The skin is composed of two major layers: a superficial epidermis and a deeper dermis. The epidermis consists of several layers beginning with the innermost (deepest) stratum basale (germinatum), followed by the stratum spinosum, stratum granulosum, stratum lucidum (when present), and ending with the outermost layer, the stratum corneum. The topmost layer, the stratum corneum, consists of dead cells that shed periodically and is progressively replaced by cells formed from the basal layer. The stratum basale also contains melanocytes, cells that produce melanin, the pigment primarily responsible for giving skin its color. Melanin is transferred to keratinocytes in the stratum spinosum to protect cells from UV rays.
The dermis connects the epidermis to the hypodermis, and provides strength and elasticity due to the presence of collagen and elastin fibers. It has only two layers: the papillary layer with papillae that extend into the epidermis and the lower, reticular layer composed of loose connective tissue. The hypodermis, deep to the dermis of skin, is the connective tissue that connects the dermis to underlying structures; it also harbors adipose tissue for fat storage and protection.
Accessory structures of the skin include hair, nails, sweat glands, and sebaceous glands. Hair is made of dead keratinized cells, and gets its color from melanin pigments. Nails, also made of dead keratinized cells, protect the extremities of our fingers and toes from mechanical damage. Sweat glands and sebaceous glands produce sweat and sebum, respectively. Each of these fluids has a role to play in maintaining homeostasis. Sweat cools the body surface when it gets overheated and helps excrete small amounts of metabolic waste. Sebum acts as a natural moisturizer and keeps the dead, flaky, outer keratin layer healthy.
The skin plays important roles in protection, sensing stimuli, thermoregulation, and vitamin D synthesis. It is the first layer of defense to prevent dehydration, infection, and injury to the rest of the body. Sweat glands in the skin allow the skin surface to cool when the body gets overheated. Thermoregulation is also accomplished by the dilation or constriction of heat-carrying blood vessels in the skin. Immune cells present among the skin layers patrol the areas to keep them free of foreign materials. Fat stores in the hypodermis aid in both thermoregulation and protection. Finally, the skin plays a role in the synthesis of vitamin D, which is necessary for our well-being but not easily available in natural foods.
Skin cancer is a result of damage to the DNA of skin cells, often due to excessive exposure to UV radiation. Basal cell carcinoma and squamous cell carcinoma are highly curable, and arise from cells in the stratum basale and stratum spinosum, respectively. Melanoma is the most dangerous form of skin cancer, affecting melanocytes, which can spread/metastasize to other organs. Burns are an injury to the skin that occur as a result of exposure to extreme heat, radiation, or chemicals. First-degree and second-degree burns usually heal quickly, but third-degree burns can be fatal because they penetrate the full thickness of the skin. Scars occur when there is repair of skin damage. Fibroblasts generate scar tissue in the form of collagen, which forms a basket-weave pattern that looks different from normal skin.
Bedsores and stretch marks are the result of excessive pressure on the skin and underlying tissue. Bedsores are characterized by necrosis of tissue due to immobility, whereas stretch marks result from rapid growth. Eczema is an allergic reaction that manifests as a rash, and acne results from clogged sebaceous glands. Eczema and acne are usually long-term skin conditions that may be treated successfully in mild cases. Calluses and corns are the result of abrasive pressure on the skin.