The Remarkable Life of the Skin

March 1, 2020
A leading expert in dermatology surveys the body's largest organ, "a beautiful mystery, cloaked in feelings, opinions and questions." Although it is a conduit to our exquisite sense of touch and the ability to convey emotion (among a bevy of other useful and life-sustaining functions), the skin is often overlooked. "Skin is the Swiss Army knife of the organs," writes Lyman, a doctor and a recipient of the 2017 Wilfred Thesiger Travel Writing Award, "possessing a variety of functions unmatched by any other, from survival to social communication." To research this intimate story, the author journeyed across the globe and through history. More than just a collection of interesting case studies and fun facts--though it is that, too--this book spans a range of fields in basic science and social science in its depiction of the skin's many roles. Drawing on his extensive clinical experience, Lyman explains the critical functions of the skin as a barrier and protector, a host for the microbiome, and a signaler of disease. He also broaches subjects as diverse as psoriasis, aging, race, and tattoos in his nuanced exploration of the profound interconnectedness of skin and self. These discussions of the mind-body connection are some of the most insightful elements of the narrative. Looking ahead, Lyman describes some of the skin's potential for life-altering therapies as researchers manipulate stem cells and genes to treat injury and disease with more effectiveness than ever before. Throughout this wide-ranging narrative, the author's writing is clear and not overly technical, and he excels in relating even the most esoteric subjects to a shared human experience. The 17-page glossary at the end is particularly helpful for readers not well versed in biology and other sciences. Illuminating and thought-provoking, this book elicits a new awareness of and appreciation for the skin.

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April 27, 2020
Lyman, a doctor of acute general medicine, presents a panoramic view of human skin in his excellent debut. Lyman discusses a plethora of skin ailments, from acne to leprosy, and describes the ideal skin care regimen (using sunscreen, abstaining from smoking, and eating a balanced diet high in fruits and veggies that contain the carotenoid pigment). To illustrate that skin is, as one chapter’s title has it, “The Swiss Army Organ,” Lyman shares fascinating information about its intricate workings, describing how the four kinds of “mechanoreceptors,” highly sensitive and specialized cells, work together to create the ability to touch and feel. He goes beyond medicine and biology, however, to discuss how skin shapes and defines identity. In addition to touching on race, in terms of how naturally occurring variations in human pigmentation have taken on outsize significance, Lyman examines the marks that people make on themselves, such as the Tā moko tattoos of the Maori, which encode detailed familial and personal histories. Whether one’s interests are in science and medicine, or in sociology and anthropology, there is something for a wide range of readers in Lyman’s skillful work. Agent: Charles Viney, Viney Agency. (June)Correction: An earlier version of this review incorrectly referred to the author as a dermatologist.

Starred review from May 1, 2020

British dermatologist Lyman (Oxford Univ. Hospitals, UK) peels back the layers of our largest and most versatile organ to reveal its physical, social, and psychological features. After describing the skin's physical structure, he examines myths surrounding the ancient disease of leprosy, the elaborate facial tattooing of the Maori, the skin's complex relationship with sunlight, and the mechanics and mysteries of our sense of touch. He also highlights contrasting cultural and religious attitudes toward the skin: the popularity of tanning in the West vs. skin bleaching in East Africa; the head-to-toe covering of the skin by Muslim women versus the nakedness of the Hindu sadhu, or holy man. And from acne to vitiglio, Lyman covers skin disorders both common and extremely rare, while weaving in recent research findings and fascinating medical cases. VERDICT Lyman conveys both the science of the skin as well as its many wonders and paradoxes while imparting much practical advice on its care. At first blush dermatology may not seem the most enticing subject, but this brilliant synthesis will be an engrossing read for anyone interested in human health and biology.--Cynthia Lee Knight, formerly with Hunterdon Cty. Lib., Flemington, NJ

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Starred review from June 1, 2020
Our skin is much more than organic bubble wrap that keeps our "insides" safely where they belong. Given its many functions beyond protection and insulation, physician Lyman dubs human skin the "Swiss Army knife of the organs." The body's largest and most vulnerable organ, skin actively participates in temperature regulation, vitamin D synthesis, fluid balance, energy storage, immune function, and sensation. Lyman covers the relationship between diet and skin, touch, the sun's effect on skin, the changes age brings, and skin's role in identity. One notable chapter, "Skin Safari," will make your skin crawl as it reviews the many minuscule critters (the integumentary microbiome and possible parasites) that call your epidermis "home," including many species of bacteria and fungi, and, on occasion, head lice, Demodex mites, and scabies (one of the itchiest occupiers). Common dermatological diseases are deftly discussed, such as psoriasis, eczema, acne, and skin cancers. Intriguing topics?blushing, the perception of pain, fingerprints, pruritus (severe itching), and tattoos?are investigated. Tantalizing tidbits of information abound: You shed more than a million skin cells daily, which make up about half the dust in your house. Skin regenerates every four weeks. The many wonders of skin are superbly detailed in Lyman's thoughtful, informative treatise.(Reprinted with permission of Booklist, copyright 2020, American Library Association.)