Why did you choose the title Skin Deep ?
The glib answer is that the former book publisher in me loves short titles. There are quite a few other books that share the same title although they are very different in approach to mine. But we settled on Skin Deep because it captures the theme of doubleness that runs through my book as it relates specifically to skin — it’s inside and out, a barrier and receptor, both surface and depth. The title also signals that the book seeks to challenge lazy platitudes about beauty only being skin deep. We say these things but, unfortunately, I don’t think we are always sincere. Our society is saturated by the visual — we are obsessed with appearances, even when we say we aren’t.
When did the inspiration to write a book about the human body’s largest organ strike you?
The idea came to me, appropriately enough, while I was sitting in the waiting room of the busy dermatology practice I go to. Like so many Australians, particularly those with a Celtic background like mine, I was there for my regular skin check, having had a few non-melanoma skin cancers removed. As I looked around at my fellow patients, it struck me that great forces of colonisation, dispossession and migration, not to mention Australia’s sun-loving culture, had made me part of a grim statistic: we are the country with the greatest prevalence of skin cancer in the world, at great cost to the health system. And great personal cost as well.
But there is a more complicated answer to this question as well, one I address in a chapter called ‘Skin Irony’, which is really about the psychology of skin, of things not being quite what they seem. I read two essays, one called ‘The Itch’ by Atul Gawande in 2008 and another called ‘Devil’s Bait’ by Leslie Jamieson in 2014; let me just say that these pieces got under my skin.
Skin is a huge topic. How did you decide which layers to keep in and out, so to speak?
As with my previous book, a biography of the year 2001, I knew it was impossible for Skin Deep to be comprehensive. Dermatologists recognise about 4,000 skin conditions – it is better to read about those in medical textbooks, though I do write about the more common conditions. I wanted to blend popular science with a cultural and interview-based approach. And everyone wants to know about moisturising, or why we blush at the worst possible moment.
It struck me that those are perceived to have ‘perfect’ skin may not have always been so blessed — nearly everyone on the planet has had acne at some point. We all have scars. I was privileged to interview people grappling with life-threatening melanoma, or others who live with chronic skin conditions such as psoriasis and eczema. I also explore how these conditions have appeared in literature or on film and television, from The Singing Detective to the Australian film Praise. I spoke to plastic surgeons, dermatologists, public health experts, a tattoo artist, a celebrity facialist, a beauty editor, a massage therapist and many more. But I decided that talking to burns victims and writing about new technologies to grow skin were beyond the scope of what I could do.
Were you tempted to try the more extreme beauty treatments or procedures that you write about?
I write a bit about Botox and cosmetic fillers, and more invasive procedures too, but no, I didn’t go down that path myself for research or other purposes. I did get an eye-wateringly expensive treatment from a celebrity facialist in Sydney that I write about, particularly as I tried to unpack the roiling emotion I felt when I walked out. (Though my skin did look great.)
The book has a chapter about tattoos called ‘Inkside Out’ in which I interview lots of people who find that their tattoos say something that is difficult to express otherwise. A few interviewees asked if I would get one as part of my research. I have not, but as with anti-ageing treatments, never say never.
You wrote the book throughout 2020 and 2021. Did the momentous events playing out in the wider world influence your book?
Yes, more than any of us could have anticipated when I signed the contract at the end of 2019. I was always going to write about skin colour, what we blithely call race, but #BlackLivesMatter made me think more deeply about the language I used, particularly around racial justice.
COVID had a big impact as well. I couldn’t meet with most people face-to-face for interviews. But working from home meant that I could log on to dermatological webinars that I might not have had access to in normal circumstances, so that was one upside. The pandemic changed many everyday behaviours and this is reflected in the book. It transformed the discussion about touch, for example, because so many isolated people —those who live alone or who were in quarantine — were deprived of touch. Social distancing precluded everyday touch, which is a key way we express ourselves and connect with others, in formal and intimate settings. Masks meant we couldn’t see each other’s faces as we usually would, something else I found interesting from the perspective of skin and perception.
But COVID also meant that rather than socialising, I sat at my desk researching and writing, so I met my publisher’s deadline! It was a huge relief when the Library reopened in 2020 (this was before I started working here) so I could check various books not available online. That was a blessing.
Do people ask you for advice about their own skin now?
I have had a few people point to their moles, or minor rashes, and ask for my opinion. My only advice, of course, is to have them checked as soon as possible by a GP or dermatologist.
Given my research, other people have asked me which skincare products really work. My only answer to that — and it happens to be the main advice from a well-known beauty editor I interview in the book — is to wear sunscreen.
But I’m happy to share the three secrets to good skin that I reveal in the book: