Obesity is the leading disease in the western and asian countries .The number is increasing day by day. Obesity is considered as “worldwide pandemic”. The list of diseases related to obesity are increasing, some of them are diabetes, hypertension, stroke, delayed wound healing, skin issues, impotence, stroke etc.
Here in this article we are dealing with skin related infections in obese individuals.
How does obesity cause skin problems?
Obesity is a condition of excess adipose(Fat) tissue and is the result of changes in lifestyle, excessive consumption of energy-dense foods with poor nutritional value, physical inactivity. However there are other related disturbances caused by obesity. Metabolic disturbances are equally important and can be interlinked with Diabetes (Insulin Related) which is responsible as an exacerbating factors for dermatitis.
Below we can see the stages, skin getting affected in various forms:
- Disproportional production of oil(sebum) from the skin cells: As we know its the oily substance that keeps the skin moisturized and avoid dryness. In obesity, the sebum channels are blocked and get infected leading to formation of Acne. Acne is also caused due to other hormonal factors like rise in androgens(Male hormones), growth hormones, insulin
- Alteration in properties of skin function:skin barrier cells have a set of critical defensive functions along with the function of holding body water in and keeping microbes and foreign molecules out. Alteration leads to infection formation
- Imbalance in collagen production and structure: Adipose cells(Fat cells) decreases the formation of collagen and leads to weakening and laxity of skin tissues
- Delay in wound healing properties: Adiponectin(Cells seen in Adipose tissue) which is responsible for Increasing the vascularity and wound healing is decreased in obesity and there is a delay in wound healing.
Commonly associated skin conditions seen in obesity and their management:
1)Acanthosis Nigricans and Skin tags: This is a common skin problem in obesity. Acanthosis nigricans appears as velvety, symmetrical dark patches. It is most commonly observed in the armpits, groin, back of the neck, elbows, knuckles, and face. This condition can be controlled with the help of decreasing the increased Insulin levels. Skin tags can be removed by a doctor.
2)Hyperandrogenism and hirsutism: This is caused by high levels of male hormones. Development of male sexual characters is seen like increase in facial hair. Acne may occur. Treatment of hyperandrogenism consists of controlling insulin levels, weight loss, oral contraceptive and antiandrogenic therapies.
3)Striae due to over extension: Striae are commonly seen on the skin due to stretching of skin and increased adipose tissue. Striae are seen more often in the areas like breasts, buttocks, abdomen and thigh regions. They appear as red marks turning violet, then finally becoming white depressed plaques. There are no treatment options.
4)Varicose veins: Appear as bulged veins and/or black itchy skin on the lower extremities. Treatment is with elastic stocking other life style intweventions, weight loss, reducing the standing time, elevation of the legs for few minutes and surgically by stripping and ligation.
Other skin related issues seen in Obesity:
- insulin resistance syndrome
- skin infections including fungal infections, mainly in the skin folds
- plantar hyperkeratosis
-Dr.Surampally Bhavani Sagar