Eczema risk seems to increase from polluted air, study finds

NEW YORK, Nov. 13 (UPI) - Living in places with more air pollution raises the risk of eczema, a chronic condition that causes dry, itchy and inflamed skin, a new study suggests.

The study was published Wednesday in the journal PLOS ONE.

Industrialization has accelerated the global prevalence of eczema, drawing attention to the health consequences of exposure to harmful substances in outside air, researchers said.

"Environmental factors are well known to exacerbate eczema," the study's lead author, Dr. Jeffrey Cohen, told UPI.

These findings "may be helpful for people with eczema who are trying to understand what triggers eczema flares," said Cohen, director of safety in the department of dermatology at Yale School of Medicine in New Haven, Conn.

After adjusting for other variables such as demographics and smoking status, researchers found that people with eczema were more likely to reside in ZIP codes with high levels of fine particulate matter, or PM2.5 - a type of air pollution that can cause serious health problems.

They used data from the National Institutes of Health All of Us Research Program, which included hundreds of thousands of U.S. adults.

This particular study looked at 286,862 people with available demographic, ZIP code and electronic health record data. Of those, 12,695 participants, or 4.4%, were diagnosed with eczema.

The researchers concluded that heightened air pollution may affect the immune system in a way that gives rise to eczema.

Identifying environmental changes that may lead to eczema is important, Cohen said.

"Specifically, the air quality index from the U.S. Environmental Protection Agency can help individuals understand particulate matter concentrations on a given day," he said.

In addition, for people whose eczema intensifies in response to air pollutants, Cohen recommended wearing long sleeves or full-length pants to decrease exposure. He also suggested spending less time outdoors when the levels of these pollutants are higher.

Other dermatologists likewise expressed concern about pollutants.

"Air pollution can affect not only other organ systems like our lungs, but also our skin," said Dr. Paras Vakharia, an assistant professor in the department of dermatology at Northwestern University Feinberg School of Medicine in Chicago. He was not involved in the study.

"We know that one of the main problems in eczema is an impaired skin barrier," Vakharia said. As a result, he said, "it intuitively makes sense that very fine air pollutants could be involved or worsen the development of eczema."

Conducted in a diverse population of U.S. adults, the study produced results comparable to similar research in Australia, Europe and Asia, indicating that this is of global concern, said Dr. Eva Rawlings Parker, an assistant professor of dermatology at Vanderbilt University Medical Center in Nashville.

The National Eczema Association reports that more than 31 million Americans have some form of this skin condition.

Ranging from mild to severe, eczema can start in childhood, adolescence or adulthood. It even can affect newborns within the first weeks and months after birth, the association notes.

Young children can have patches of skin that are extremely dry, and excessive scratching of itchy areas can lead to blisters and infections. In adults, eczema most commonly develops in the 20s or after age 50, according to the association.

"As a population, we should continue our efforts to combat pollution, as it can have a significant impact on our health," Parker said.

"Eczema is a very environmentally sensitive skin disease and may flare with exposure to atmospheric aggressors such as air pollution, pollen, heat and ultraviolet light," she said.

Parker also pointed out that "climate change is now linked with rising rates and more severe presentations of this skin disease in children, adults and the elderly."

Episodic increased air pollution levels are becoming more frequent and prolonged due to the burgeoning intensity of wildfires, and petroleum-based energy sources could compound the problem, said Dr. Maria Wei, a professor of dermatology at University of California, San Francisco and San Francisco VA Health Care System.

This study adds to mounting evidence that degradation of air quality can aggravate eczema, as well as psoriasis and acne, Wei said.

"It is likely that many inflammatory skin diseases could be affected by increased levels of air pollution," she said.