Skin: The Vitalest Organ

Doctors, especially single organ specialists, like to proselytize about the importance of their organ. Cardiologists crow about how human life can’t exist without a pump, while neurosurgeons back-pat about their role in facilitating consciousness and maintaining our agency in the physical world. Hepatologists and nephrologists have an obviously lesser argument but for some reason still try to edge into the conversation, seemingly oblivious that filters (aquarium/pool/bloodstream) can often be replaced.

But you’ve probably never heard a dermatologist make such a claim… until today.

I hereby declare the skin the most vital organ. Not only in the human body, but in the history of the world.

1. Life as a construct cannot exist without skin

Inherent to the concept of life is the notion that it is distinguishable from non-living matter. Therefore all life must have an outer boundary. The basic unit of life is the cell, and the cell is defined by its membrane. Skin has been vital from the moment that life became life, because no living thing has ever existed without some form of protective outer barrier. Skin was around for three billion years before any other recognizable organ evolved. Hearts and brains are only about 540 million years old (Maybe that’s why they’re so likely to kill you).

2. Skin rarely fails

Your heart sucks. Odds are that when you die it’ll be because it up and quit on you. Your ticker’s the weakest link in the whole system, yet for some reason cardiologists see this as reason to boast. We don’t elevate the player who consistently strikes out to end the game by naming them MVP. The skin, meanwhile, almost never fails. If it does, you will die. Rest assured that if all your skin falls off (and it sometimes does), you will very quickly learn that it is every bit as vital as the heart, brain, lungs, or any of your other innards. The fact that it almost never fails does not suggest irrelevance. Rather, its very resilience proves the opposite.

3. Your other organs are cowards

I’ve never understood why “having guts” is idiomatic for courage. Your guts hide behind the skin because they can’t bear the thought of interacting with the outside world. Think your intestines can handle 10F temperatures and 0 percent relative humidity? Think again. What do your eyes do when they get scared? Hide behind eyelids! Your other organs spend all their time coddled by the skin so your musculoskeletal system can transport your brain from place to place. Muscles don’t get a pass, either; skin bears the brunt of all your motion on this rocky gravity well we call Earth. Just ask the calluses on your feet.

Skin is our primary physical protection from the harshness of a gaseous atmosphere, and from the legions of bacteria, fungi, parasites, and viruses that live on and around us at all times. It allows you to carry on as a walking, talking bag of seawater in an inhospitable world. Don’t let nephrologists fool you: the skin is the primary homeostatic organ. The kidneys just add a pinch of salt.

4. Skin picks up a lot of slack

In addition to schlepping your lazy innards around the physical world, the skin performs many of the end functions that other organs can’t do themselves. Foot fell asleep? Tough luck, brain. You’ve been rendered useless without signals from the skin (our primary sensory organ). Overheating? The hypothalamus had better hope the eccrine glands are up and running. Want to say something without really saying it? The eyes need the help of eyebrows, lips, and our ability to yank facial skin in various directions. Our whole social fabric would simply unravel without skin.

5. The lungs are okay, I guess

Props to the lungs for dealing with all the garbage we breathe in. Also cool that they help us exist in a gaseous atmosphere. Kind of lame, though, that all that air gets warmed up, humidified, and partially filtered in the nasopharynx (nose and throat) before arriving in the “delicate” lung tissue. B-.