Globally, obesity is a major public health problem with an alarmingly increasing incidence over more than two decades. The consequences of obesity related skin disorders are underestimated. In this review paper, the effect of obesity on the skin has been discussed. This includes in what way the increased body mass index affects skin physiology and barrier, wound healing and collagen structure.

Obesity affects sebaceous and sweat glands causing circulatory and lymphatic changes. Common skin manifestations associated with obesity consist of acanthosis nigricans, acrochordons, keratosis pilaris, striae distensae, cellulite, and plantar hyperkeratosis. Also, obesity has metabolic effects, such as it can cause hyperandrogenism and gout, which are associated with cutaneous manifestations. Moreover, obesity is also associated with an increased prevalence of bacterial and Candida skin infections, along with onychomycosis, inflammatory skin diseases, and chronic dermatoses such as hidradenitis suppurativa, psoriasis and rosacea. The association between atopic dermatitis, obesity and the increased possibility of skin cancer among obese patients is controversial. Obesity is related to rare skin conditions and also with premature hair graying. Physicians should understand these clinical signs and symptoms along with the underlying systemic conditions, as it will enable earlier diagnoses for better treatment and avoidance of further complications.

Source: Hirt PA, Castillo DE, Yosipovitch G, Keri JE. Skin changes in the obese patient. J Am Acad Dermatol. 2019 Nov; 81(5):1037-1057