Air Pollution's Skin Rash: Is It Possible?

Air pollution has been linked to a range of skin problems, including premature ageing, eczema, hives, and acne-like breakouts.

The skin is the body's first line of defence against external factors, and air pollution can affect its structure and function. Air pollutants such as particulate matter, polycyclic aromatic hydrocarbons, volatile organic compounds, and ozone can induce oxidative stress, which counters the skin's antioxidant defences. This can lead to a range of skin issues, including premature ageing, pigmentation, acne, eczema, and even skin cancer.

Research has shown that an increase in particulate matter due to traffic-related air pollution is associated with a higher number of pigment spots on the forehead and cheeks. Similarly, higher levels of indoor fine particle pollution, often associated with cooking with solid fuels and inadequate ventilation, have been linked to increased pigment spots and wrinkles.

In addition to these specific skin conditions, air pollution can also cause everyday skin aggravation, such as acne-like breakouts and disturbances in the skin's natural flora, or microbiome. Protecting the skin with cleansers, antioxidants, and sunscreens can help mitigate the negative effects of air pollution.

Air pollution can cause premature skin ageing

Ultraviolet radiation, polycyclic aromatic hydrocarbons, volatile organic compounds, oxides, particulate matter, ozone, and cigarette smoke are all air pollutants that can damage the skin. The skin is the body's first line of defence, and air pollution affects many organ systems, including the integumentary system.

Air pollution can cause oxidative stress, which counters the skin's antioxidant defences. This can lead to genetic damage, activation of transcription factors, and signalling pathways involved in cell growth and differentiation and the degradation of the connective tissue of the dermis.

Air pollution can also cause inflammation, which can result in the accumulation of neutrophils and other phagocytic cells that further generate free radicals, creating a vicious cycle.

In addition, air pollution can cause an imbalance in the skin's lipid-rich plasma membrane, initiating a lipid peroxidation reaction cascade.

Air pollution can also affect the skin by:

• Increasing squalene by-products, which can lead to comedogenesis and inflammatory acne.
• Inducing wrinkling and extrinsic skin ageing by oxidising epidermal lipids and disturbing the activity of matrix metalloproteinases.
• Increasing the risk of skin cancer.
• Increasing the incidence of psoriasis, acne, and skin cancers.
• Contributing to allergic skin conditions such as atopic dermatitis and eczema.

Air pollution can trigger eczema and other allergic skin conditions

Air pollution has been linked to a range of skin problems, including premature skin ageing, eczema, hives, and breakouts.

Eczema

Also known as atopic dermatitis (AD), eczema is a chronic skin condition that causes red, itchy patches on the skin. While the primary risk factor for developing eczema is genetic, research shows that environmental factors like air pollution, humidity, and temperature play a significant role in triggering and aggravating symptoms.

A study of primary school children in Seoul, Korea, found that eczema rates were significantly higher for children who had a family history of allergic diseases and had moved into a newly built house in their first year of life. Newer houses are more airtight, which can cause air pollution to reach higher concentrations than outdoors. In addition, harmful chemicals (VOCs) are emitted by many common building materials, fresh paint, and furniture. For these reasons, moving to a new home was considered an environmental trigger for the eczema gene.

Even if you live in an older home, you may still be vulnerable to air quality-related symptoms. Routine household activities such as cooking and cleaning can increase airborne pollution levels and trigger eczema flare-ups.

Other Allergic Skin Conditions

Air pollution can also trigger other allergic skin conditions. One study conducted in Windsor, Canada, found that emergency room visits for hives increased in relation to short-term spikes in ambient air pollution.

Oxidative Stress and Skin Barrier Impairment

The pathogenic mechanisms of air pollutants on skin diseases primarily include the aryl hydrocarbon receptor (AhR) pathway, oxidative stress, and skin barrier impairment.

Air pollutants enter the skin via nanoparticles and generate quinones, which are redox-cycling chemicals that produce reactive oxygen species (ROS). This increase in ROS and free radicals within the cell and its mitochondria overcomes the skin's innate antioxidant defences, leading to inflammation and metabolic impairments.

Strategies for Mitigation

To protect your skin and health, it is important to improve indoor air quality and reduce exposure to environmental triggers. Using an air quality monitor can help you identify sources of skin-related symptoms and take steps to reduce flare-ups.

Other strategies for personal protection include physical photoprotection, the use of sunscreens, and the use of topical antioxidants such as vitamins C and E.

Air pollution can cause skin irritation, breakouts and inflammation

Air pollution is a mixture of particles and gases that can reach harmful concentrations both outdoors and inside buildings. It is a generation's silent killer, responsible for more than 7 million premature deaths every year.

Air pollution affects the skin by causing oxidative stress. This happens when air pollutants enter the skin via nanoparticles and generate quinones, which are redox-cycling chemicals that produce reactive oxygen species (ROS). This increase in ROS and free radicals within the cell and its mitochondria overcomes the skin's innate antioxidant defences, including depletion of enzymatic and non-enzymatic antioxidant capacities. The ROS and free radicals interact with the lipid-rich plasma membrane, initiating a lipid peroxidation reaction that unleashes proteolytic activity, causing further tissue injury.

The effects of air pollution on the skin include premature ageing, photodamage, solar lentigines, melasma, and increased incidences of atopic dermatitis, psoriasis, skin cancers, and acne.

Airborne pollutants can cause everyday skin aggravation, even if you don’t have an existing skin condition. Just as large particles such as dust and dirt collect on our skin, so do fine particles that are invisible to the naked eye. This microscopic build-up of pollution can trigger acne-like breakouts and disturb our skin’s natural flora (the microbiome of bacteria that exist on the outermost layer of our skin).

Many of the bacteria on our skin, such as Staphylococcus epidermidis, act as anti-inflammatories and help defend against potential pathogens. When air pollution upsets the natural balance of this ecosystem, it can decrease our skin’s ability to combat dryness, humidity, sunlight, UV radiation, pathogens, and allergens.

Air pollution can cause skin cancer

Air pollution has been shown to play an increasingly causal role in our most common skin diseases. Skin, being the largest organ of the human body, is susceptible to damage from air pollution. The skin acts as a physical, chemical, and immunological barrier against environmental factors, but prolonged or repetitive exposure to high levels of air pollutants may have profound negative effects on the skin.

Air Pollutants and Their Effects on Skin

Major air pollutants that affect the skin include solar ultraviolet radiation, polycyclic aromatic hydrocarbons, volatile organic compounds, oxides, particulate matter, ozone, and cigarette smoke. These pollutants damage the skin by inducing oxidative stress, which counters the skin's antioxidant defenses. This leads to an increase in free radicals and reactive oxygen species within the skin cells, causing genetic damage and the activation of transcription factors and signaling pathways involved in cell growth and differentiation.

Air Pollution and Skin Cancer

Ultraviolet radiation, a physical pollutant, is considered the factor most responsible for skin cancers in humans. Exposure to ultraviolet radiation has been associated with skin cancers such as malignant melanoma, basal cell carcinoma, and squamous cell carcinoma. The depletion of the ozone layer by environmental pollutants increases the penetration of ultraviolet radiation, leading to an increased incidence of skin cancers.

Cigarette smoke, which contains thousands of chemical substances, is another major contributor to skin cancer. It has been associated with premature aging and an increased incidence of skin cancers, including squamous cell carcinoma and cutaneous squamous cell carcinoma.

In addition to cigarette smoke and ultraviolet radiation, exposure to other air pollutants such as polycyclic aromatic hydrocarbons and volatile organic compounds may also play a role in the development of skin cancer. These pollutants can be absorbed through the skin and have been linked to genetic damage and the activation of pathways involved in cell growth and differentiation.

Strategies for Prevention

To protect against the harmful effects of air pollution on the skin, it is important to advocate for clean air, non-fossil fuel energy sources, and environmental protections. Additionally, individuals can take steps to improve their indoor air quality and protect their skin through the use of anti-pollution skincare regimens and diets rich in antioxidants.

Air pollution can cause acne

Air pollution is increasingly being recognised as a contributing factor to acne. While there is a lack of data on the exact correlation between pollution exposure and acne incidences, studies suggest that pollution has a marked effect on sebum levels and inflammation.

The Link Between Air Pollution and Acne

Acne is a common skin condition that occurs when pores become clogged with dead skin cells and oil. It is most common in people assigned female at birth, and during puberty for both sexes. The condition is caused by a multifactorial etiology, including increased sebum production, abnormal keratinization of the pilosebaceous duct, and inflammation.

In recent years, an increasing number of studies have indicated a link between skin problems and exposure to airborne pollutants, such as particulate matter, volatile organic compounds, ozone, nitrogen dioxide, and sulfur dioxide.

The Evidence

A 2017 study by Krutmann et al. found that increased ambient air concentrations of some of the most important traffic- and industry-related pollutants were associated with an increased number of outpatient visits for acne vulgaris.

A 2015 study by Lefebvre et al. in Mexico City found that skin quality changes with chronic exposure to ambient pollution. Skin quality changes were defined as reduced vitamin E and squalene levels, which are known signs of sebum oxidation. The Mexican studies also found raised sebum levels, but clinical signs of acne were not measured. Nevertheless, increased sebum is one of the known early, pathophysiological pillars of acne.

A 2014 Eurasian board of experts published a state-of-the-art review of the current knowledge about the effects of common pollutants on the skin. The next step was to further investigate the link between airborne pollution and acne symptoms exacerbation and to propose appropriate measures to protect acne-prone skin from further aggravation by pollution.

How to Protect Your Skin

Although you can’t influence outdoor conditions, you can take steps to improve your indoor air quality and protect your skin’s natural defences.

• Use an air quality monitor to help you troubleshoot the source of your skin-related symptoms and take steps to reduce flare-ups.
• Prioritise products and ingredients that restore and strengthen the skin barrier, such as niacinamide, ceramides, and natural plant oils like rosehip.
• Take antioxidants internally and apply them externally for the best results. Consider taking a resveratrol supplement for superior antioxidant protection.
• Use products with a cocktail of antioxidants – the more, the better.
• Don’t wait to wash away the day’s pollution. As soon as you step through the front door, clean your skin.
• Double cleanse: first with an oil-based cleanser to break down pollution and cut through the build-up of grime, then use a cream cleanser to thoroughly cleanse and eliminate pollution particles that adhere to the skin.
• Exfoliate, but don’t scrub. Sweep away bacteria, dead skin cells, and pollution particles with a BHA liquid exfoliant tailored to oily, acne-prone skin.
• Up your vitamin C and E doses to help prevent all manner of skin damage, from blemishes to age spots.
• Back up your skin barrier. Look out for emollient squalene on skincare labels in particular.
• Don’t scrimp on SPF. Use an oil-free sunscreen and avoid spending too much time in the sun.
• Daily facial massage works to remove toxins from deep within your pores, leaving your skin hydrated, glowing, and radiant.
• Moisturise with an oil-free moisturiser to avoid dry skin, which can make acne worse by causing dead skin cells to accumulate.
• Choose oil-free skincare or hair care products.

Frequently asked questions