Health + Wellness

The invisible aggressor: How pollution is damaging our skin

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The month of September saw the return of the haze that had challenged Singaporeans and people in other parts of Southeast Asia in recent years. A flurry of news articles on the rise of haze-related illnesses and a spike of visits to clinics and hospitals across the island, marked the unfortunate period.

While the air quality has since improved, thanks in part to the rain, it is important to remember that the haze is not the only clear and present danger lurking in our midst. Some threats may not even be clear at all.

Indeed, pollution is often insidiously invisible. In Singapore, the National Environment Agency measures the levels of particulate matter (PM2.5) and shares this information with the public, but we need to remind ourselves that these are microscopic particles that are not seen by the human eye.

These tiny particles are produced by combustion engines in cars and buses, by factories and power plants, and even in our own homes when we cook! They are not the only air pollutants, with others like nitrogen dioxide coming from many of the same sources.

So far, much of the clinical research has focused on air quality and its effect on our lungs, on the cardiovascular system, and on cancer rates, all of which are justifiably major health concerns. Less research has been done on the effects of pollution on the skin, the body’s largest organ. And yet, the studies conducted concludes that air pollution is also damaging to our skin.

Eczema is one of the most common skin conditions in the world, including in Singapore. While there is a genetic component to eczema, environmental factors also play an important role. This means that you must have a genetic predisposition, engaging with a particular set of environmental conditions, to produce the classic signs of a red, scaly, dry rash, and the common symptom of itch.

Although hard data isn’t easy to come by, anecdotally eczema rates are on the rise. What we do know is that currently about one in 10 adults in Singapore are affected by the condition. Doctors have also noticed that during periods of haze, there is an increase in clinic attendances of people with eczema flare ups, which is predictable from the research done on air pollutants. So, air pollution does make eczema worse, even if it isn’t the cause of it.

The effects of air pollutants on skin are mediated through several routes.

Firstly, the pollution can interfere with the skin barrier itself. The skin barrier is the outermost layer of the skin, which acts as a seal retaining the skin’s moisture and a buffer against irritants and noxious substances.
When disrupted, the skin barrier cannot function properly, which means moisture escapes, leaving the skin dry and flaky. Irritants can enter the skin, where they can trigger a response from the body’s immune system (which is what happens in eczema flare ups).

Secondly, these pollutants can interfere with the functioning of the immune system in the skin. Overall, you are left with a disrupted skin barrier and a weaker immune system, as well as issues such as rash and itch.

So, what can be done to protect our skin from the effects of air pollution?

For people with eczema or chronic dry skin, they already have an impaired skin barrier. Ideally, they should moisturise regularly (a few times a day), using a product that contains skin-identical ceramides, which are one of the key building blocks of the skin barrier, and which are often depleted and damaged in dry skin.

For those with normal skin, it is still worthwhile trying to protect the skin surface from pollutants, and using the same moisturisers will help to achieve this. Regular bathing to remove the build-up of pollutants on our skin is also essential, but we do need to be careful that the skin cleanser we use isn’t damaging the skin further. In fact, ingredients such as sodium lauryl sulfate, sodium laureth sulfate and parabens are potential skin irritants, and so are best avoided. For those with eczema, they should also avoid products with fragrance, and only use products with the right pH balance of around 5.5 to 6.5.

If you have already developed a rash, then you need to see a doctor to get a prescription cream or oral medication to manage the condition. Also, if you have an itch, then you must try to stop the itch and break the itch-scratch cycle. Topical creams with menthol are very effective at soothing the skin and relieving itch, and as long as the menthol is in a moisturising base, they are good for dry or eczema prone skin.

Finally, we should seek to limit our exposure to air pollution. This isn’t necessarily easy if we live near a busy expressway or in a very polluted city. However, we can use air purifiers to try to reduce the level of indoor pollutants, and when outdoors, try to avoid areas where levels of air pollutants are high.


This article is contributed by Dr. John O’Shea, Co-Founder of Good Pharma Dermatology.

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