Skin blood flow in adult human thermoregulation: How it works, when it does not, and why
Abstract
The thermoregulatory control of human skin blood flow is vital to the maintenance of normal body temperatures during challenges to thermal homeostasis. Sympathetic neural control of skin blood flow includes the noradrenergic vasoconstrictor system and a sympathetic active vasodilator system, the latter of which is responsible for 80% to 90% of the substantial cutaneous vasodilation that occurs with whole body heat stress. With body heating, the magnitude of skin vasodilation is striking: skin blood flow can reach 6 to 8 L/min during hyperthermia. Cutaneous sympathetic vasoconstrictor and vasodilator systems also participate in baroreflex control of blood pressure; this is particularly important during heat stress, when such a large percentage of cardiac output is directed to the skin. Local thermal control of cutaneous blood vessels also contributes importantly--local warming of the skin can cause maximal vasodilation in healthy humans and includes roles for both local sensory nerves and nitric oxide. Local cooling of the skin can decrease skin blood flow to minimal levels. During menopause, changes in reproductive hormone levels substantially alter thermoregulatory control of skin blood flow. This altered control might contribute to the occurrence of hot flashes. In type 2 diabetes mellitus, the ability of skin blood vessels to dilate is impaired. This impaired vasodilation likely contributes to the increased risk of heat illness in this patient population during exposure to…
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During severe hyperthermia, the magnitude of skin blood flow is significantly large and the ability of heat transfer via convection of blood with postulated linear relationships might be wrongly estimated.
“For example, Charkoudian (2003) reported that during severe hyperthermia, the magnitude of the skin blood was significantly large and the ability of heat transfer via heat convection of blood with the postulated linear relationships might be therefore wrongly estimated.”
From A two-node mechanistic thermophysiological model for pigs reared in hot climates – Part 1: Physiological responses and model development (2021) · cites this paper as Charkoudian, 2003
Core body temperature plays a dominant role in controlling thermoregulatory effectors compared to skin temperature.
“Core body temperature played a dominant role in controlling the thermoregulatory effectors compared to the skin temperature (Charkoudian, 2003).”
From A two-node mechanistic thermophysiological model for pigs reared in hot climates – Part 1: Physiological responses and model development (2021) · cites this paper as Charkoudian, 2003
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- Authors
- Charkoudian, N.
- Affiliations
- Mayo Clinic (US)
- Corresponding author
- Charkoudian, Nisha
- ORCID
- Charkoudian, Nisha
- Venue
- Mayo Clinic Proceedings
- Publisher
- Elsevier BV
- Published
- 2003-05
- Volume
- 78
- Issue
- 5
- Pages
- 603-612
- ISSN
- 0025-6196 (ISSN-L)
- OpenAlex
- W2166143114
- Cited by
- 1,041
- References
- 3
- Citations by year
- 2026: 64 · 2025: 58 · 2024: 51 · 2023: 53 · 2022: 59 · 2021: 47 · 2020: 41 · 2019: 64 · 2018: 57 · 2017: 44 · 2016: 54 · 2015: 58 · 2014: 59 · 2013: 47 · 2012: 37
- FWCI
- 3.11
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Mayo Clinic Proceedings (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institutes of Health (5f32ar008610-03)
- National Heart, Lung, and Blood Institute (HL63328, R01HL063328)
- National Institute of Arthritis and Musculoskeletal and Skin Diseases (AR08610)
- National Center for Research Resources (RR-00585, M01RR000585)
- Topics
- Health Sciences › Medicine › Physiology › Thermoregulation and physiological responses
- Health Sciences › Medicine › Complementary and alternative medicine › Cardiovascular and exercise physiology
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Heart Rate Variability and Autonomic Control
- Keywords
- skin blood flow, thermoregulation, cutaneous vasodilation, baroreflex control, nitric oxide, menopause, hot flashes, type 2 diabetes, heat-related illness, Raynaud's phenomenon, erythromelalgia, hyperthermia
- MeSH terms
- Adult, Blood Pressure, Body Temperature Regulation, Diabetes Mellitus, Type 2, Erythromelalgia, Humans, Menopause, Microcirculation, Raynaud Disease, Regional Blood Flow, Skin, Skin Temperature, Sympathetic Nervous System, Vasoconstriction, Vasodilation, Thermogenesis
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