Obesity and the Skin

Cutaneous Pathophysiology in the Obese

Obesity alters the epidermal barrier of the skin in some way, so that obese individuals have increased transepidermal water loss and dry skin.^[16] Erythema is more pronounced, compared with controls,^[17] and there is reduced microvascular reactivity.^[18] The obese have larger skin folds and will sweat more profusely when overheated than the nonobese.^[7] Obesity inhibits lymphatic flow^[7] and alters collagen formation.^[19] Delayed-type hypersensitivity is increased in obesity and reduces with weight reduction,^[20] which may relate to an alteration in the balance of adipocyte cytokine production.^[12,21]

The shape of the foot changes with obesity.^[22] For example, obese children have a lower footprint angle and obese individuals have a wider forefoot width and also higher plantar pressures during standing and walking.^[22] These pressure effects may eventually lead to plantar hyperkeratosis, a cutaneous sign of severe obesity.^[22]

Interestingly, no differences have been found between the activity of sebaceous, apocrine or eccrine glands in the obese compared with the nonobese,^[7] despite the evidence of changes in endocrine homeostasis with increasing weight gain (see also the section 'Adipocytokines, obesity and psoriasis').^{[2,5,6,10–13,23]}

The British Journal of Dermatology. 2011;165(4):743-750. © 2011 Blackwell Publishing

Cite this: Obesity and the Skin - Medscape - Oct 01, 2011.