Diseases Of The Skin
( Originally Published 1938 )
We sincerely believe that enough has been said to convince the reader that the skin deserves as much care as any other organ and we hope that those of you who have been guilty of neglecting it, will hence-forth treat it with all the respect it deserves. However, for you who are known as skeptics, we have another proof of the importance of this organ, in the form of the dread diseases that may attack it and through it the whole body. And, strangely enough, some of them may be caused by as innocent an looking object as a cake of soap.
It is not for us, of course, to describe the gruesome diseases in detail. Just stop a moment and recall the pictures you've seen when furtively glancing through a textbook on dermatology, or recall the face of a friend (or your own) who was suffering from a severe case of allergy or eczema. That will be sufficient. Here we need only point out the various ways in which a skin may be affected. Two wellknown authorities sum up the causal factors in skin diseases under fourteen broad headings. Individual sensitivity or allergy heads the list. More and more the medical profession is realizing that allergy is the root, not only of much skin trouble, but of serious systemic disturbances. For this reason we have devoted an entire chapter to the subject. It will not be necessary to discuss the subject again here.
Race and nationality are also important factors in skin diseases. For instance, psoriasis is common amongst the Irish, pellagra amongst the Latins, such as the Italians, and various diseases of nervous origin among the Hebrews. Age, too, affects the skin. Advertisements, if nothing else, have impressed upon the public that acne is a condition usually associated with adolescence, being due to an oversecretion of the sebaceous glands of the skin. Likewise a form of pruritis or itching is associated with old age and still other conditions with infancy and childhood. Still other conditions are limited to one or the other sex.
Doubtlessly you have experienced some of the annoying and embarrassing rashes that break out on your skin when the seasons change or you move from one climate to another. Psoriasis and eczema, for example are worse in winter than in summer and prickly heat is worse in hot weather.
Occupation is another cause and a very important cause, of skin trouble. Dish washers, laundry workers,housemaids, bakers, etc., are all subject to dermatitis due to the materials they constantly handle, such as soap and other cleaning materials, bleaches, flour, sugar in short, anything with which the skin may come in constant contact. The reaction may be chemical or allergic.
A faulty diet may cause serious and persistent skin trouble, such as pellagra and scurvy. These types of dermatitis are considered fully in the chapter on vitamins. Various foods, too, may produce hives, redness and swelling, as we shall see when we come to the study of allergies. Drugs taken internally frequently cause eruptions on the skin. Bromide and luminol rashes are quite common. Moreover, drugs merely applied to the skin may be highly injurious sulphur, cresol, carbolic acid, etc. This, too, is often an allergic condition.
Internal secretion disturbances may produce abnormal skin conditions, and circulatory disturbances may produce varicose veins, eczema or ulcers.
Boils are caused by bacteria and ringworm and similar diseases are caused by fungi. In this connection it should be remembered that dermatitis caused by any of the other factors opens the way for invasion by bacteria.
Prolonged exposure to the sun's rays produce sun burn, freckles and more serious inflammatory conditions which sometimes involve the whole organism. Blonds are more likely to be subject to such disturbances than brunettes. It should be pointed out here that the color of the hair and eyes has nothing to do with the scientific classification of blond and brunette. One may have black hair and still have a blond skin with its sensitiveness to the sun's rays and a tendency to dryness.
The form of skin irritation which is probably of greatest interest to us at the present moment, since soap is one of its major causes, is known as "contact dermatitis". It is also known as trade or occupational dermatitis or eczema. Its manifestations are familiar to all of us. They vary from a mild itching and scaling and redness to actual pain, swelling, inflammation, even cracks, lesions, vesicles and ulcers which are not only unsightly and pain giving, but which pave the way for bacterial invasion and disturbances of a serious constitutional order. And it must be remembered that the vast majority of skin troubles are usually mild in the outset and that this mild condition is nothing but a warning of impending disaster if steps are not taken at once to remedy it.
While all contact dermatitis, as the name implies, is due to the contact of the skin with a given' substance or a combination of substances, the reaction may be one of several. It may be purely physical. That is, it may be due to some abrasive substance, such as pumice in soap, which may scrape and tear away the outer covering of the skin, exposing the more delicate inner layers to the invasion of bacteria or harsh chemicals. Or it may be due to weather conditions, as chapping in winter. Again, the reaction may be chemical or physicochemical. For example, carbolic acid and cresol (which are often found in so called deodorant soaps) may actually burn the skin. And sometimes, as we mentioned above, the reaction may be allergic. Orris root, to take a common allergen,which is found in many cosmetics and soaps, causes an allergic reaction in a large number of persons.
More will be said of contact dermatitis and allergy anon. Here it is only necessary to emphasize that one form of irritation opens the door for other forms and forms of a more serious nature. For instance, if a person is suffering from an allergic condition due to contact with a perfume such as bergamot, which causes many cases of allergy, the resistance of the skin is lowered and the way is paved for various other diseases. Nor is this fact only true of those forms of irritation which may be definitely classed as occupational dermatitis. Doubtlessly you have suffered from the painful annoyance of ordinary chapping in cold winter weather. The chapping is due, in this instance, to the unnatural dryness of the skin caused by the cold. Chapping may also be caused by too frequent washing, especially with strong soaps, or by the failure to dry the parts thoroughly. Naturally, a chapped skin has not the resistance that a healthy, well-oiled skin has, and is therefore subject to external irritants, and more liable to infection.
Chapping, whether due to cold weather or to harsh soaps, is not the only cause of lowered skin resistance. The coming on of occupational rash is hastened weeks by hyperidrosis or excessive perspiring, and months by seborrhea or excessive fat secretion. High temperatures or strenuous exercise causes the body to sweat freely. The sweat, which is normally acid in reaction, becomes markedly alkaline in reaction and dissolves out and washes away the natural fats of the skin. Under these conditions even bland dusts may become irritants. Recall, too, that sweat is favorable for the growth of bacteria, some molds and wild yeast. Moreover, working in a moist or dry heat, especially if added to strenuous exertion, produces congestion and abnormal activity of the skin glands. Prickly heat is the result.