	Page 32 -- THE SUBCUTANEOUS FAT LAYER

Keloid scars

     keloid scar

Scars in older people tend to be cosmetically better.

   Sometimes the skin cells go on working at the repair process for much longer than necessary, so that far too much scar tissue is formed. This produces a permanent raised scar called a keloid. Keloids are common with certain types of skin, particularly in young people and those from an African background. They can be injected with steroids by a doctor, which sometimes helps. Cutting them out is seldom effective, and usually makes them worse. Eventually they decrease in size.

Skin creases

In many regions of the body the skin is separated from the muscles by loose fatty tissue (of variable depth) and moves very easily. In other areas it is anchored to the bones. This is most obvious in the palms of the hands, where the skin is arranged so that it closely follows the movements of the fingers. Some of these creases form while a baby is still in the womb, or very soon after birth.
  Folds and creases are also found on the face even in very young babies, as the skin accommodates the movements of the muscles of the face. In the face of a very fat person the subcutaneous layer of fat becomes thick and bloated, and reduces the appearance of these creases.

The subcutaneous fat layer

The subcutaneous fat layer cushions the dermis from underlying tissues such as muscle and bones.
   As we have seen, this layer consists of cells containing fatty deposits, called adipose cells. The blood vessels and nerves it contains are larger than those in the dermis. It may also house the hair follicles when they are in the growing phase.
   One of the functions of this fatty layer may be to act an insulation to conserve body heat. The human body stores fat as an energy reserve, in the same way that some animals store fat for winter when food supplies are likely to be short. Unfortunately the numbers of people with excess fat are increasing, thanks to their genetic predisposition together with habitually eating the now abundant sources of food. An excess of stored fat is seldom due to hormone problems, although as we get older fat deposition naturally increases as our metabolisms slow down. Getting normally heavier is therefore not necessarily due to us eating more food - just to eating.
   Fat is stored outside the muscles. Although calorie reduction as part of an overall plan helps to make us slimmer, specific remedies to improve muscle tone in the tummy by exercise do not necessarily help to reduce the fat in that area. Distribution of fat in the body differs between men and women: in women it is stored mainly in the buttocks and thighs, and in men in the abdominal wall (the notorious 'beer belly').
   The subcutaneous fat is organized into fat lobules, which are separated by collagen fibres. When these lobules become grossly distended and engorged by fat they adopt characteristic patterns (cellulite), in women particularly on the bottom and thighs where the skin is tethered down to the underlying muscles. These patterns tend to develop from the teens onwards.