Instant Genius - What does our skin tell us about ourselves? – Dr Monty Lyman

Episode Date: August 28, 2019

The largest organ in the body isn’t the lungs or the brain, but the skin. Our skin performs a vast array of functions for us, from protecting us from disease to helping us make friends. Dr Monty Lyman, author of The Remarkable Life of The Skin (£20, Bantam Press), calls skin the ‘Swiss Army Organ’ because of all the tasks it carries out. Monty talks to BBC Science Focus Online assistant Sara Rigby about what the skin is for, why vanity is good for you, and what kind of creatures inhabit our skin. We now have more than 75 episodes of the Science Focus Podcast, each of which is still well worth a listen. Here are a few that you might find interesting: Is an implantable electronic device the future of medicine? – Gordon Wallace What is your brain doing while you sleep? – Dr Guy Leschziner Is the cure for cancer hiding in human breast milk? – Professor Catharina Svanborg Is gene editing inspiring or terrifying? – Nessa Carey Can we slow down the ageing process? – Sue Armstrong Is body positivity the answer to body image issues? – Phillippa Diedrichs Follow Science Focus on Twitter, Facebook, Instagram and Flipboard Hosted on Acast. See acast.com/privacy for more information. Learn more about your ad choices. Visit podcastchoices.com/adchoices

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Queen Cleopatra of Egypt who is famed for her beautiful skin, had 700 donkeys, a stable of 700 donkeys who provide milk in which she would bathe. And there is a little bit of science behind that because some of the acids in milk and in some citrus fruit, alpha hydroxy acids, actually have a sort of an exfoliating effect on the skin. You're listening to the Science Focus podcast from the BBC Science Focus magazine team, with the UK's best-selling science and technology monthly, available in print and in several digital formats throughout the world.

Find out more at sciencefocus.com or look out for us in your app store. Hello and welcome to the Science Focus podcast. I'm Alexander McNamara, online editor at BBC Science Focus magazine. The largest organ in the body isn't the lungs or the brain, but the skin, and it performs a vast array of functions for us. Some, like protecting us from disease, seem pretty obvious, but there are other, less obvious uses for our skin such as helping us make friends. Dr. Monty Lyman is the author of The Remarkable Life of Skin, which, was recently announced as one of the six books on the prestigious Royal Society Science Book Prize. He calls the Skin the Swiss Army Organ because of all the tasks it carries out. And in this week's episode, he talks to BBC Science Focus online assistant Sarah Rigby

about what the skin is for, why vanity is good for you, and what kind of creatures inhabit our skin. What made you so interested in studying skin? That's an interesting, interesting point. A lot of my medical colleagues, and friends generally either often think of the skin as either a bit boring or just a bit gross. But I found skin fascinating as a medical student because you can, I felt that you could sort of see the skin as a way of reading the body, seeing symptoms that tell you a little bit of what's going on underneath. and I found the skin fascinating in when I realized that it's not only really interesting physically, but it's also a very psychological and social substance.

I realized that when I went on a medical trip to Tanzania and I was studying albinism, a genetic condition where people don't have a melanin, which is the pigment that blocks out sunlight in the skin. So their skin's white. And I was searching the skin of this young

person with albinism called Danny. And I was looking for potential areas of skin cancer or pre-cancerous areas that I could either cut away or blast away with liquid nitrogen that we had in the clinic. But the more I spoke to him, the more I realized that he wasn't interested in the fact that because he didn't have melanin, he was at such a great risk of having skin cancer.

But as he began to speak to me, I realized that he was much more worried about his fellow man, because in that area of Tanzania, especially over the last of 10, 15 years, lots of young albino people have been taken away from their families, often by family members killed and their body parts used as medicines by local witch doctors. And it just completely fascinated me that one genetic change in one gene that just affects the amount of pigment in someone's skin completely changed their life physically,

but also socially. And that's sort of what I find completely fascinating about the skin is that it's physical, but it's also psychological and it's social. So a lot of us would think of skin as just something that keeps the insides in and the outsides out. So how is it important, as you say, psychologically and socially? So there are lots of ways in which our skin is a huge communicator. So it's our most visible organ and it's fascinated scientists for centuries. One example could be blushing.

Often we get really frustrated by blushing and don't really understand it. And often you can think what's the point of blushing? What's the purpose of it? Darwin found it really interesting. He called Blushing the most peculiar and most human of all expressions. He said it wasn't, it's not only involuntary, but it's the very wish to restrain it, worsens it. And psychological studies on blushing have actually found that blushing endears us to other people. It makes us, it makes people more likely to have us as part of their social group. And it's very counterintuitive, but it's, The theory behind it is that when someone blushes, it's easily recognizable that they recognize that a social norm has been broken, whether they've broken it or someone else has broken it. And that's much more likely to indeed you to someone else. So that's just one way in which the skin communicates to other people. Another one is sweat, which, I mean, you don't want to get me talking about sweat because I find sweat absolutely fascinating.

It does so many things for our body. It's the one that most of us probably know about is the fact that it is one of the incredible aspects of our skin's thermostat. So when we're really hot, we can pump out, in theory, the human body can pump out liters of sweat every day. and the evaporation off the skin cools the skin down and then cools the rest of the body down. But sweat itself, the nose skin communication with sweat

and body odor might actually be saving us from extinction. So in the late 90s, there was something called a Swiss researcher carried out something called the sweaty T-shirt study where, and there have been a few studies done since that to replicate it, where he got a group of men to wear a T-shirt and not wash for about a week, I think. And then after that week, each man would put his sweaty shirt in a box, in a separate box.

And then he got a large group of women who were either very brave or well-paid in the study. to sniff the boxes and then they'd rank it on a number of different criteria so intensity, attractiveness, even sexiness I think was one and fascinating. The study found that the women were more attractive to the sweat of men with different immune genes to them so that would, I mean, it would make,

at the one hand, it makes sense from not wanting to be attracted to someone who's close to you genetically, but it's more the fact that these specific genes called MHC genes are the genes responsible for our body's immune system recognising potential foreign microbes. And not one individual, so one individual can't have this whole set of genes. So it's spread around the herd.

It's spread around different humans. So actually, the fact that we're attracted to the, the skin, the sweat of people with different immune genes suggests that this is beneficial for the whole of humanity in that the offspring of these two people would have a more varied immune system recognising different types of pathogens. So if there was some kind of huge pandemic that swept across the world, there'd be a group of people who would survive it and then reproduce and propagate. So, yeah, the skin's got lots of weird and wonderful ways of communicating.

So in your book, you talk about the Maori people and how they use tattoos on their, on their skin as a form of displaying their identity. Can you tell us a bit about that? So there's an amazing Maori saying that is, it's, it's, something along this it says it's inscribe yourself so you have a friend in death which goes to the heart of

what tattooing is in many sentences it's presenting our best inner self sort of on the outside and it's sort of the ultimate way in some ways of communicating via our skin and

the Maori Tamoko is one of of the most intricate and amazing tattoos. It's incredibly elaborate and it essentially has lots of different aspects. So your rank might be on your forehead, your birth status might be on your jaw. It's essentially like having your genealogy, your bank balance and your CV on your face. So my family is from New Zealand and I've been there on a number of occasions to see my family and to do and to do research in in roto to

having discussions with Maori elders there and one of them I met who's part of a sort of resurgence in in Maori tattoos sort of showed me how they'd do it is a slightly more painful than the way that tattoos are usually done with. with the tattoo stencil, the tattoo machine. And what they do is they would cut open with a sharp chisel, sometimes from an albatross bone. They'd cut the skin open so that it would just heal on its own, but with the ink, sometimes things like ash would be put inside.

And then their skin would sort of heal over, but also open. So it wouldn't just be a pigment. It would be open carvings, which, is why if you see a picture of a Maori tattoo, it looks really elegant. And it's a fantastic way of combining form and function. So it looks beautiful and it's meant to bring out features of the face to be attractive, but also to convey information. But tattooing varies in, so that's probably one of the most advanced types of tattoos.

but in other cultures across the world, so the Hamar tribe in Ethiopia, one thing they do, they don't include pigments, they just use scars as a way of communicating. So when young men or young boys come of age, what they do is they have to run across the back of a herd of bulls that are lined up in a line. And then once they've done that, the men of the village will sort of whip each other,

including the sisters and the brothers of this boy across their back, giving them really deep scars. And then the scars would then heal over, often like big, thick heeloid scars. But they would be a sign of a bond between this, this, new young man in the village and his family that he now has a duty to look after his family. So tattoos have a huge range of meanings. And yeah, that's absolutely fascinating. So is marking the skin in this way? Would you say that was a very human thing to do?

Humans are, as far as we know, there are no animals that in terms that, in terms, intentionally mark or permanently mark their skin to communicate with others. There are animals that can change the surface of their skin, but humans, as far as we know, are the only organisms that communicate in this way. Okay. So in your book, you often describe skin as an organ, but I think a lot of us, you know, without medical training, would think of an organ as a lump of pink tissue that sits inside the body.

So why is it that skin can also be described as an organ? Yeah, so essentially an organ is a structure of different types of tissues that carries out a variety of functions. And I think skin probably carries out, I think the most diverse variety of functions of any, of any organ in the body. I call it the Swiss Army organ.

So we all know that the skin is a barrier, keeping the bad stuff out and the good stuff in. So the outer, the skin is simply split into two main layers. The outer bit, the epidermis, is only about a millimeter thick. It's about the thickness of a sheet of paper. But that carries out most of the skin's barrier functions. It's incredible. It replaces itself about once a month, yet it keeps, it's incredibly watertight.

And it's a really dynamic aspect of the skin. But then below the skin, there's something called the dermis, which is a thicker layer beneath. And that has lots of different structures in it. So I mentioned sweat glands, but it also has things like hair follicles, lots of different immune cells to protect us. and we're discovering new aspects of the skin all the time. So one thing is that molecules in our skin might even be able to recognize the level of oxygen in the atmosphere around the skin and then control our blood pressure virus. And 90% of people with high blood pressure, we don't know the reason why they have high blood pressure and potentially one of those. causes might be related to the skin.

But it's an incredibly dynamic organ. It's probably the fastest growing organ and it's intricately related to the rest of the body, whether it's our gut and what we eat, but also our body clock. A recent study found that having a midnight feast might actually lead to sunburn the next day via our skin's body clock, which is really interesting because our skin sort of works on a 24-hour cycle. So overnight the skin replenishes itself, gets ready for the batches, the cuts and bruises of the next day, and also the ultraviolet light from the sun for the next day. So in the morning, we have lots of genes that are responsible for protecting our DNA from

sunlight damage and they tend to start kicking in at about six, seven, eight in the morning. But if you have a midnight snack, say around midnight one o'clock, it tricks our body clock into thinking that it's dinner time, so six hours earlier potentially. So then our skin isn't prepared for protecting itself against the sun the next day and we're at a higher risk of getting sun damage and even our skin in a sense is at more risk of being damaged by by physical damage the next day. That's really interesting because so now the weather's getting all hot and sunny. People are going to be spending a lot more time outside, but there seems to be a lot of

conflicting advice about whether spending a lot of time out in the sun is good for us or not. So could you please sum up the sort of benefits and risks that the sunshine can have for our skin. Yeah, this is often a tricky one because this is sort of the big debate as to we know sunlight damages our skin and can lead to skin cancer, but also we need to get vitamin D. Most of our vitamin D we get from the sunlight. So yeah, there's a lot of confusion. And so there's a long and a short answer, the short answer is to just have balance and be sensible. But there are ways of going out in the sun and getting your vitamin D fix without burning your skin. So that would be, so in the spring and summer months, say from March to October,

if you go out about three or four times a week without sun protection for roughly half the amount of time it takes your skin to burn. So that's quite a hard thing to measure. But it's usually, if you have quite fair skin, very fair white skin, that could be 10 to 15 minutes. About three times a day, between sort of 11 in the morning and three in the afternoon when the sun's at its highest. That's all the vitamin D you need to get. And then any more than that, you are sort of, you're exposing yourself to the risk of getting, sun damage. So it's about being sensible. It's not getting burnt at all. It's about wearing

loose clothing and hats if you can, seeking shade when it's sensible. And also understanding that there is no such thing as a healthy tan. Any tan is to some extent is our bodies, response to DNA damage. And I'm not saying you never get a tan at all, but it's understanding that it is damage and it's important not to get burned and very important to wear sunscreen as often as you can in the summer.

So how serious is it if you go outside and stay outside a little bit too long and get a bit of a sunburn? Hmm. It's so it's If you go out and get a sunburn It doesn't automatically mean that it's going to develop into into skin cancer But every exposure is a risk It's some people say it's sunlight is the most abundant

Of carcinogen In the world it's like exposing yourself to It's a process meats or cigarette smoke is that one dose isn't going to cause skin cancer, but it increases your risk. And I think actually psychologically, humans are much more likely to be careful in the sun if we tap into our vanity a bit. So sunlight not only increases our risk of getting skin cancer,

but it's also the greatest cause of skin aging, probably greater than all other factors combined. And there was a study done that I had two groups of people. One group was told, if you wear this sunscreen for a couple of weeks, it will reduce your risk of getting skin cancer in the future. So that was the first group. The second group were told, which is completely correct. And the second group were told, if you wear sunscreen over these three weeks,

it would reduce your skin aging. So your skin would age at a slower rate because you'll, have less exposure to ultraviolet light. And it was the second group who were much, much more likely to wear sunscreen. Most people in the first group sort of forgotten after a few days. But actually, interestingly, psychologically, we're much more interested in sort of how we look at the moment than humans. We're quite bad at assessing risk in the long run.

So I'd say when you go on holiday or just when you're, you if you when you go out the summer, be on the safe side. I think it's important to go outside for your physical health, your mental health, and to get your vitamin D. But you can do that while protecting yourself with sun cream. Okay. So for all the people who want to go out and get a tan to have this sort of healthy glow, is there any way we can get that without putting us at risk of skin damage? Well, there's, there are a number of really interesting ways in which that can be done. And this is one of the really interesting things about how looking after our skin results

in looking after the rest of our body. So a couple of studies that have been done over the last five, ten years that have shown that if we eat colourful vegetables, so things like carrots, peppers, things like tomatoes. It gives our skin a glow that is actually more a sort of a yellowish glow that's more attractive as deemed by people in the study than a suntan. So they got a lot of men into different groups. One of these groups were people who were encouraged to eat sort of colorful fruit and veg.

And then women were asked to judge the attractiveness. of the faces. And really interestingly, they found that the men who'd had this very slight sort of golden glow from eating these colourful vegetables, not in crazy amounts, but as part of a balanced diet, were deemed more healthy and attractive than people who didn't eat these, and also people who had a yellow globe from a suntan. And there was also another, and psychologically, there was another study that had two groups of people. The first group were told that if you eat lots of these vegetables, it will reduce your risk of heart disease and cancer in the future, which is true. The second group were told that if you eat these colorful vegetables,

then your skin will look more attractive. You probably won't be surprised to hear that it was the second group again who were much more likely to eat the vegetables. So then again, tapping into our skin's vanity sometimes isn't a bad thing. because it's good for the health of our whole body as well. And interestingly, there is a molecule that's being studied, actually, called an S-I-K inhibitor that is potentially, it's being produced over the, it's been shown to work, but it'll be quite a while until it's sort of being released as a medication.

but it's a medication that actually gives you a complete tan just by taking the tablet. But that will probably be only be used specifically for people with very fair skin. And I mean, so people potentially with albinism and things like that. But it's fascinating. It was only discovered about two years ago that the molecule that causes, it basically creates a molecule that blocks the molecule that stops the melanin production. So it basically pushes the accelerator and causes a real tan, but without any risk of sunlight. But I think there needs to be a lot more research into the safety of that before that potentially comes onto the market.

Wow, that's really interesting. So I have really, really pale skin. I've been burned in Scotland and May before. So I'm obviously at a great risk for skin damage. So what should I look out for on my skin? So, yeah, that's a really good point. I'm very similar. And it's important to check your skin regularly for just getting to know your skin,

getting to know where the moles are and to see whether there are any kinds of changes. So the big thing to look out for is a potential risk of melanoma, which is of the three main types of skin cancer. It's the rarest, but it's also the most dangerous. And there's an easy way of recognizing these in your skin. And it's very helpfully, categorized into an A, B, C, D, E. And so A is for asymmetry. So if you see a mole that looks very asymmetrical, most are fairly circular.

So A is asymmetry. B is for borders, so irregular borders. So it also has quite a squiggly, strange border. That's important to note as well. and C is if it has more than one color in it so if you have a mold that has one bit that's quite quite dark blacky color and ones a bit red and a bit brown

and then D is diameter sort of of over six millimeters and it's quite hard to measure but that's roughly the rubber the eraser end of a pencil any any sort of any wider than that and then important importantly, as of E is both evolution, so how quickly it's been growing on your skin. So if you notice it growing over days or weeks.

And then the most important one for E is expert. So if you're just unsure about something if a mole on your skin that looks a bit unusual, go to your local GP and then get that scene too. Okay, great, thank you. So trying to get a tan, that's something that quite a lot of people tried to do to get to attain better looking skin, but it's not the only way. You know, we use a lot of moisturising creams, we exfoliate, take supplements. Is this a new thing? Is this a very sort of modern thing that humans do, or historically as doing these sort of complicated skin routines, has that been something that we've done a lot? So, yeah, no, complicated and bizarre skin routines have been around for as long as, as long as we've been around. I've got quite a few favourite beauty regimes of people historically. So there's Princess Elizabeth of Austria had made a cream of from the spermacety wax from the head of a sperm whale combined with, I think, almond oil and some kind of rose water.

And then at nighttime she sort of slapped raw veal on her face and then had a made-to-measure leather mask that sort of covered the veal over her face overnight. And there are, so quite a lot of bizarre and sort of quite faddish ways of trying to make skin look more attractive that come in and out of, in and out of fashion. But there are some that stand the test of time. So Queen Cleopatra of Egypt, who is famed for her beautiful skin, had 700 donkeys, a stable of 700 donkeys who provide milk in which she would bathe. And there is a little bit of science behind that because some of the acids in milk and in some citrus fruit,

alpha hydroxy acids, actually have a sort of exfoliating effect. effect on the skin, sort of making it look fresh, look more fresh. There's a bit of debate as to whether that actually results in a sort of an anti-age, has an anti-aging effect. But, no, there are a number of ways in which people try to either slow skin aging or make skin more beautiful. And there aren't too many that have actually been, in terms of of anti-aging. There aren't too many that have been shown to work or be effective.

By far the most effective anti-aging cream is sunscreen by far. And then after that, retinoids, which are sort of a products of vitamin A have been scientifically shown to have some effect. But then after that, it gets into a complicated world of slightly dodgy science. and a lot of money behind the marketing. And it's, so some people swear by different things, but it's often hard to tell whether something's worked for different people and whether that's actually the effect of their genetics or not. Yeah, there do seem to be a lot of different products out there

remarkable claims about anti-aging, making you look 10 years younger. Is it really realistic that any sort of cream or product could do that? Well, we haven't yet found something that reverses, reverses aging. And yeah, there's a lot of very convincing marketing out there. I think it's just being sensible about if you're going to get something. If something says, if a cream says that it's being clinically proven, that actually means that it could have been proven on skin cells under a microscope and it might not even be noticeable on human skin.

Or if something says a dermatologically tested, it doesn't necessarily mean it's been tested on a thousand people and it's been proven to work in 80% of them. It can literally have been tested on one person. Maybe the marketing directors in different father. As in it, there's a lot of, yeah, a lot of hype and a lot of misleading information. But I think as you,

mentioned at the beginning, moisturising, and studies have shown that fairly cheap moisturises are just as effective as really expensive ones. So, moisturising is sensible if you have dry skin.

Exfoliating does make the skin look fresh, but it's important not to exfoliate too often because our skin works really hard at making a really good barrier. and we didn't want to remove that barrier all the time. So a lot of dermatologists and beauticians recommend maybe three times a week,

max quite gently exfoliating probably is. But it varies from different types of skin type. But in my book, I don't dwell too much on skin beauty or skin aging. I think that if you want to have beautiful skin, The key to that is to first have healthy skin, to understand your skin. And then everything comes from there. So, for example, in terms of diet and those colourful vegetables that have been scientifically shown to make skin look more attractive, I think that's a very sustainable

way of trying to have healthy looking skin, but also a healthy body as well. So now looking a little bit closer into the skin, I don't think it would surprise anyone to learn that we have bacteria living on our skin, especially on our hands and places like that. But that's not all that lives on our skin, is it? No, we have a huge panoply of organisms that live in our skin. So yeah, we have about a thousand different types of bacteria who dwell on our skin in different populations on different. people. But we also have different types of mites of varying degrees of of ugliness. And one of my favorites, which is unfortunately a really horrible looking mite, it looks like the cross between a sort of a worm and a spider is called a Demodex mite. And they're present on the skin of quite a lot of people. and they tend to sort of cling to the bottom of hairs, usually around the face,

so maybe they cling to eyebrow hairs and the males at night sort of swim quite sluggishly across the surface of your face, searching for a mate. And they have quite sort of sad and short lives, really. They're quite good at being the rubbish cleaners of the skin. So they eat dead skin on the surface of our faces. But because they have quite a small digestive tract, these little mites,

and they don't have an anus. So they just keep on hoovering up the skin. And eventually they more and more bloated until they effectively burst and die on the skin. I'm sorry if anyone's eating while they're and so whilst they are good at clearing up the debris on our skin they actually contain bacteria within their microbiome and there are some theories that suggest that our skin, the immune cells of our skin

once these mites die and all of their gut microbes splurge out onto our skin our skin can react quite badly to them And that could be one cause of rosacea, which is a reasonably common skin condition, usually on the face around the area of the nose and just below the eyes. But our discoveries into the skin microbiome are a really interesting. A 2017 study found that an underarm bacterial transplant could potentially be the skin. cure for body odour. So they got two, a pair of twins,

one of whom smelled pretty fresh, the other of whom had quite bad BO, and they hypothesized that it was due to different populations of microbes. So our sweat doesn't smell, but it's the bacteria that

digest the sweat and create smelly molecules that contribute to be, body odour. So in this study they got the twin who didn't smell at all not to wash for a couple of days and then they swabbed some of his underarm skin for the bacteria and then for the slightly wiffy twin they scrubbed his his armpits and placed his twins at microbes on his skin. And amazingly, after weeks and weeks, both twins didn't smell at all. So the twin with the bad bio didn't smell. And that's backed up by studies that show that people of East Asian heritage,

particularly people of Korean heritage, have the least amount of body odour of any humans. and that's because they, for various different reasons, they have very small to negligible populations of the smelly bacteria, carini bacteria being the main culprit really. That's really interesting. So having this microbiome on our skin and these mites on our faces, that's all part of a perfectly normal skin. I don't need to go home and sandp over my face to try and get these mites off.

No, we've, it's like any civilization, our world of microbes on our skin has the, for good, the bad and the ugly. And most of them are really good for our skin. We have bacteria who contribute to a healthy surface. We have bacteria that just sit there and don't do very much. And sometimes there are bacteria that are bacteria that are, that do cause disease. So in acne, one of the causes of that is a bacteria that lives in our skin, but then proliferates to a massive degree. So the acne bacteria is usually absolutely fine in our skin, but when you have testosterone causing rises in the sebum, the oily, the oil on our skin, then they go into overdrive and that can be bad.

There's also a bacteria called staphoreus on our skin which usually doesn't cause too much of a problem but if we have a weakened skin barrier, so most commonly in eczema, this bacteria can sort of creep down into the lower layers of the skin and release toxins causing inflammation and then worsening the cycle of eczema. But no, I wouldn't get back in

try and scrub all these millions of microbes off your skin. They're mostly very friendly. That was Dr. Monty Lyman talking about the diverse range of things our skin does for us. His book, The Remarkable Life of Skin, is out now. We've barely scratched the surface of how the human body works. So for even more fascinating science, check out the latest issue of BBC Science Focus magazine. In this issue, we discover what the dinosaurs can tell us about preventing our own mass extinction. There is, of course, much, much more inside.

But if you can't wait to get hold of a copy, then check out our previous Science Focus podcast episodes. They're all marvellous, and we'd love to know what you think about them with a review or a comment. Thank you for listening to the Science Focus podcast from the BBC Science Focus magazine team. With the UK's best-selling sites and technology monthly,

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