Thomas J. Kehoe reviews Phillipa McGuinness, Skin Deep: The Inside Story of our Outer Selves, Vintage, Sydney, 2022.


Phillipa McGuinness is an excellent writer and storyteller and in Skin Deep she takes the reader on a journey through the multifaceted dimensions of experience and the permutations of meaning associated with our skin. Skin is ubiquitous to the human experience, as she eloquently points out in the introduction. It protects us. We feel through it. And it very often defines how we interact with the world and, perhaps more importantly, how the world relates to each of us. To McGuiness, skin is almost like a palimpsest, with layers of interactive meaning transposed upon each other. Her book is essentially an exploration of these different meanings and experiences that are mediated by our skin as seen through her experience. However, to complement her personal journey through this world of skin that covers history, health, culture, and society, she collected an impressive number of interviews with doctors, historians, public health workers, and politicians, among others, who convey the underpinnings and context for hers and other Australians’ lived experiences. The result is a beautifully written synthesis of knowledge that makes the hidden interior and exterior functions of skin penetrable for a non-specialist audience.

Matheus Vinicius, via Unsplash

McGuinness’s focus is primarily on Australia and the meaning of skin in an Australian context. Her adoption of a personal narrative that centres the author in that Australian context and experience therefore functions quite admirably. Using this model, she takes the reader on a voyage of discovery through her own embodied experience as a white Australian woman in a land with rigorous skin-connected beauty standards, racial ideals, and disease. Her book interrogates the history of an Australian society long structured on skin colour and colonial racism, that has in recent decades glorified tanning and white-bronzed “beauty”, and through the related issues of skin cancer and other skin conditions. For a reader unfamiliar with these important parts of Australia’s past and present culture, this book will be eye-opening and McGuiness’s fluid, accessible writing style will make easier to penetrate, the complicated and challenging complexities of the scientific and ideological connotations of skin.


One could find some limitations to this approach when considering the academic contributions of Skin Deep. McGuinness does not bring anything new to the table on salient issues of colonialism, racism, or public health in the Australian context. For instance, the history she relates on the connection between skin-colour defined racism and settler-colonialism—and its legacies—is well known and there is no original data in this book that extends our existing knowledge of these topics. The same critique could be made of her forays into public health. She echoes an oft-made assertion that the SunSmart program founded in 1981 has been “one of the most effective public health campaigns in history” (p. 127). This is certainly a popular view. Yet a few pages later, she quotes Head of Prevention at Cancer Council Victoria Craig Sinclair explaining the program’s ineffectiveness at changing the sun-related behaviour of teenagers and young adults. Sinclair has been an active driver of SunSmart almost from its very beginning and the question of “efficacy” that he raises remains unresolved in McGuiness’s telling. However, her aim in these discussions of skin conditions and cancer is to relate existing knowledge to a new audience, not to break new ground in public health scholarship.

But such scholarly nit-picking would overlook the valuable, original contributions that this book makes. Notably, her interrogation of the “bronzed” Australian ideal for physical health explores a subject that has too often been overlooked. Whilst the trope is well-known, McGuiness raises the tantalizing question of what it meant in Australian culture historically, and by extension the role that such past meanings have had for our present. Such questions have rarely been posed. In this book, they emerge from an impressive effort to cohesively condense much of our accumulated knowledge of skin and its cultural, historical, and physical importance into one accessible output. As a result, a key problem that she highlights is how little we know of the cultural history of skin and skin-disease. One of the strengths of this book is its interdisciplinary nature. Historians and social scientists have rarely been placed into scholarly conversation with scholars and advocates from medicine and public health. The history of sun culture in Australia and its connection to racial and colonial histories on the one hand and to disease—especially cancer—on the other, is virtually unwritten. In Skin Deep, McGuiness exposes this gap in our knowledge by bravely placing herself, the “white Anglo-Celtic Australian woman”, in a history in which whiteness and a culture of sun worship that equated health with a tan was until very recently normalised. These beliefs about race and health are both toxic cultural traits that have maintained colonial racial stratifications and affected inter-group relations, and have also affected public health. McGuiness shows their damage historically and sociologically, as well to the individual. She eloquently relates how her skin does not bronze but burns a bright red, a colour that was neither considered healthy or desirable, but it is the frequent outcome among the palest peoples. Importantly, she illustrates how these issues of race, beauty perception, and health are intimately connected and mediated by an Australian cultural history that continues to affect our lived experience, most clearly by shaping social policy.

Overall, this is a powerful and challenging book that for the first-time focuses on skin itself in discourse rather than using it is a medium through which to discuss closely related, yet separate, issues of race and health. Conceptually linking whiteness and love of the sun and its physical results to race, health and vitality is itself not new. Warwick Anderson and Alison Bashford, among others, have addressed important aspects of this history. But, importantly, neither centred on skin itself. McGuiness’s book is therefore very fresh in its linking of these same concepts to modern understandings of disease and health promotion, wherein skin is the medium upon which meaning is layered and, like the palimpsest, gently—often unintentionally—cross-mediated. As a result, this is a pleasing, well-written, and enjoyable book that points the way towards new approaches to writing histories and popular studies of skin and health. It should be a vital addition to the scholar’s shelf as much as it is to the casual, interested reader’s collection.

Thomas J. Kehoe
Thomas J. Kehoe

Thomas J. Kehoe, PhD is the in-house historian and head of the Heritage Project at Cancer Council Victoria. He is also Honorary Research Fellow in history at the University of Melbourne. He has published on governance, crime management, and public health in European and Australian history in books and leading journals. These include publications on tobacco business in Business History and on the management of sexually transmitted infections during military occupation in the Journal of the History of Sexuality. His second sole-authored book forthcoming with Palgrave—Cancer Data for Good—explores the history of cancer registration and epidemiology in Victoria. His current research explores the histories of anti-cancer campaigning in Australia with a focus on tobacco control and skin cancer prevention.