- The Washington Times - Sunday, July 1, 2007

It weighs about 9 pounds, darkens in the summer and wrinkles as the body ages. It is also the body’s largest organ. Yes, the topic is skin, but let’s go beyond the importance of applying sunscreen in the summer — an otherwise hot topic during sizzling July and August — because skin and what it represents goes well beyond the only skin deep.

“Skin reflects our age, ancestry and state of health — and we manipulate and adorn it to convey things about ourselves; to make us unique,” says Nina Jablonski, author of “Skin — A Natural History.”

“Skin means something to us both culturally and biologically,” adds Ms. Jablonski, professor and head of the department of anthropology at Pennsylvania State University.

One of the ways we manipulate our skin is by plastic surgery. Americans spent more than $12 billion in 2006 on invasive and noninvasive cosmetic procedures, according to the American Society for Aesthetic Plastic Surgery, a national professional organization of plastic surgeons.

“Nonsurgical procedures are becoming very popular,” says Dr. Foad Nahai, president of the American Society for Aesthetic Plastic Surgery.

“They are safe and effective, relatively inexpensive, and there is very little downtime,” adds Dr. Nahai, who is in private practice in Atlanta.

These nonsurgical procedures include injections of Botox (a toxin used to relax facial muscles and smooth the skin) and fillers (fat used to puff up and smooth the skin).

It used to be that patients focused only on the face for these procedures; now the treatments are becoming more common in other areas of the body.

“One of the yardsticks I used to use at cocktail parties was, ‘Do the hands match the face?’ and if they don’t, the person has had something done,” Dr. Nahai says.

You can’t do that as easily anymore, he says, because patients use fillers in their hands.

The future? We will be spending upward of $25 billion on cosmetic procedures, says Dr. Nahai, who adds that he anticipates anti-aging procedures being performed at a cellular level within a few years.

“It will become much more scientific,” he says, adding that — aside from cellular manipulation — radio frequency will be used to heat subcutaneous collagen to tighten the skin.

But before getting too sci-fi, let’s go back to where it all started, namely the evolving properties of human skin going back millions of years. One major aspect of human skin that separates it from that of other mammals is its relative hairlessness.

Theories abound about the origins of this unique lack of hair, Ms. Jablonski says. The most supported one, though, is that hairless skin enables sweat to cool the body faster than hairy or furry skin. This cool-down system is essential for us restless and active humans.

“Our brains were bigger than other mammals’ and our grapefruit-sized brain needed to be maintained at thermo-equilibrium,” Ms. Jablonski says.

If our brain temperature rises just a few degrees above the normal 98.6 — 106 degrees — we die.

“Without that efficient cooling mechanism, we wouldn’t be where we are today,” Ms. Jablonski says.

Another aspect of skin evolution is pigment. We talk about race today, Ms. Jablonski says, but the issue really comes down to pigment. Lighter-skinned people migrated from Africa to Northern Europe, where their skin adapted — lightened — to the fewer hours of sun they got.

It’s all about survival and practicality: Lighter skin allows for a faster production of vitamin D, which is essential to human well-being and health.

People with dark skin who move to, say Scandinavia, must take vitamin D supplements because the pigmentation slows the process of producing the vitamin, she says.

“Even in this day and age, we are shackled by the dictates of our biology,” Ms. Jablonski says. “Skin color relates to vitamin uptake.”

While vitamin deficiency can be an issue for dark-skinned people who move north, they fare a little better in the sun-ray-protection realm than light-skinned people do.

“There is a genetic factor in skin cancers,” says Dr. Sandra Read, a Washington dermatologist and member of the American Academy of Dermatology.

Persons with blond hair and blue eyes are at a high risk, but no one is exempt, Dr. Read says.

“Everyone has to be careful. Everyone needs to take care of their skin,” Dr. Read says. “Bob Marley, for example, died of melanoma.”

Unfortunately, Dr. Read says, we tend to take our skin for granted until something goes wrong, including developing skin cancer, a condition she says is rising rapidly in the United States.

“A lot of people don’t know this, but about 10,000 people die of skin cancer every year,” she says.

In addition, about 1 million new cases of skin cancer are treated each year. Patient groups on the rise include children.

“The rate of increase is terrifying,” Dr. Read says. “It’s an epidemic.”

She recommends staying out of the summer sun during the peak hours — 10 a.m. to 4 p.m. — wearing sunscreen with an SPF of 15 or higher, wearing a hat and staying in the shade.

“People don’t realize that skin is the biggest organ of the body and we really need to take care of it,” she says. “The skin is not just a bag that holds together everything else. … It’s a complex, intricate organ.”

This organ also is a canvas. Chris Rainier, a photographer with National Geographic, has traveled the world documenting with his lens various tattoo traditions.

Some, like the Japanese yakuza, or mafia, tattoos are often full-body tattoos that can take two years and upward of $200,000 to complete, he says. Conversely, Ethiopian Christians mark only a small portion of their body — usually the forehead — with a cross.

But while tattoos look very different depending on where you are in the world — New Zealand is famous for mokos or facial tattoos; in Thailand tattoos often include depictions of elephants — they often have a similar objective: making a statement about the person and the culture to which he or she belongs, Mr. Rainier says.

“They’re a reflection of themselves, their families, their village, maybe even their totem,” Mr. Rainier says.

The epicenter of tribal tattooing, Mr. Rainier says, is Samoa in the South Pacific, where tattoos often depict the traditional Samoan canoe. The tradition there never really went away, while in other parts of the world — with the spread of Christian missionaries in the 18th, 19th and 20th centuries — it took a long hiatus until just a few years ago.

“Tattoos are experiencing an amazing resurgence all over the world,” Mr. Rainier says. “Even in Western culture, it’s becoming very mainstream. It’s not just the motorcycle gangs and the sailors.”

Why this popularity among Westerners, where the tradition never has been that strong?

“I see it as a crisis of identity. Wanting to belong,” Mr. Rainier says. “It’s the feeling that religion doesn’t work, but you want to connect to something. … Some people believe that body markings help them connect.”

Connecting in terms of human touch is another hot topic that relates to skin, Ms. Jablonski says.

“Touch is very important to humans — for our physiological and emotional well-being,” she says. “So, what’s happening today when people are literally out of touch with each other?”

We miss it, and we crave it, she says. That’s why touch and feel elements, such as sensors that could be implanted under the skin, are being developed for the virtual world where people spend more and more of their time, she says.

“The fact remains that people really need this kind of thing,” she says. “There’s much more feedback and satisfaction if you can also touch and feel while you’re in a virtual chat room.”

Ms. Jablonski’s own favorite aspect of skin is its pigment. She says she hopes her “guidebook on skin” can help demystify skin color a bit.

“It’s an aspect of our differences that has been magnified as a criteria to sort people out,” she says, “but a dark pigment is a simple filter against the sun. It has nothing to do with other aspects of our bodies.”

In other words, we shouldn’t let this aspect of skin get under our skin?

“I hope we can obsess about it less when we can look at it in a straightforward way.”

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