Chapter 11 - Skin health and integrity

Abstract

The main function of the skin is to protect from various external insults and to maintain the internal homeostasis. In addition, the outer appearance and the skin sensations are important for well-being, self-esteem, attractiveness, and communication. The concept of skin integrity plays an important role in the dermatological, skin research, biomechanical, and nursing literature, but a formal definition was lacking so far. Within this chapter, skin integrity is defined as the combination of an intact cutaneous structure and a functional capacity that is high enough to preserve it. This definition indicates that intact epidermal and dermal structures are only one aspect of skin integrity. The skin must be also functionally competent to compensate internal and external hazards. At the same time, functional capacity is not a fixed property. It does change during the life course, during changing environmental conditions, or during diseases. The important question is whether the functional and repair capacity is high enough to maintain the cutaneous structure. Especially in aging individuals, maintenance of adequate body weight, control of systemic diseases such as diabetes mellitus, and compensation of functional impairments are indirect measures to promote and to maintain skin integrity. Protection from UV exposure, smoking, air pollution, and the avoidance of unnecessary exposure to water and irritants, on the other hand, are key interventions, which directly help to maintain skin integrity and health.