SKIN PROBLEMS during OBESITY

In general a woman is considered obese when her weight is 20% or more above normal weight. Nowadays every woman knows that overweight and obesity have several risk factors not only for health but also for women look and appearance. The obesity usually occurs when a person consumes more calories than they need for the energy they use – body weight depends on a balance between the energy you get from food/drinks and the energy you spend.

Besides several risk factors for many diseases (heart disease, high blood pressure, type 2 diabetes, certain types of cancer, etc.), the obesity could cause skin problems and skin diseases. Additional weight and increased fat result in extra folds of skin – not only unpleasant and uncomfortable but also difficult to clean properly. Fat skin folds create a warm, moist environment, skin deformation that is ideal for many types of bacteria, viruses and fungus.

During obesity very often women could have insulin resistance which could trigger insufficiency of the veins and causes certain skin problems. Increased levels of growth factors during obesity also have influence at skin physiology.

Generally speaking the bigger a woman is (severe obesity), the more skin she has and the higher risks she has for skin problems development during obesity. Skin appearance is always changed during obesity which could be a reason for women stress, decreased self-confidence and reduced attractiveness.

Obesity in women has severe influence at several skin function including the skin’s barrier function, sebaceous glands and sebum production, sweat glands, small lymphatic channels under the skin, collagen structure and function, wound healing, microcirculation and macrocirculation, and subcutaneous fat metabolism.

SKIN FUNCTIONS during OBESITY

Skin barrier function during obesity is reduced because of increased water loss across the extended. Skin becomes significantly dry and skin repair after wounds is impaired.

Skin sebaceous glands and sebum production is changed during obesity – sebaceous channels are blocked and infected which trigger increased numbers of acne. At the same time, increased levels of some hormones in obese women (male hormones, insulin, growth hormone) are also known as risk factors for acne.

Skin sweat glands function is also damaged during obesity – larger skin and increased skin fat folds tend to sweat more profusely due to thick layers of subcutaneous fat.

Lymphatic channels under the skin play an important role in lymphatic flow which is usually slow down during obesity. Decreased lymphatic flow causes collection of protein-rich lymphatic fluid in the subcutaneous tissue – this is why obese women could suffer from lymphedema.

Skin blood vessels are very important for skin blood flow which is increased in obese women – this can be a reason for microangiopathy and hypertension.

Skin collagen structure is also changed during obesity and healing process after wounds can be damaged.

Subcutaneous fat in healthy women serves as energy storage but during obesity the subcutaneous fat is dramatically increased which could cause several skin problems.

What are main SKIN PROBLEMS during OBESITY?

Stretch Marks
Stretch marks (so called “striae distensae”) during obesity are the result of extra weight and stretched skin (highly tensioned skin) – they can be pink, reddish, brown or purplish. In most cases stretch marks have red color at the beginning and late they turn to more dark colors (brown or violet). Most common places of stretch marks during obesity are breasts, buttocks, abdomen, and thighs. At final stages skin stretch marks usually turn to white depressed plaques.

Acanthosis Nigricans
It is a very specific skin pathology often related to obesity that causes brown or velvety dark or black marks (usually symmetric) which usually appear in the groin, armpits, neck, elbows and/or knees. Most experts associate acanthosis nigricans with elevated insulin levels and insulin resistance.

Folliculitis
Infection (inflammation) of hair follicles called “folliculitis” – sometimes called “hot tub folliculitis” or “barber’s itch”. During obesity hair follicles can be damaged because of heavy additional weight which is adding additional pressure on the hair follicles and damaged hair follicles allow infection to occur and develop inflammation.

Skin Tags
Skin tags are tiny, benign raised bobbles of skin (skin growth) that stick out and may be connected to the skin with a narrow stock. Many obese women have skin tags because of extra weight which causes friction between the affected areas of skin. Skin tags during obesity could appear on the neck, armpit area and groin.

Cellulitis
Obese women are at risk for cellulitis because of skin infections and cleaning difficulties in many fatty skin folds. Skin cellulitis can cause pain and tenderness in the affected area of the skin, chills, shaking, muscle aches and sweating. Esthetic component of cellulitis cannot be underestimated.

Varicose Veins
Main cause of varicose veins during obesity is explained by increased blood flow at skin level – obesity can lead to a weakening of the valves in the veins, it is related to the development of varicose veins. Damaged blood vessels appear as swollen, enlarged veins that are raised above the skin’s surface. Common places of varicose veins during obesity are inside of the legs and backs of the calves.

Stasis Dermatitis
Poor blood circulation could trigger skin inflammation called “stasis dermatitis”. Main cause of statis dermatitis during obesity is explained by difficulty for the veins to carry fluid to the heart.

Hyperandrogenism
Sometimes during obesity women could have increased levels of androgens (male hormones) which called “hyperandrogenism” – increased production of male hormones by the excess fat.
Symptoms of hyperandrogenism include some skin disturbances such as acne and increased hair grow on the face.

Adiposis dolorosa
Fat redistribution during postmenopausal period could cause so called “adiposis dolorosa – it is pretty rare skin condition with multiple, painful, subcutaneous lipomas.

Erythrasma
As it was mentioned earlier, fat skin folds are perfect place for infections – warm, wet, oily environment. Erythrasma is a bacterial infection of the skin that is caused by the bacteria Corynebacterium minutissimum and appears between skin folds.

Tinea Cruris
Tinea cruris is a fungal infection that is also known as “jock itch” – appears usually in fat skin folds (in warm, moist areas of the skin). Excessive sweating during obesity is considered as triggering factor for fungus grows on the skin.

Acrochordons
Acrochordons are soft brown papules or growths seen commonly on the neck and in the armpits and groin. Dermatologists noted frequent appearance of acrochordins with acanthosis nigricans

Keratosis pilaris
Very specific spiny papules or growths on the external surface of the arms sometimes called “goose bumps”. Some experts associate it with dry prone skin.

SKIN PROBLEMS aggravated by OBESITY

1.    Lymphedema (impedance of lymphatic flow);
2.    Psoriasis (red lesions with silver scale);
3.    Chronic venous insufficiency;
4.    Plantar hyperkeratosis or calluses (most commonly as a horseshoe callous);
5.    Skin infections (fungal and/or bacterial).
6.    Hidradenitis suppurativa (abscesses and scarring tracts).