The skinny on skin

By: Dr Peter Hall

You gotta have skin. All you really need is skin.
Skin’s the thing that if you got it outside,
It helps keep your insides in.”

I like this old Allen Sherman song. We really do gotta have skin but we have a strange relationship with it.
On one hand, making it look good is a billion dollar industry. The universal desire to improve our appearance has led to all sorts of products being inflicted on our poor dermis. Victorian ladies whitened their skin with arsenic cream and various other toxins, and some of our modern remedies seem nearly as drastic.
On the other hand, the message that we have to protect our skin from sun damage has taken a long time to filter through. I come from the generation that thought that if you didn’t get burnt twice in a summer it wasn’t a good one. In fact, I still have memories of people tanning with the aid of coconut oil, a process which seems disturbingly close to being fried. As a patient of mine said, “Whangamata in 1963 has a lot to answer for”.
As a consequence, my skin reminds me daily that I am getting older. Overnight, it seems, I have developed rough spots, wrinkles, freckles and other signs that make me look like my father did. And I still forget to sunblock and moisturise properly.
I should really know better. Old skin is in trouble, basically. It tends to be fragile, slow to heal, itchy and dry.
There is very little we can do to rejuvenate it but it’s worth the effort to protect it from further damage. And by that I mean you should avoid being attacked by dishwasher doors and other sharp immovable objects. While these are good for my business, I would still rather that my elderly patients kept their skin intact. Maybe we should issue shin guards to everybody over the age of 70?
And there are of course more serious consequences. New Zealand continues to outdo the whole world in skin cancer rates and I can think of a few patients who are maintaining this record all by themselves. But interestingly we have very good cure rates for melanoma compared to other countries. This might be due to the fact that you can now get most skin cancers dealt with through your GP, for free. 
So take that spot to your own doctor and, if appropriate, they will refer you via the Waitemata District Health Board minor surgery scheme to a local practitioner for excision or biopsy. You might as well get something for your taxes!

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