Pollution And Acne: Is There A Link?

There are many known causes of acne, including hormones, age, genetics, and skin type. However, external factors such as cosmetic products, weather conditions, and environmental pollution can also contribute to acne. In recent years, studies have found a link between air pollution and acne, with evidence suggesting that pollutants may exert harmful effects by generating oxidative stress and inflammation. This is particularly true for adult acne, with tiny dust particles known as PM 2.5 being able to penetrate the skin's protective barrier and trigger a chain reaction that leads to pimples and oily skin problems.

Environmental pollution and chloracne

Environmental pollution is a leading cause of acne, particularly in adults. Outdoor air pollution is an external factor that can trigger inflammation of the skin and lead to acne breakouts.

Chloracne is a rare skin condition that is a variant of acne. It is caused by systemic exposure to certain halogenated aromatic hydrocarbons called 'chloracnegens'. It is considered one of the most sensitive indicators of systemic poisoning by these compounds. Dioxin is the most potent environmental chloracnegen.

Causes of Chloracne

Most cases of chloracne are caused by occupational and non-occupational exposures (environmental exposures). Non-occupational chloracne usually results from contaminated industrial waste and contaminated food products. Exposure can occur through direct skin contact, ingestion, or inhalation.

Symptoms of Chloracne

The skin may first appear excessively oily before the typical lesions of chloracne arise, including open and closed comedones (blackheads and whiteheads), cysts, and pustules. Generalized lesions can appear on the face, neck, trunk, extremities, genitalia, axillary, and other areas. The severity of chloracne is related to the dosage of exposed chloracnegens, chloracnegenic potency, and individual susceptibility.

Prevention and Treatment

The only way to control chloracne is to prevent exposure to chloracnegens. In cases of exposure, appropriate cleansers can be used to eliminate pollution on the skin surface. Mild medical cleansers are recommended, and it is advised to avoid using facial or body scrubs, as these can further disturb the natural barrier function of the skin.

Outdoor air pollution and acne

Outdoor air pollution is a mixture of chemicals and gases emitted into the atmosphere from both natural and man-made sources. Man-made sources include smog and exhaust fumes. These pollutants can cause breakouts, particularly in adult skin, as they can squeeze through the skin's protective barrier and trigger a chain reaction that starts with the oxidation of sebum on the skin's surface. This leads to a change in the composition of the sebum and a deficiency of vitamins C and E, which are the skin's natural antioxidants. This, in turn, causes pimples and oily skin problems such as excess shine, blocked pores, blackheads, uneven skin texture, and a dull complexion.

There is growing evidence that these pollutants exert their harmful effects by generating oxidative stress and inflammation. A study conducted in Lebanon, a country that has experienced severe pollution events, found a link between exposure to ambient air pollution and the occurrence of inflammatory acne in the adult population. The results showed that female gender, younger age, and using hydrating cream were all factors that increased the likelihood of developing acne in polluted environments.

Additionally, a cross-sectional study conducted between March and August 2020, during the COVID-19 outbreak, also investigated the link between outdoor air pollution and acne. The study used an anonymous online platform to collect data from participants living in regions with Air Quality Monitoring stations. The results of this study are not provided, but it contributes to the growing body of research on the impact of air pollution on acne.

While the exact mechanism of how pollution affects acne is not yet fully understood, it is clear that outdoor air pollution can have detrimental effects on skin health and may contribute to the development or exacerbation of acne. To mitigate the impact of pollution on the skin, it is recommended to use appropriate cleansers that do not disturb the natural barrier function, mild medical cleansers, and sun protection with UVA and UVB protection and a texture adapted to oily skin.

Atmospheric pollution and adult acne

While the main causes of acne are hormonal, occurring at key times such as puberty, premenstrual syndrome, and pregnancy, there are also less well-known causes, such as stress, sun exposure, and pollution. After more than 15 years of research, La Roche-Posay has identified atmospheric pollution as a cause of breakouts, particularly adult acne.

The Science Behind It

The skin is the body's primary protective barrier against external chemical and physical elements. Atmospheric pollution, a mixture of chemicals and gases emitted into the atmosphere from natural and man-made sources, can wreak havoc on the skin. Tiny dust particles known as PM 2.5 can penetrate the skin's protective barrier. Accompanied by ozone and other pollutants, they trigger a chain reaction that starts with the oxidation of sebum on the skin's surface. These pollutants change the composition of the sebum and also cause a deficiency of vitamins C and E, two of the skin's natural antioxidants. These attacks on the skin's protective layer of surface lipids (the skin barrier) cause pimples and oily skin problems in the form of excess shine, blocked pores, blackheads, uneven skin texture, and dull complexion.

Evidence

There is growing evidence that atmospheric pollutants exert their harmful effects by generating oxidative stress and inflammation. A cross-sectional study conducted in Lebanon between March and August 2020, during the COVID-19 outbreak, used an anonymous online platform to survey people who lived in regions with Air Quality Monitoring stations. The results showed that acne symptoms might exacerbate in regions of high ambient air pollution. Similarly, a group of five Asian and three European scientists with expertise in dermatology reviewed the current literature and described current acne treatment practices in their countries. During this activity, they identified the need for further epidemiological and clinical research and found evidence that acne symptoms might worsen in regions of high ambient air pollution.

Protecting Your Skin

To protect your skin from the effects of atmospheric pollution, it is important to keep your skin clean with a gentle cleanser and exfoliate gently to keep your follicles clear. Using sunscreen can also be helpful, especially if you are traveling to a hot and humid environment. Adding a non-comedogenic moisturizer to your routine can also help, as highly polluted environments can strip the moisture from the skin, which then increases the amount of sebum excretion. Look for sun protection products in an anti-pollution texture to stop fine particles and pollution from sticking to your skin.

The role of inflammation in acne

The skin acts as a protective barrier between the body and the outside world. However, environmental factors can cause breakouts, and acne is one of the most prevalent skin diseases responsible for dermatological consultations.

Inflammation plays a critical role in the development and progression of acne. The innate immune system is triggered when the duct ruptures, releasing P. acnes into the surrounding epidermal tissue, causing pustule formation and potentiating local inflammation. This process is driven by the proliferation of P. acnes, which is recognised by follicular keratinocytes that start releasing inflammatory cytokines in response.

Asian women have been found to have a higher prevalence of inflammatory acne than Caucasian women, and they also report that their symptoms worsen during periods of high air pollution. A cross-sectional study in Lebanon, a country with severe pollution events, found a link between exposure to ambient air pollution and the occurrence of inflammatory acne in the adult population.

Environmental pollutants can result in a variant of acne called 'chloracne', which is considered a typical environmental skin disease. Chloracne is caused by systemic exposure to certain halogenated aromatic hydrocarbons, known as 'chloracnegens', and is characterised by acne-like eruptions of comedones (blackheads and whiteheads), cysts, and pustules.

To protect the skin from the effects of pollution, it is important to keep it clean with a gentle cleanser and to exfoliate gently to keep the follicles clear. Sunscreen and non-comedogenic moisturisers can also help, as pollution can strip the skin of moisture, increasing sebum excretion.

Skin protection against pollution

Our skin acts as a barrier to protect our bodies from external chemical and physical elements. However, skin-damaging pollutants are everywhere—both indoors and outdoors, in rural and urban environments.

Air pollutants like carbon monoxide, smog, and tobacco smoke contribute to free radicals that cause signs of premature aging. These pollutants can pass through the skin, much like they can enter through inhalation. They can lower naturally occurring levels of antioxidants and create oxidative stress, making skin cells less efficient at repairing and reproducing new cells, including collagen and elastin tissue. Studies have found that airborne pollutants are associated with common signs of aging skin such as hyperpigmentation or so-called “age spots” and wrinkles like the “laugh lines” on either side of the mouth that extend down from the nose.

Pollution can also cause breakouts, particularly adult acne. Tiny dust particles known as PM 2.5 can squeeze through the skin's protective barrier and cause havoc. Accompanied by ozone and other pollutants, they trigger a chain reaction that starts with the oxidation of sebum at the skin's surface. These pollutants change the composition of the sebum and also cause a deficiency of vitamins C and E, two of the skin's natural antioxidants. These attacks on the skin's protective layer of surface lipids (the skin barrier) cause pimples and oily skin problems in the form of excess shine, blocked pores, blackheads, uneven skin texture, and dull complexion.

How to protect the skin against pollution

• Cleanse your skin: Use a gentle non-rinse cleanser to remove microscopic pollution particles from the skin's surface. Cleanse your skin morning and evening, with no exceptions.
• Anti-adhesion textures: Use products with anti-adhesion textures to stop pollution particles from sticking to your skin and causing breakouts.
• Sun protection: Use a light, non-comedogenic SPF product daily to protect against UV rays.
• Hydration: Use skincare products with hydrating ingredients like ceramides and hyaluronic acid to help build up your skin’s barrier function to protect against environmental assaults.
• Antioxidants: Use skincare products with antioxidants like vitamins C and E to help prevent free radicals from damaging the skin.
• Sunscreen: Use a mineral sunscreen (with zinc oxide or titanium oxide) every day to block UV rays and pollutants.

Frequently asked questions