Director, Emergency Services, Bikur Cholim Hospital
Let's talk about the biggest "organ" in the body: your
skin.
This remarkable device is indeed dead — that is, not
alive. It is the product of special cells that produce
elastin and collagen. This forms a cover to your body that is
impermeable to liquids, keeps out germs and dirt, and moves
and stretches with you.
Skin has in it a rich array of nerves and melanocytes which
are cells that produce pigment (color). It has pores that can
release fluids to cool off the skin such as in sweating, but
do not allow water in. Hair follicles abound. Why is this
important?
First the nerves. The skin has the ability to warn you about
too hot, too cold, and too sharp. The inside of your body
does not have as many nerves, and indeed in surgery, bleeding
is often controlled by burning the blood vessel and it
doesn't hurt since you do have a rich array of nerves.
Sometimes skin reaches into the body, in particular in two
places: the anus and the ear. The anus is why hemorrhoids
that are on the outside hurt so much, while ones in the
inside are painless. The ear is significant since foreign
bodies in the ear hurt, while in other places, like the nose,
the pain is much less.
Melanocytes keep your color the way it should be. Obviously
people with darker skin have more of the cells. Those with an
absence of cells are called albinos and are extremely
sensitive to sun. These cells also react to sun exposure to
make a tan. As you get older, these cells become less active
and you have less elastin in your skin. Thus you have gray
hair and wrinkles.
So with that introduction of the beauty of skin, let us give
you some information about this amazing organ. First: we now
know that too much sun exposure can be dangerous. Skin can
show precancerous changes like darkening spots. But once
ulcers develop it can be skin cancer, and it needs
treatment.
Fortunately treatment is easy. These lesions can be removed
by surgery, burning them off, or freezing them off. However,
if one of the melanocytes turns cancerous, it can spread
through the body fast and it can kill.
This cancer is called melanoma. It is more common in light
individuals with extensive sun exposure. Therefore, if you
have dark spots or freckles and there are color changes or
black spots — check them out. Avoid tanning salons and
use a strong sunscreen.
Skin is full of bacteria who live on any dead layer, so hand
washing is important. Wetness on skin, especially in the
summer in skin folds, is a risk for fungus. This is a problem
in diabetics who must keep their feet dry and must also check
the dryness between their toes. Loose-fitting, breathing
clothes such as cotton will prevent wetness, but you may need
absorbent powder or an antiperspirant.
Tattoos come from the injection of dye beneath the skin layer
which is permanent. Many baalei teshuva must deal with
this, as well as tattooing that can occur from other sources
such as road rash (sliding on concrete) or being stuck with a
pen. Tattoos can be removed, but it is difficult.
We have discussed acne before. By the way, physicians cannot
explain why babies have soft skin and why kids have freckles.
They serve no purpose other than making them cute.
And while we are on the subject, let me deal with another oft
asked question from yeshiva guys. Shaving your beard does not
make it grow in stronger or fuller. But on the positive side,
there is some hope for baldness, but that is for another
time. Write me in care of the Yated.
