Author(s): Neha Patnak

Is climate change hurting your skin?

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Skincare has always been more challenging in the summer. And climate change has raised the level of difficulty, with frequent hot spells and more exposure to pollution from wildfires that can damage our skin, leading to premature wrinkling, skin discoloration, and sun spots.

As temperatures rise, sunscreen is just the first step in skin protection.

It also means potentially higher risks for skin cancer.

Experts I spoke to say children, elderly people, and anyone living in areas exposed to a lot of traffic, wildfire smoke, or other pollution are particularly at risk. But a warming climate could take a toll on anyone's skin.

In recent years I have even noticed increased skin care challenges for me and my family.

My 10-year-old daughter and her friends come home from summer camp at the end of the day with hot, prickly skin covered in small bumps along their necks and arms - a heat rash commonly caused by inflamed and clogged sweat ducts.

My 13-year-old finds that her eczema, usually calm in the summer, is more active than usual. Dry, irritated patches on her arms and legs keep her up at night scratching.

When I peek at my face in the rearview mirror while sitting in Atlanta traffic, with the sun beaming in through my windshield and exhaust fumes sneaking in through my car vents, I notice more fine lines and freckling as I age.

Daily encounters with environmental hazards can accelerate skin damage and aging.

"Our skin is a big environmental interface organ," says Dr. Misha Rosenbach, professor of dermatology and rheumatology at the University of Pennsylvania.

He warns that skin troubles are poised to worsen in a world with escalating climate hazards such as soaring temperatures, widespread air pollution, and more wildfires. We can protect ourselves, but applying sunscreen is only the first step.

The science behind skin damage

As our largest organ, skin envelops the entire outer surface of our body. It has three distinct layers: the epidermis, dermis, and hypodermis. This complex network houses a variety of cells and structures that act as a formidable shield against germs, harmful ultraviolet - or UV - light, and environmental chemicals while helping maintain a stable internal body temperature and hydration level.

Exposure to intense heat, UV radiation, pollution, and smoke can break down the skin's protective lipid coat, deplete skin antioxidants, and trigger a process known as oxidative stress. This leads to production of free radicals, unstable molecules that damage cells and DNA, cause inflammation, and can break down the collagen and elastin that are essential for maintaining our skin's elasticity and firmness.

This inflammation can be more than skin-deep. Problems inside our body linked to climate change and air pollution from burning fossil fuels, such as allergic asthma, certain autoimmune conditions, and infectious diseases, can manifest with skin changes like dry, itchy, broken patches of skin or uncomfortable rashes.

How heat damages skin

As global warming keeps causing longer stretches of higher temperatures and more frequent and intense heat waves across the globe, prolonged exposure to high temperatures can worsen dehydration, weakening our skin barrier and making it more susceptible to injury.

"As it gets hotter, people are outside more, wearing less clothing," Rosenbach points out - which can increase their exposure to UV light and other environmental dangers, like air pollution.

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Most of us know that UV radiation can cause skin damage, premature aging, and an increased risk of skin cancer, but heat in a warming world can damage our skin in other ways.

"Chronic low-grade heat exposure can contribute to skin aging and discoloration of the skin," says Dr. Shadi Kourosh, director of the dermatology division of community health at Massachusetts General Hospital and an associate professor of dermatology at Harvard Medical School.

People with heat-sensitive skin conditions like rosacea and melasma, common skin conditions that cause raised discolored patches on the face, may also find their skin troubles worsening as temperatures heat up.

Kourosh explains that short-term intense heat exposure also harms skin health.

"There's another level of heat radiation exposure that people might encounter from an occupational standpoint, like firefighters fighting wildfires. That thermal damage can actually increase their risk of skin cancer."

From skin darkening, wrinkles, and premature aging to a potential risk for increasing skin cancer risk, the combination of heat and radiation from sunlight can harm the complex infrastructure of our skin.

Even with all of the risks, "our skin has amazing resilience and capabilities to improve if we give it the chance and put it in a healthier environment," Kourosh says. She advises deploying multilayered skin protection strategies and finding ways to stay out of the heat if possible to give our skin the best chance to heal.

How air pollution damages skin

Burning fossil fuels in cars and power plants results in air pollution - such as carbon monoxide, tiny particles called particulate matter, and nitrogen oxides, which can interact with heat and sunlight to form ozone - that can damage the skin.

"They bind to the skin, and they corrode the protected lipid barrier of the skin and cause DNA damage, which can accelerate skin aging," Kourosh says.

She pointed to research showing that traffic-related particulate matter plays a role in skin aging. Nitrogen oxides are linked with the formation of dark spots, and ozone is implicated in premature wrinkle formation. Studies have also shown that eczema development is associated with exposure to air pollution, specifically truck traffic.

In 2023, Kourosh says her clinic saw more eczema patients in Boston after air pollution exposure from Canadian wildfires over 300 miles away. This event prompted her to study the potential connection between skin health and pollution from wildfires and the chemical fire retardants used to combat them.

"Patients were coming into my dermatology clinics and saying that they were having eczema flares in the summer, which is unseasonable. And we found that the acute pollution events, like wildfires, were causing this. And this coincided with a spike in eczema visits."

Kourosh points out that eczema worsens not just because of the direct impact of wildfire smoke on skin: "Breathing it into their lungs flares their asthma, which then in turn, because they're getting this systemic immune response, triggers their eczema. So they're really getting a double hit, these poor people."

Prioritize skin health

Kourosh stresses that it is important for everyone to prioritize skin health. But she notes that some people are more vulnerable to skin damage, such as children and elderly people, who have weaker skin barriers and can be more prone to the effects of pollution.

"Socioeconomically disadvantaged communities, who often live in urban or industrial environments with higher baseline pollution levels, are also particularly vulnerable," Kourosh says.

Rosenbach says many patients ask him about the best sunscreen to use that will not damage coral reefs. He is quick to reassure them that "the reason corals are dying is not because of sunscreen, it's because of CO2 emissions leading to ocean acidification and global warming."

Therefore, Rosenbach said, an important part of skin protection is also advocating for addressing the root causes of climate change and for the transition away from dirty fossil fuels. This can minimize the risk of even more frequent wildfires, higher temperatures, and poor air quality and protect ourselves and our entire community.

Practical tips for protecting your skin

Three experts, including Shadi Kourosh, director of the dermatology division of community health at Massachusetts General Hospital and an associate professor of dermatology at Harvard Medical School, Misha Rosenbach, professor of dermatology and rheumatology at the University of Pennsylvania, and Randal Antle, a certified physician assistant at Dermatology Associates of Georgia, offered advice on optimal skin protection to promote skin health and limit the impacts on premature aging, skin breakdown, and skin cancer risk.

Hydrate: Drink plenty of water.

Protective clothing: Wear lightweight, sun-protective clothing and accessories like wide-brimmed hats and UV-blocking sunglasses. Avoid tanning.

Guard against pollutants: "I recommend wearing a mask and sunglasses, especially during acute air pollution events. Mineral sunscreens containing zinc, titanium, or iron oxide can act as a shield against pollutants," Kourosh says.

Kourosh says it is also important to have a good cleansing regimen at night to wash off pollutants, keep car windows up during high pollution, and invest in HEPA air filters to improve home air quality.

Maintain a healthy lifestyle: Eat a diet rich in antioxidant-rich fruits and vegetables because this is the best way to absorb skin-health-promoting antioxidants. Limit alcohol, avoid smoking, avoid indoor tanning, and get enough sleep.

Morning routine

Gentle cleansing: Use a mild, gentle cleanser to remove pollutants and protect the skin barrier. Avoid over-washing the skin, as it may damage the natural skin barrier function.

Moisturize: Strengthen your skin barrier with moisturizers. "Many emollients or moisturizers such as creams, lotions, or ointments, can generally improve the skin barrier function of the skin. However, emollients that contain ceramides will replenish and improve the skin barrier most effectively," Antle says.

Consider topical antioxidants: "In the morning for an added boost, a topical antioxidant such as vitamin C can be applied before your sunscreen to help fight against free radicals from UV exposure," Antle says. Talk to your doctor about the best skin care products for effective topical antioxidants. Koroush points out that even though research suggests that topical antioxidants can theoretically help, "vitamin C, for example, is an incredibly unstable molecule - it denatures with exposure to heat and light - so a lot of products may be charging people but not doing an effective job."

Daily sunscreen is nonnegotiable: Apply a broad-spectrum sunscreen daily and reapply every two hours. "Chemical sunscreen filters only protect against UV radiation. Mineral sunscreen filters, like those containing zinc oxide, titanium dioxide, or iron oxide, act as a shield and can protect against radiation and pollution settling on the skin," says Kourosh.

Evening routine

Don't forget to rinse off: "It's important to have a good cleansing regimen at night to wash off pollutants," Kourosh says.

Skin repair: Talk to your doctor about the safest options for improving skin barrier function and repairing skin damage. Koroush points out that there is evidence that certain vitamin A-based compounds can help with cellular turnover and aid with skin repair. She cautions that a dermatologist is best suited to help you identify products that are safe and effective.

Long-term protection

Advocate for clean air and lower carbon emissions: Remember that minimizing the risk of even more frequent wildfires, higher temperatures, and poor air quality can protect you and your entire community.

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