The incidence of obesity is alarmingly increasing over the past two decades posing a universal major public health problem. The consequences of obesity in the skin are often underestimated. The effect of obesity on the skin that includes the increased body mass index affecting skin physiology, skin barrier along with the collagen structure and wound healing has been reviewed in this paper.

Obesity affects sweat and sebaceous glands causing circulatory and lymphatic changes. The most common skin manifestations associated with obesity are acanthosis nigricans, keratosis pilaris, acrochordons, cellulite, striae distensae and plantar hyperkeratosis. Obesity also has metabolic effects, causing hyperandrogenism and gout, which are further associated with cutaneous manifestations.

Moreover, obesity is related with an increased occurrence of bacterial and Candida skin infections along with onychomycosis, inflammatory skin diseases and chronic dermatoses such as hidradenitis suppurativa, rosacea and psoriasis. The relationship between atopic dermatitis and obesity as well as increased risk of skin cancer in obese patients is controversial. Obesity is also linked to rare skin conditions and premature hair graying. For physicians, considering these clinical signs and the underlying systemic conditions will enable earlier diagnoses for enhanced treatment and avoidance of any sequelae.

Source: Hirt PA, Castillo DE, Yosipovitch G, Keri JE. Skin changes in the obese patient. J Am Acad Dermatol. 2019;81(5):1037-1057. doi:10.1016/j.jaad.2018.12.070