דרמיס רשתי

The reticular dermis accounts for approximately 80% of the dermal thickness, making it the much thicker layer underlying the papillary dermis. This substantial proportion reflects its critical role in providing structural support and mechanical strength to the skin through its dense, irregular connective tissue composition.

The reticular dermis contains Pacinian corpuscles, which detect pressure and deep touch, and Ruffini corpuscles, which sense skin stretching. These sensory receptors contribute to the sensory functions of the skin that allow us to perceive mechanical stimuli and respond to our environment.

Collagen fibers provide structure and tensile strength, while elastic fibers provide elasticity and enable skin movement. Together, these interwoven thick bundles in the extracellular matrix make the skin strong, extendable, and elastic. Collagen also binds water to maintain skin hydration and turgor.

Arteries branch into the cutaneous plexus, supplying blood to the reticular dermis and accessory structures of the skin, including hair follicles, sweat glands, and sebaceous glands. This rich vascularization ensures these structures receive adequate oxygen and nutrients for proper function.

The reticular dermis contains stem cells, fibroblasts, macrophages, and mast cells. Fibroblasts synthesize collagen and elastic fibers, while macrophages and mast cells support immune and inflammatory responses. Stem cells contribute to tissue repair and regeneration within this important dermal layer.

Cleavage or tension lines form due to less dense regions in the extracellular matrix and separations between collagen bundles in the reticular dermis. These lines reflect the directional arrangement of collagen fibers and indicate areas where the skin has natural lines of tension, which is clinically important for surgical planning.

Collagen injections introduce collagen externally to restore skin turgor and volume. Alternatively, Retin-A creams stimulate blood flow and promote dermis repair, encouraging the body to produce new collagen. Both approaches address loss of skin elasticity and firmness by either replacing or regenerating dermal collagen.