What Your Skin Is Telling You About Your Health

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Your skin impacts your health.   

Skin color shouldn’t have a large impact on human health and quality of life, but it does.  The color of your skin influences your access to basic rights that affect your health and well-being: freedom, clean air and water, nutrient-dense food, shelter, healthcare, education, and jobs.  

The color and texture of your skin also affect how much physical, chemical, psychological, and emotional stress you’re consistently exposed to throughout your lifetime.  Stress is inflammatory.  

Your skin is a visible representation of your health.  

Sensitive, flushed, red, wrinkly, dry, oily, patchy, pimply, weepy, crusty, and/or hyperpigmented skin is telling you something.  It’s not telling you you’re ugly (although that’s what the cosmetics industry would have you believe).  It’s telling you that something is going on internally that requires your attention. 

Skin care is health care.

Your skin is the largest organ in your body, intimately connected to your nervous, immune, gastrointestinal (gut), and cardiovascular systems and the microbiota living in your gut and on your skin.  It’s the interface between you and your environment.  It’s dynamic, constantly communicating with and responding to the rest of your body and your environment.  

When your skin stops working properly, you lose barrier protection (among other things), and your immune system is forced to work overtime to protect you from your environment, generating chronic inflammation in the process.  Chronic inflammation is damaging and disease-causing. 

Dry itchy skin is the sixth most common systemic manifestation of Sjogren’s disease experienced by over three quarters of the 6,630 people who took the 2025 Living with Sjogren’s Survey published by the Sjogren’s Foundation.  Dry, itchy skin is a systemic manifestation of Sjogren’s disease because it can be caused by small fiber neuropathy.  Sjogren’s is more than just dryness/sicca, although research and medicine are slow to acknowledge the evidence.

Thirty-two percent of survey respondents took more than 5 years to get diagnosed with Sjogren’s disease.  It took me 10 years of actively seeking a diagnosis and advocating for myself.  Long before my blood tests were positive or I had dry eyes or dry mouth, my skin was showing signs of chronic inflammation and metabolic dysfunction.  Yours might be, too.  But if your approach to skin care is to correct and cover up, you’ll miss these early signs that something is awry internally.  Rather than covering these changes in your skin, identifying and addressing the underlying problems causing them may save you from lasting organ damage that may disable you and wreak havoc on your life.

Ten skin red flags:

1. Skin sensitivity, heat intolerance, seemingly overly dramatic responses to touch, skin that feels like it’s ice cold or burning up, a persistent itch that’s not alleviated by topical skincare products, and/or inexplicable sensations on your skin with no visible cause, e.g., bugs crawling, electric shocks, pins and needles, or burning.  These symptoms are indicative of small fiber neuropathy (SFN), i.e., damage to the small fiber nerves in your skin.  SFN can occur anywhere in your body, including in your organs.  It can also lead to autonomic neuropathy (dysautonomia), which is disabling and debilitating. 
2. Patches of redness across your face, chest, arms and legs that come and go, don’t itch or hurt, and last several hours or days (often mistaken for rosacea).  These indicate immune dysfunction and an underlying auto-inflammatory or autoimmune disease, e.g., Sjogren’s disease or lupus. 
3. Cold, numb, discolored fingers and toes that turn white, then blue, and then red as the blood returns.  These indicate Raynaud’s syndrome, a vascular condition that’s common in many autoimmune diseases, including Sjogren’s disease, lupus, and scleroderma.  Raynaud’s is a sign that your blood vessels are inflamed and unstable all over your body, not just in your extremities.
4. Chronically dry skin that’s unresponsive to moisturizers and/or drinking lots of water.  Chronically dry skin means chronic inflammation.  Everything that looks like eczema may not actually be eczema.  Those dry, scaly rashes might be caused by Sjogren’s disease.  Hydrocortisone creams and lotions are temporary, superficial solutions that leave your immune system unchecked and wreak havoc all over your body.
5. Fragile skin that breaks and bruises easily indicates damaged connective tissue.  The damage might be caused by an autoimmune disease, e.g., Ehler’s Danlos Syndrome, Sjogren’s disease, scleroderma, dermatomyositis, or from long-term corticosteroid use.
6. Slow wound healing.  If a nick from shaving or a blister from new shoes stays red, irritated, turns into a lingering scab, or leaves behind dark marks or discoloration that wasn’t there before, you might have inflammation of the blood vessels in your skin (cutaneous vasculitis) or nutrient deficiencies. 
7. Yellowing skin or finger nails may be indicative of liver dysfunction e.g., autoimmune hepatitis or primary biliary cholangitis (two conditions that can be caused by Sjogren’s disease).
8. Dark grey/brown spots or patches of skin that are hyperpigmented are often caused by chronic inflammation, adrenal stress, or longterm use of certain medications, such as corticosteroids or hydroxychloroquine (the disease-modifying anti-rheumatic drug used to treat Sjogren’s disease). 
9. Purplish/red spots that don't itch and don't fade or change color under pressure (petechiae or pupura).  These occur when blood vessels break or leak, which, depending on what’s causing the spots, may be happening elsewhere in your body, e.g., your brain, liver, and kidneys, causing lasting damage.  In Sjogren’s disease, these are a sign of cutaneous vasculitis.
10. A net-like/lace-like/mottled purplish or bluish pattern across your thighs and arms indicates disrupted blood flow in the tiny vessels in your skin (livedo reticularis).  It can be the earliest sign of vasculitis or antiphospholipid syndrome, a clotting disorder that sometimes overlaps with Sjogren’s disease and lupus.

Document these changes to your skin: take photos, write down the dates and times of symptoms appearing and disappearing, and share them with your doctor. 

Advocate for the care you need.  I had 7 of the 10 red flags, but I did not recognize them as such.  Had I documented them and shared them with my doctors as soon as I observed them, I may have arrived at a Sjogren’s disease diagnosis faster.  Instead, I wasted years and thousands of dollars trying to correct and cover them up with cosmetics.  When I finally took a different approach, addressed my gut-brain-skin axis, and revitalised my skin using skincare products I make from whole foods, my skin looked so radiant and healthy that I had an extremely difficult time getting anyone to believe I was seriously ill.  But appearances can be deceiving.  Don’t allow yourself to be deceived.  

A version of this blog post is published in my local newspaper, The Davis Enterprise.

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