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The thick middle skin layer of connective tissue that gives skin strength and elasticity and houses nerves, vessels, and glands.
Medically reviewed & updated
The dermis is the thick, supportive middle layer of skin, sitting beneath the epidermis and above the subcutaneous fat. It is the structural backbone of the skin, providing strength, flexibility, and a home for blood vessels, nerves, hair follicles, and glands. Unlike the epidermis, the dermis is richly vascular and contains the connective tissue that gives skin its resilience.
The dermis is divided into two layers. The superficial papillary dermis is made of loose, highly vascular connective tissue. It folds into finger-like projections called dermal papillae that interlock with the epidermis, anchoring the two layers and increasing the surface area for nutrient and oxygen exchange (the epidermis has no blood supply of its own). Beneath it lies the deeper reticular dermis, a thick layer of dense connective tissue that makes up the bulk of the dermis. Collagen, principally type I and type III, is the dominant protein, woven together with elastic fibers and an extracellular ground substance rich in hyaluronic acid and proteoglycans.
The dermis performs several essential roles. Collagen provides tensile strength while elastin lets skin stretch and recoil. Its dense network of blood vessels nourishes the skin and helps regulate body temperature by dilating or constricting. The dermis also carries sensory nerve endings for touch, pressure, pain, and temperature, and it surrounds the hair follicles, sebaceous glands, and sweat glands embedded within it. Fibroblasts, the main dermal cell type, manufacture and maintain this connective tissue scaffold.
Because the dermis stores collagen and elastin, its gradual breakdown with age and sun exposure produces wrinkles and sagging. Stretch marks (striae) form when rapid stretching tears dermal collagen. Deep (full-thickness) burns and wounds that reach the dermis heal with scarring because mature dermal architecture does not fully regenerate. Conditions such as scleroderma involve abnormal collagen deposition in the dermis. This content is educational and not a substitute for medical advice.