Skin deep: Healthy skin comes from the inside out

How much do you know about your skin?

Your skin is the remarkable interface between the world outside of the body and the world inside the body. There is a continuous dialogue between what is happening outside and what is happening beneath the skin.

Living on our skin and in our gut, we have a unique ecosystem of billions of bacteria, viruses and fungi and other organisms.  In the past these have been seen as things we need to remove from our skin but this understanding is changing rapidly.  

We know that healthy skin needs a balanced and diverse community of microbes. It’s also why overuse of antibacterial skin products such as hand sanitisers is best avoided if possible.

What we notice on the surface of our skin is only the tip of the iceberg, good skin health comes from the inside out. It takes around 40-56 days for the innermost layers of skin to work themselves outwards to the outmost layers.

Improving skin health isn’t a quick fix especially where skin issues are long-standing. It usually takes patience and some persistence. We hope that your Skin Health Check will prove to be a useful tool to monitor yours.  

📲Not taken the questionnaire yet? Download the Evergreen Life app and get notifications when a new questionnaire is available that helps you stay informed on your health and wellbeing.  

Very often skin health relies on topical application of products to the skin surface, such as moisturising creams, ointments, serums and topical steroids. Whilst this is essential for managing skin conditions and flare-ups, by itself it’s limited, since skin health is built more from the inside out than vice versa.  

This article discusses some things you might not know about skin and explores those things that influence it the most.  There are very many essentials for a healthy skin, and what one person needs is not the same as the next person; its highly specific to the individual. Good skin health like good health and wellbeing is a stack and requires a combination of favourable conditions for best results.  

Your skin is affected by:  

  • Your unique microbiome – the make-up of organisms that live on your skin and in your gut
  • Your diet - the source of the ingredients necessary to build a healthy skin  
  • Your genetics – including those genes influencing detoxification and those influencing the barrier properties of the skin  
  • Your exposure to foreign chemicals we encounter in our everyday environment
  • Your stress levels
  • Sunlight

Skin function

The skin is the largest and one of the most important organs in the body in terms of size, function and sheer versatility It protects us from harmful chemicals, excessive sun, water loss and infections.  The skin is a formidable barrier; it keeps the outside out and the inside in. It allows us to feel pleasure, warmth, pain. It is involved in communication between people; the way in which we see and are seen in the world and when its less than healthy it can impact our quality of life, self-esteem and our happiness.

The skin is not a perfect seal. It has holes through which there is an exchange of substances and water. It regulates body heat and eliminates toxins. The skin is the largest detoxification organ in the body, through sweating and shedding skin cells.  

The outermost layer of the skin is made up of 15-20 layers of dead cells called corneocytes. The outer layer contains a substance known keratin which gives it structure.  

These dead cells shed constantly, they rub off and flake and are continuously replaced with new ones. Every 30 days, your body produces a totally new outer skin layer.

The skin has many thousands of sense receptors that notice and signal what is happening in our environment. Our skin responds to vibration, pressure, pain and touch. It senses light and turns energy from sunlight into crucially important vitamin D.  In total the skin weighs 10-15lb with a surface area of approximately 1.5-2m.

Skin microbiome

The outer layers of the skin are home to billions of bacteria, viruses, fungi and other organisms which live in happy co-existence most of the time, helping to maintain a healthy barrier. Around 10 billion microbial cells on each of us.  

These organisms communicate with our skin cells and our immune system to signal how to protect us from pathogens as well as how to heal from injury.  Microbes are able to alter the amount of sebum the skin secretes which in turn protects and lubricates and provides an antibacterial shield.

The precise balance and diversity of species that make up a healthy skin varies from body site to site and when upset can lead to infections and skin disorders.

Since 2008 the Human Microbiome Project has looked at microbes in five areas of skin, the nostrils, mouth, gut, vagina, and urogenital tract. Moist regions such as the navel or armpits harbour Staphylococcus and Corynebacteria species.  Sebaceous (oily) sites have different bacteria, commonly Cutibacterium acnes which influences sebum production. When it’s out of balance it is linked with acne.  Dry areas are more diverse and changeable. What this research reveals is that skin microbes have benefits.  e.g. Staphylococcus epidermidis produces a secretion that reduces inflammation and speeds wound healing. S. epidermidis also inhibits the highly pathogenic S. aureus, resistant strains of which cause hospital-acquired infections known “MRSA.”  

What was strange and most surprising, was that most molecules on the skin are newly discovered and previously unknown, which illustrates just how much there is still to know about our amazing skin.  

Overuse of hand-sanitisers and antibacterial skin products

Frequent use of hand-sanitisers and other antibacterial skin products disturbs this crucial skin barrier by altering the balance of the microbial ecosystem and strips the skin of beneficial bacteria.  It can also lead to antibiotic resistance. In some countries, steps are being taken to ban some common chemicals e.g. triclosan, used in antibacterial wash products. Best to stick with plain soap and water.

Skin hydration

Too much washing and the over-use of harsh soaps also depletes the natural oils that make up the skin’s barrier, which the skin needs to be properly hydrated.

For the skin to function properly as a barrier it needs adequate hydration - we lose water continuously through the skin. This is not sweat from pores but losses through the skin itself, all over the body. Someone with skin in good condition can lose up to 750ml of water every 24 hours.

If the skin is damaged in any way, water losses increase. Drinking plenty of water to maintain hydration makes good sense. Hydration is a key indicator of skin health which we will be returning to in the next skin health article, where we will discuss the best ways to hydrate the skin.  

Chemical and environmental sensitivities

The skin is also able to absorb many substances directly. It’s the reason why many drugs can be given as patches since they are able to cross the skin, e.g. nicotine patches used for smoking cessation.

👃🏻A simple demonstration that you might like to try is to cut a clove of garlic in half rub it on the skin without inhaling and within a few short minutes the smell can be detected on the breath.

This means that things we put on our skin can easily be absorbed into the body including chemicals and foreign substances that can be harmful. There are thousands of foreign chemicals in our industrialised world; substances that our bodies have not evolved to deal with. Contact with such agents can give rise to skin reactions and uncovering what those that might be requires a certain amount of detective work and sometimes professional help.  

It’s a good idea to pay attention to the ingredients that you place on the skin and avoid those with long and complicated lists of ingredients – better still make you own from ingredients that you know and recognise.

In a similar way the components of the food we eat and the additives, preservatives and flavourings as well as different types of proteins and sugars can affect our skin if we have insufficient means to deal with them. Common food sensitivities include e.g. gluten, lactose, eggs, vegetables from the nightshade family such as tomatoes and bell peppers.  

Skin nutrients

Due to rapid turnover, new skin cells need to be made constantly. This continuous demand requires lots of ingredients. When nutrients are in short supply and the skin being a low priority organ, nutrients will be diverted elsewhere in order to maintain other more essential processes in other areas of the body.

To function properly the skin has a particular demand for certain vitamins and minerals, essential fats and importantly, protein. If any are lacking in the diet, or occasionally if present in excess, it can affect the health of our skin. Without the necessary nutrients the skin will develop a variety of responses including rashes, itching, acne, pimples, infection or eczema.  

💡Nutrients known to be required for good skin health are widely varied and large in number. To name a few... they include the Vitamin A family, Zinc, Vitamin C, Omega 3 fatty acids, Biotin, Selenium, Silica, Niacin, Vitamin K2, Probiotics, Sulphur, Vitamin E, Pantothenic acid, Collagen, Ceramides, and hyaluronic acid... Phew! Did we say a few?

Of those Collagen Is the most common protein in the human body. It is responsible for structure, stability and strength within the layers of the skin. As we age, collagen and elastin in the skin decreases and this process is accelerated by over-exposure to the sun. Collagen is a common ingredient included in nutritional supplements and products marketed for skincare and there are studies in the literature of its effectiveness in improving skin health.  

Skin and stress

Stress levels, especially chronic stress, affects every area of health which often appears visibly on the skin. This may be because resources are being diverted elsewhere to support the stress response. Increased levels of the stress hormone, cortisol leads to an increase in oil production which can lead to acne breakouts, perhaps to prevent the body from pending infection in a conflict.

😰Increased levels of stress hormones are linked with other skin conditions such as psoriasis and atopic dermatitis, where flare-ups are more likely. Chronic stress may even accelerate skin ageing.  

People under emotional stress recover much more slowly from skin problems and existing skin problems become worse. Negative emotions affect the immune system and cause inflammatory changes via inflammatory compounds known as cytokines which predisposes to inflammatory skin diseases and making them worse.  

Skin and your genetics  

Your skin health is influenced by your genetics. There are DNA tests that can report your risks of collagen degradation, stretch marks, rate your skin ages, moisture and sensitivity to UV radiation from sunlight. These are the areas included in our Evergreen life DNA test some of which are also in your skin health check e.g. your skin type and propensity to burn.  You might be interested to discover if your genetic profile of skin health accurately reflects your experience.  

It’s another piece of the puzzle, to learn more about skin health. Your DNA is not your destiny simply your predisposition. Environmental factors – a nutrient diet rich especially in antioxidants and protein, exercise, good hydration, avoiding sunburn, smoking and alcohol are major determinant of your skin health.  

This article and questionnaire are for educational and informational purposes only and are not a substitute for professional advice, diagnosis and treatment of those with established skin conditions. Getting expert advice from your GP is and should remain your first port of call.