Examining the impact of airborne pollution on eczema

Atopic dermatitis (also known as AD or eczema) is an extremely common inflammatory skin condition. The prevalence (how common it is) of eczema has increased over recent decades. This has occurred alongside an increase in industrialisation and urban living, in which we are exposed to more environmental pollutants during the course of our daily activities. The aim of this review, from the U.S.A., was to highlight the impact of pollution on the skin's functioning, examine the evidence linking pollution with AD, explain how this process works, and how we might reduce or prevent pollution‐based damage to the skin. Pollutants were found to cause oxidative stress in the skin, which damages the skin barrier. This barrier is provided by the outmost layer of skin, and prevents potentially harmful things, such as bacteria, allergens and irritants, from entering the body, as well as preventing excessive water loss. The skin barrier is often not as effective in people with eczema, and both long‐ and short‐term pollutant exposure have been linked to worsening of symptoms and increased eczema rates in population studies. Airborne pollutants were found to cause this disruption through several mechanisms in the skin. Patients should be encouraged to wash daily (preferably at the end of the day following exposure to pollution), with subsequent moisturiser (emollient) application to help skin barrier repair. Further research is needed to fully understand how pollutants cause skin barrier dysfunction. This is a complex area as the skin is exposed to several substances per day, and environmental factors including temperature, humidity and ultraviolet light are likely to interact with environmental pollutants, and impact how they affect the skin. Linked Article:   Hendricks et al . Br J Dermatol 2020; 183 :16–23.