5 Ways Obesity Is Related to Skin Problems
Overweight and obese populations have a higher chance for skin conditions
Edited By:Raja Sivamani , MD, MS, AP
People who are overweight or obese have increased risk for many health problems, including the skin. Body Mass Index (BMI) is a weight to height ratio that is calculated by taking the person’s weight in kilograms and dividing it by their height in meters squared. Someone is categorized as overweight if his or her body mass index (BMI) is 25.0 to 29.0 kg/m2. Obesity is defined as having a body mass index (BMI) of 30.0 kg/m2 or higher. Over the past two decades obesity in the United States has been steadily rising, with many calling the current status an “obesity epidemic.” In fact, over 35% of men and women in the United States are obese, and over 33% of children are overweight. It is not only the United States experiencing such a high rise in obesity; Mexico reports up to 40% of adults are obese. The alarming rise in obesity is directly correlated with dire health concerns, including heart disease, strokes, cancer, diabetes, and even serious skin disorders.[4,5]
How Is Obesity Linked with Skin Health?
Obesity is known to alter healthy skin function and lead to the following changes in skin physiology:
- Disregulated skin oil (sebum) production
- Altered skin barrier function properties
- Impaired collagen production and structure
- Delayed wound healing[8,9]
Insulin Resistance and Hyperinsulinism
Overweight and obese populations have a much higher risk of developing insulin resistance, which can commonly lead to the development of type 2 diabetes mellitus or metabolic syndrome. With insulin resistance, the pancreas produces more insulin, but the insulin receptors on fat and muscle cells are unable to effectively respond and help remove glucose from the bloodstream. This leads to increased glucose levels in the blood stream (commonly referred to as “increased blood sugars”). The increased glucose levels lead to a vicious cycle where more and more insulin is produced, leading to a cycle of increased insulin and increased blood glucose levels. It is thought that higher amounts of adipose (fat) tissue in those with obesity is a key contributor to insulin resistance. Up to 90% of patients with type 2 diabetes mellitus are obese.[11,12]
Five Skin Conditions Commonly Associated with Obesity
Acanthosis nigricans consists of dark brown or violet plaques that have a velvety appearance, most often present on the sides or the back of the neck, the armpits, and the groin area. According to a review of the scientific literature, acanthosis nigricans is the single most common disease affecting overweight and obese populations. One study found that almost 75% of people who were obese had acanthosis nigricans, and it even affects overweight children. High insulin levels, such as those in people with insulin resistance, leads to high levels of a protein called insulin-like growth factor 1. Insulin-like growth factor 1 causes skin cells in the skin’s dermis layers to divide too quickly and may be the cause behind acanthosis nigricans.
2. Skin Infections
People who are obese are at greater risk for skin infections, including candida infections, folliculitis, tinea cruris (ringworm), and intertrigo.[16-18] People with a high body mass index tend to have deeper skin folds and excess sweating, which can lead to friction, moisture, and skin maceration. All of these components can create an environment in the skin prone to infections from yeast, bacteria, and fungus.
Striae, commonly known as stretch marks, are extremely common in obese children and adults alike. Stretch marks result in areas of skin tissue perpendicular to the direction of the greatest tension. As the skin stretches with weight gain and obesity, the skin may become more prone to develop stretch marks most often on the abdomen, breasts, and buttocks. Striae happen commonly in non-obese individuals as well, such as in pregnant women and adolescents going through rapid growth spurts.
4. Hidradenitis Suppurativa
Hidradenitis suppurativa is a physically and emotionally devastating skin disease consisting of chronically re-occurring painful bumps, abscesses, fistulas and scarring. Hidradenitis suppurativa affects over 2% of people across the world and is a clinically challenging disease due to its associated pain, relapses, and treatment difficulty. Not all people with hidradenitis suppurativa are obese or overweight, but increased weight is known to worsen symptoms probably due to mechanical skin trauma and the effect of androgen hormones. Overweight people who lose weight often experience improvement in their symptoms.
5. Delayed Wound Healing
Obese individuals tend to have poor wound healing due to increased risk for infections, prolonged pain, and poor collagen formation. Additionally, a diet rich in processed foods like the standard Western diet, include calorie-rich foods that are rich in sugar and fats, but low in vitamins, minerals, and other nutrients that are found in plant-based foods. Diets that are limited in vitamins and minerals have a greater risk for nutritional deficiencies such as vitamins C and A, zinc, and protein that can further impair collagen production and the wound healing process.[24-26]
Many painful and disfiguring skin diseases are strongly correlated with a higher body mass index (BMI). Lifestyle changes consisting of healthy eating and exercise will not only reduce the worldwide prevalence of obesity but may also improve and prevent associated skin problems.
To learn more about different types of exercise, read on here.
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- Sturm R, Ringel JS, Andreyeva T. Increasing obesity rates and disability trends. Health Aff (Millwood).2004;23(2):199-205; PMID: 15046144.
- Baskin ML, Ard J, Franklin F, et al. Prevalence of obesity in the United States. Obes Rev.2005;6(1):5-7; PMID: 15655032.
- Plascencia Gomez A, Vega Memije ME, Torres Tamayo M, et al. Skin disorders in overweight and obese patients and their relationship with insulin. Actas Dermosifiliogr.2014;105(2):178-185; PMID: 24238328.
- Dixon JB. The effect of obesity on health outcomes. Mol Cell Endocrinol.2010;316(2):104-108; PMID: 19628019.
- Guh DP, Zhang W, Bansback N, et al. The incidence of co-morbidities related to obesity and overweight: a systematic review and meta-analysis. BMC Public Health.2009;9:88; PMID: 19320986.
- Cordain L. Implications for the role of diet in acne. Semin Cutan Med Surg.2005;24(2):84-91; PMID: 16092796.
- Loffler H, Aramaki JU, Effendy I. The influence of body mass index on skin susceptibility to sodium lauryl sulphate. Skin Res Technol.2002;8(1):19-22; PMID: 12005116.
- Enser M, Avery NC. Mechanical and chemical properties of the skin and its collagen from lean and obese-hyperglycaemic (ob/ob) mice. Diabetologia.1984;27(1):44-49; PMID: 6468798.
- Goodson WH, 3rd, Hunt TK. Wound collagen accumulation in obese hyperglycemic mice. Diabetes.1986;35(4):491-495; PMID: 3514328.
- Kahn SE, Hull RL, Utzschneider KM. Mechanisms linking obesity to insulin resistance and type 2 diabetes. Nature.2006;444(7121):840-846; PMID: 17167471.
- Stumvoll M, Goldstein BJ, van Haeften TW. Type 2 diabetes: principles of pathogenesis and therapy. Lancet.2005;365(9467):1333-1346; PMID: 15823385.
- Halpern A, Mancini MC. Diabesity: are weight loss medications effective? Treat Endocrinol.2005;4(2):65-74; PMID: 15783244.
- Yosipovitch G, DeVore A, Dawn A. Obesity and the skin: skin physiology and skin manifestations of obesity. J Am Acad Dermatol.2007;56(6):901-916; quiz 917-920; PMID: 17504714.
- Hud JA, Jr., Cohen JB, Wagner JM, et al. Prevalence and significance of acanthosis nigricans in an adult obese population. Arch Dermatol.1992;128(7):941-944; PMID: 1626961.
- Cruz PD, Jr., Hud JA, Jr. Excess insulin binding to insulin-like growth factor receptors: proposed mechanism for acanthosis nigricans. J Invest Dermatol.1992;98(6 Suppl):82s-85s; PMID: 1316928.
- Daus AD, Hafez ES. Candida albicans in women. Nurs Res.1975;24(6):430-433; PMID: 1105432.
- Ross EV, Baxter DL, Jr. Widespread Candida folliculitis in a nontoxic patient. Cutis.1992;49(4):241-243; PMID: 1521475.
- Montes LF, Dobson H, Dodge BG, et al. Erythrasma and diabetes mellitus. Arch Dermatol.1969;99(6):674-680; PMID: 5783076.
- Itin P. [Intertrigo--a therapeutic problem circle]. Ther Umsch.1989;46(2):98-101; PMID: 2928985.
- von der Werth JM, Jemec GB. Morbidity in patients with hidradenitis suppurativa. Br J Dermatol.2001;144(4):809-813; PMID: 11298541.
- Slade DE, Powell BW, Mortimer PS. Hidradenitis suppurativa: pathogenesis and management. Br J Plast Surg.2003;56(5):451-461; PMID: 12890458.
- Banerjee AK. Surgical treatment of hidradenitis suppurativa. Br J Surg.1992;79(9):863-866; PMID: 1422743.
- Pence BD, Woods JA. Exercise, Obesity, and Cutaneous Wound Healing: Evidence from Rodent and Human Studies. Adv Wound Care (New Rochelle).2014;3(1):71-79; PMID: 24761347.
- Wilson JA, Clark JJ. Obesity: impediment to postsurgical wound healing. Adv Skin Wound Care.2004;17(8):426-435; PMID: 15492679.
- Printen KJ, Paulk SC, Mason EE. Acute postoperative wound complications after gastric surgery for morbid obesity. Am Surg.1975;41(8):483-485; PMID: 1147403.
- Lasocki S. The true obesity paradox: obese and malnourished? Crit Care Med.2015;43(1):240-241; PMID: 25514714.