The field of medicine has known from inception that internal disease can manifest on the skin. As scientific breakthroughs and innovation advanced medicine, visible signs of disease became more identifiable over time and easier to associate with specific illnesses. As a dermatologist, I am trained to care for those with skin, hair, and nail disorders. I am skilled at identifying visible signs and symptoms essential to reliably make accurate diagnoses and guide further evaluation. But you do not have to be a dermatologist to know that things may be going right or wrong based on what you can see of your visible self.
What is health?
The World Health Organization’s definition of health in its Constitution from 1948 is still readily accepted :
"Health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity."
I sum up health as the collective condition of one’s physical body, social being, and mental state. Therefore, wellness or well-being is our pursuit of a disease-free but fit physical body, positive social connections, and productive mental state. That pursuit or goal of good health means that we must involve ourselves in the process. Actionable steps must be taken to physically remain disease-free ( or fit if afflicted with chronic disease), enhance ourselves socially, and preserve mental health.
One component of health that has become more apparent to me as I practice dermatology is what I call visible health. After seeing thousands of patients in the academic and clinical setting over the past three years, I realized that clinical evaluations were more than just an assessment of physical health. The visible presentation reflected one's overall health status. Visible signs of physical, social, and mental health spoke to a person’s overall wellbeing.
From a clinical presentation, signs of physical, mental, and social health that may be visible include:
- Acute or chronic dermatologic disease and signs of internal disease
- Past health events (surgical scars, injury, missing body parts, implantable medical devices)
- Lifestyle (smoking, sleep hygiene, self-care, physical activity level, alcohol use, coffee consumption, tanning, recreational drugs)
- Mental state (anxiety, depression, self-mutilation, and worry)
- Social factors (occupation; abuse; parent, child, partner, or caregiver interaction and relationships)
- Risk factors for future disease (tanning, smoking, obesity)
Thus, our visible attributes not only contribute to our health status but also reflect how we interact with the World, others, and ourselves.
Achieve visible wellness
Visible wellness is the process of actively pursuing positive visible health to improve quality of life and prevent disease.
This Skin Cancer Awareness Month, I encourage everyone to consider their visible health and what may be positively or negatively impacting it. While you might not have any health disorders, know that behaviors like indoor or outdoor tanning leave visible and irreversible signs and dramatically increase one’s risk of skin cancer. Also, smoking dependency causes deep facial wrinkles and skin texture abnormalities while increasing your risk for lung disease and cancer. Be involved in your overall health and monitor your visible attributes. If what you see is not reflecting positive physical, social, and mental health, set goals and take actionable steps to reach your visible wellness.