Obesity is a growing epidemic that affects millions of people worldwide. It has diverse effects on various body systems, resulting in physiological changes that can lead to the development of diseases such as high blood pressure, high cholesterol, and type 2 diabetes. Excess body weight puts stress on almost every area of the body's function.
Obesity (being overweight) may cause skin problems due to several factors. It has been associated with a number of skin health effects that affect the barrier function of the skin, working of the sebaceous glands, and the production of sebum, sweat glands, small lymphatic vessels, and small blood vessels under the skin.
Effects of Obesity on The Skin
Skin barrier function
Obesity greatly increases water loss through the skin. In patients with obesity, the skin is significantly drier and skin recovery from wounds is impaired.
Sebaceous glands and sebum production
Sebum plays an important role in the development of acne. It is an oily substance made to keep the skin moisturized and supple. Acne occurs when oil ducts become blocked and become infected. Acne appears to be exacerbated by obesity-related diseases.
Androgens (male hormones), insulin, growth hormone, and insulin-like growth factors are elevated in obese people. These are the common risk factors for acne.
Sweat glands
Obese patients have larger skin folds and tend to sweat more because of the thick layer of subcutaneous fat.
Lymphatic channels
Obesity blocks or slows lymph flow. As a result, lymph fluid rich in protein accumulates in the subcutaneous tissue. This is called lymphedema.
Skin blood vessels
Obesity alters blood flow to the skin, causing microangiopathy and obesity-related hypertension. Blood circulation in the skin increases in people who are overweight.
Collagen structure and wound healing
Obesity is also associated with changes in the structure of collagen. Collagen forms the structure of the skin and helps wound healing. However, obese patients rarely show facial wrinkles and skin laxity due to increased subcutaneous fat.
Subcutaneous fat
Subcutaneous fat consists of white adipose tissue. In normal people, it provides insulation and functions as an energy store. This adipose tissue contains adipocytes that secrete peptide endocrine hormones such as leptin and tumor necrosis factor. People who are overweight have excess subcutaneous fat.
Skin Manifestations in Overweight People
Obesity is associated with a number of skin diseases. They include-
Acanthosis nigricans
This is the most common skin problem in obesity. Acanthosis nigricans appear as velvety, symmetrical dark spots. It is most commonly seen in the armpits, groin, neck, elbows, ankles, and face. This medical disease is related to insulin resistance.
Acrochordons
These are soft brown papules or growths that are often seen on the neck, armpits, and groin. These are often seen in people with Acanthosis nigricans.
Keratosis pilaris
They cause the formation of spiny papules, or growths, on the outer surface of the hands.
Hyperandrogenism and hirsutism
It happens due to high levels of male hormones. These features are common in polycystic ovary syndrome and insulin resistance.
Striae distensae
These are commonly referred to as stretch marks. They are long plaques found in areas of the chest, buttocks, abdomen, and thighs. They appear as red spots that turn purple and eventually turn into white sunken plaques.
Adiposis dolorosa
This is a rare condition involving multiple, painful, subcutaneous lipomas seen in obese and postmenopausal women.
Skin Diseases Exacerbated by Obesity
Some skin conditions are aggravated by obesity and being overweight. They include-
- Lymphedema.
- Psoriasis.
- Skin infections, including fungal infections.
- Chronic venous insufficiency.
- Insulin resistance syndrome.
- Cellulite.
- Plantar hyperkeratosis.
- Tophaceous gout.
- Intertrigo.
- Hidradenitis suppurativa.
Conclusion
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