Let’s talk about skin. We all have a skin story. Mine is one of chronic psoriasis. No, it’s not just a ‘cosmetic issue’ – an inconvenient plaque or two. Psoriasis has been an all-pervading presence in my life since I was about 16. In the lead up to my wedding in the 1990s, my favourite wedding prep supporter was my dermatologist. We were faced with the challenge of getting my skin as clear as possible for the big day. Fast forward to just over a decade later, and my dermatologist was trying to work out how to clear the skin around my possible epidural site. My treatment took a necessary backseat for years of pregnancy and breastfeeding to protect my children’s health, and my psoriasis ran rampant. My score hit a high of 16 which is considered severe. And it took my dermatologist and me about a decade to significantly lower it. My best score is around 4. I’m currently sitting on a 6 and hoping (cue praying) it will go down. And please, nobody comment below with a ‘cure’; I guarantee I have tried it all – from diets to udder cream! After 34 years of living with psoriasis, I’m still embarrassed by shedding skin, shiny pink plaques, the waft of tar that follows me everywhere, and strange looking fingernails. I’m on cytotoxic medication, and my moisturiser comes with a flammable warning! So why am I sharing all this? Because of Skin Deep by Phillipa McGuinness (2022). For the first time in my journey with psoriasis, this book has made me feel seen and heard and not ashamed of my chronic and likely lifetime illness.

McGuinness explores the body-mind-self connection, skin and its relationship with culture, genetics and ethnicity, the profession of dermatology, skin cancer, microbes, touch, and the art of tattooing.

McGuinness’s voice is warm, her insights careful, considered and intelligent, and her fascination with skin evident.

Written in accessible language, Skin Deep illuminates our relationship with the largest organ in our bodies. McGuinness’s book will entice you to consider your skin differently and prompt you to think about your skin and that of others in an altered light.

Highly recommended for all wearers of skin!

Many thanks to Penguin Random House for sending me a copy of Skin Deep to review. I’ll be sharing this copy with my dermatologist. After more than two decades together, I’ve got a fair inkling that she will love it!

I’ve pasted below my favourite quote and the publisher’s blurb:

“In literature, as in life, psoriasis is graphic. The psoriatic diarist in John Updike’s 1976 story ‘From the Journal of a Leper’ writes:

The form of the disease is as follows: spots, plaques, and avalanches of excess skin, manufactured by the dermis through some trifling but persistent error in its metabolic instructions, expand and slowly migrate across the body like lichen on a tombstone. I am silvery, scaly. Puddles of flakes form wherever I rest my flesh. Each morning I vacuum my bed. My torture is skin deep; there is no pain, not even itching; we lepers live a long time, and are ironically healthy in other respects. Lusty, though we are loathsome to love. Keen-sighted, though we hate to look upon ourselves. The name of the disease, spiritually speaking is, Humiliation.”

Publisher’s blurb:

This is a book about skin. The strange wonderfulness of our bodily covering. What happens to it when something goes wrong. How the world responds to imperfection and difference. It’s about how skin makes us who we are.

Skin serves as a barrier between us and the germs that would otherwise invade and destroy us. It regulates our temperature. Skin remains waterproof even while our entire epidermis replaces itself each month. The body’s biggest organ even has its own sub-set of organs – sweat glands, sebaceous glands and hair follicles.

Primeval, sometimes mysterious forces drive skin-to-skin contact, but erotic desire is but one of many deep-seated urges that make us want to touch the skin of another. Touch is how we express love and affection as well as darker, violent emotions.

Skin keeps the outside out and the inside in. You will intuitively compile information and judgements about a stranger based on their skin and the clothing that covers it. Skin shouldn’t give you the measure of a person but we function as if it does.

Skin Deep explores beauty, ageing, imperfection, health and illness, all of which are closely related to skin, and interrogates whiteness, both historically, structurally and through current notions of white fragility and victimhood. Paradoxically, skin is a barrier and a point of contact. It is miraculous, our biggest organ. It heals itself! It’s wafer-thin! Skin cells remake themselves!

Phillipa McGuinness has interviewed plastic surgeons, dermatologists, burn survivors, beauticians, melanoma sufferers, people who suffer from body dysmorphias, victims and perpetrators of racism, and all kinds of people who are and are not comfortable in their own skin, to write a book where science meets art and culture, history and politics. Philosophy too, given skin is the point where our self, and our self-perception, struggles with or embraces the way others see us, and the way we see ourselves.