‘Normal’ skin (def): skin that works well, and that can do all the jobs that it needs to.

Skin is much more than just a wrapper that holds our bodies in place; it’s a dynamic, active organ. Each of the organs in your body is made up of similar cells that work together, and in fact, your skin is the largest one of them all. The skin cells that it consists of are constantly on the go, and every month they are completely renewed.

The skin has so many roles to fulfill. It holds us together, acting as a responsive barrier that keeps the right things in and the wrong things out. It’s home to a host of its own bugs, which work and live together, and it also does a pretty good job of fighting unwelcome infections. You have cells in your skin that will target problematic bugs, leaving just the friendlier ones behind.

Skin is a barrier to sunlight too, and can use the sun’s rays to make the vitamin D we need to keep our bone strength up. Plus, if you’re getting too much sun and start to feel a bit hot, your skin can fix that as well; by altering the amount of blood flowing to your skin you can either let heat out or keep it in. This is why your skin goes red when you’re hot and white when you’re cold.

Inflammation is caused by increased activity of the immune cells in your body. These are the ones that hang around ready to fight infections and repair damage. They can become active even without an infection triggering things, which is often the problem in ‘inflammatory’ skin conditions. The process of inflammation causes increased blood flow, which means areas look redder or darker (this is called erythema although the color will de- pend on skin pigment type), will be raised, and can be itchy or sore. It is important to understand that these inflammatory conditions are not contagious or catching—although you can pass on infections, you do not pass on inflammation.

Skin is pretty incredible, and thankfully just gets on with all these jobs most of the time. It can get damaged though, like any other organ, and become infected, inflamed, or even cancerous. Many common skin conditions can be managed with the right treatments. However, rarely skin really can’t do its job—for example. after severe burn, or widespread skin disease. If skin stops working properly people can get really ill, and we’re re- minded how important normal, functioning, healthy skin can be.

The other reason that people worry so much about skin is that it is the bit of us that everyone can see, the face that we show to the world. This is where a different and more complicated kind of ‘normal’ comes in. What should normal skin look like? Who defines this anyway?

We all want to be ‘normal’—this feels particularly important during teenage years, but to be honest, most adults think it too. You don’t want to stand out in any way that is bad, and so that means being the same as everybody else. But do we all want to be the same? Normal skin includes many variants, and so even if we did all want identical skin it would be pretty much impossible. We are all different, inherit different genes, live in different environments, and all have different skin. Some differences are celebrated, some are not, but this varies across societies and changes massively over time.

Beautiful skin in one part of the world might be totally ordinary somewhere else, and while admit- tedly there aren’t many societies that celebrate spots or boils, even this could change. We—hopefully—now live in a time when people are more accepting of difference, and so there is no longer a clear definition of beauty or beautiful skin. There is certainly a reassuring trend emerging, and models and celebrities these days tend to be more varied in terms of looks; people who have no hair due to alopecia bare their scalps, for example, when some years ago this would have been considered unacceptable. Similarly, there is a black supermodel with a condition that causes the skin to lose its colour (vitiligo), and her pigmentation changes are now seen as beautiful too.

However, if you’ve got vitiligo and you’re not famous, the fact that there is now a celebrity who does have it might not make you feel that much better. Yes, some areas of the media celebrate conditions like these, but there are still lots of pictures and adverts, particularly on social media, that would suggest something totally different. They would have you believe that normal skin is flawless and glowing and that everybody should look perfect all of the time. And that’s when your ‘normal’ skin starts to feel like it isn’t good enough. If you’re pale you should tan, if you’re dark you should bleach. If you’ve got spots or a rash then these should definitely be covered up, or stop you from doing things because nobody ever has those kinds of imperfections in the images we are exposed to.

Skin conditions like acne and eczema are rarely, if ever, seen in the media, so plenty of people think they’re rare and abnormal. If you look at the numbers though, this is clearly a mistake. Over 90% of people get spots in adolescence, and about 1 in 5 have eczema at some point in their lives. Approximately 1 in 5 people are left-handed, but not many people think being left-handed is out of the ordinary; why should eczema be any different? When you look at these statistics, you have to ask what’s really more common—the skin that you see on social media, or all the ‘imperfect’ skin you see in the real world around you.

Back to my definition of ‘normal’: skin that works well, and that can do all the jobs it needs to.

Normal skin is hairy and sweaty. Normal skin has freckles and moles on it, normal skin gets spots, normal skin gets rashes on it sometimes, and normal skin bears scars. We all have a say in what normal is, and normal cannot just be an unblemished, ‘photoshopped’ version of the skin. Young people are in control of a lot of that and will have a big part in deciding what kind of skin is judged to be normal and beautiful in the near future.

Skin doesn’t have to look perfect in order to be healthy, and we certainly don’t need to look the same in order to be beautiful. The only way to be happy and healthy is NOT to have skin with one pigment colour, no hair (or lots of hair), no sweat, no moles, no freckles, no scars, and never any redness anywhere—that is not normal, and to be honest it’s not even possible. Flawless skin isn’t normal; our differences in skin are both interesting and necessary, and we should all celebrate this.

The BSPAD website should help with information and resources skin conditions. If you’re feeling bad about your skin, or other people are being negative about it, then please do seek support.