system of nervous fibres connected to 5 million cm2 of sensory cells. It is the most innervated organ in the body and the “primary communication centre” according to the psychoanalyst Didier Anzieu(1) who, in 1974, first developed the idea of the “Skin-Ego”, an analytic interpretation building upon the principle that the survival of a new born depends upon the sensations registered on the surface of the epidermis. As an organ that plays a determining role in the development of human behaviour, “skin enables us to feel but also to express our experiences and to communicate our thoughts.” Science has subsequently confirmed that skin and brain share a common origin: they come from the same embryonic tissue (at 2 weeks old , the embryo has three cellular levels of which the outermost, the epiblast, will develop into the nervous system and the skin). Twins, nerve cells (neurons) and skin cells will retain a shared language and keep up a permanent dialogue made up of electrical impulses and chemical messages sent by the neurons: neurotransmitters (endorphins, adrenaline, serotonin) which inform other cells when an emotion is experienced (stress, pleasure, anger, fear). “We have identified a score of neurotransmitters shared by the skin and the brain. They enable the nervous system to be continuously informed but also to control the totality of skin functions – sudation, regulation of internal temperature, dilation of blood vessels,” explains Professor Laurent Misery, Head of the Dermatology Department and chief investigator of the laboratory of cutaneous neurobiology at the University Hospital of Brest(2). He has established that skin cells have receptors (locks) for the neurotransmitters (keys) in order to modulate their properties.
More surprising still, cutaneous cells can act on neurons. The skin is thus capable of sending messages to the brain and, reciprocally, can respond. An extension of the cerebellum, the skin expresses what we experience externally and internally. “It is clear therefore that psychic processes act on the skin (...) It is equally likely that the nervous system translates stress, emotions and thoughts into a bio-chemical language in which the neurotransmitters act as letters. They can act on the skin: inducing and curing,” explains Dr Danièle Pomey-Rey, dermatologist, psychoanalyst and pioneer of dermato-psychiatry(3) for whom the majority of skin conditions (psoriasis, eczema, acne) are psychosomatic in origin, and can only be addressed at a deep level through a combination of local treatments, antidepressants (to rebalance serotonin and thus promote skin-brain harmony) and psychoanalysis. “We cry out for help through the skin when words fail us,” says Dr Pomey- Rey, who has treated numerous dermatoses triggered by stress or an emotional shock with this holistic therapeutic approach..
“SKIN IS THE BLACK BOX OF THE BODY”
“Traditional Chinese medicine holds that dermatological conditions originate from an internal problem and that psychic activity effects organs, themselves linked to specific emotions (heart = joy, bladder = fear, liver/gall bladder = anger etc). As a result, unregulated emotions alter the body and can have as great an impact as a virus,” adds Catherine Marin, epidermatological therapist and practitioner in Chinese Medicine(4) who sees the skin as the black box of the body. “If you are in a good mental state, the five major organs function well and that is visible on the skin. Observation of the epidermis provides information in the same way as taking somebody’s pulse does: a greenish tinge under the eyes indicates biliary drainage is needed; a grey or black shading around the eyes indicate a disturbed gall bladder, a redness, a malfunction in the immune system,” explains this epidermatologist who treats the skin principally through rebalancing the diet (in Chinese medicine it is the stomach which controls the flesh and the quality of the skin) and acupuncture, which reboots the energy meridians to re-establish the skin/organ/ nervous system connection.
In 2017, body and spirit are being realigned through wellness, namely the achievement of a serene mind and a healthy body. The interior is as cared for as the exterior, since beauty is synonymous with health and skin is its mirror. In the same way that the intestine is now considered a ‘second brain,’ the scientific understanding of the skin and the increase in problems linked to stress is leading to wider acceptance of holistic wellness therapies when the epidermis is ‘burnt out’ (acupuncture, meditation, sophrology, reflexology, Ko Bi Do massage, nutritional rebalancing, gluten-free diets) in order to treat not just the consequences but the cause, to prevent rather than cure - and, in doing so, to try to gain a few cellular years.
“THE SKIN IS A BRAIN” A hypersensitive mind will have a matching epidermis; a stressed-out, ruminating brain creates physiological modifications in the skin: cellular slowing, the accumulation of free radicals, inflammation, irritation, rashes... “There is a natural link between stress and the skin: the skin is one part of the brain that interfaces with the external world. The skin is a brain, it is its manifestation in nerve form,” concludes Régis Martin, Doctor of Pharmacy, and cosmetics developer and the founder of the brand Lull. Dr Martin discovered the harmful effects of stress 16 years ago when he was an intern at hospital. “I remember a young patient whose skin was badly damaged because of burn-out. She had a greyish complexion, her skin looked lifeless, and was already clearly line. The epidermis showed signs of accelerated aging.” A fan of aromatherapy, enthused by its results in improving general wellbeing, he notes that “during the first three days of use, aromatherapeutic stimulation necessarily involves a “liberation” from the effects of stress owing to its spontaneous action”. For 15 years he has been gathering and testing a number of essential oils to find the best anti-stress formula, then combining them with active ingredients to create a holistic cosmetic product which is calming for the mind. “We entice the senses with specific scents, richly sensuous textures and ‘soft touch’ packaging” - all intended to excite the cutaneous neurons, send pleasant messages to the brain to help it unwind, and to reduce the appearance of wrinkles. It’s almost as if wrinkles were smoothed out by positive thinking.
Like the brain, the skin receives, transmits, emits and can create, for example, endorphins, wellbeing hormones, a sort of natural morphine which sends your mind into orbit and lifts the skin (have you ever noticed how much your face glows when you’re having fun, and seems rejuvenated after a reflexology session?) “These substances act in the nerve fibres and on the skin cell receptors. Now, these are the same receptors that also ensure the effective renewal of cells; they have a direct impact on the dermis and then the epidermis, since the face is the most innervated part of the body. This creates a powerful vasodilation and as a result, ‘new’ cells proliferate,” explains Dr Carlo Pincelli, Professor of Dermatology at the University of Modena in Italy. In layman’s terms, the activation of the neurotransmitters seems to serve as an excellent natural anti-wrinkle treatment. This belief has given rise, at the start of the 21st century, to ‘neuro-cosmetics’ which boasts of its ability to harness happiness to beauty creams through using highly sensuous textures, (plant-based) happiness molecules (Kenzoki), peptides which boost beta-endorphins (Lancôme Hydra-Zen) or Botox-like active ingredients which relax the neurotransmitters responsible for muscular contraction, and, therefore, responsible for wrinkles (Nirvanesque by Nuxe). Pampering the skin and exciting the senses is the primary goal of all cosmetics, but the key to efficacy is the accompanying gestures: massaging the skin increases self-esteem, reduces anxiety, boosts the immune system and improves the oxygenation of the brain(5). To touch, or not to be? That is the question. What we must remember is that speaking to one’s skin, is speaking to one’s mind. And vice versa.