Skin Diseases and Aging Linked to Air Pollution

Air pollution significantly contributes to and worsens various dermatologic conditions through oxidative stress, inflammation, and disruption of the skin barrier. | Image Credit: tonjung- stock.adobe.com

Various dermatologic skin diseases can be attributed to or worsened by air pollution, including skin aging, atopic dermatitis, acne, psoriasis, hair loss, and skin cancer, through mechanisms involving oxidative stress, inflammation, and disruption of the skin barrier, according to a study published in Annals of Dermatology.¹

In 2019, 99% of the global population lived in places where the air quality guideline levels did not meet the World Health Organization index.² Air pollution consists of particulate matter (PM) of various sizes, polycyclic aromatic hydrocarbons (PAHs), and gaseous components, like carbon monoxide and nitrogen oxide.¹

Air pollution exposes individuals to oxidative stress and inflammation in human cells, which could lead to chronic diseases and cancer, according to the National Institutes of Health.³ Public health issues related to high air pollution exposures include cancer, cardiovascular disease, respiratory diseases, diabetes, obesity, and reproductive, neurological, and immune system disorders.

Researchers conducted a review to consolidate the existing knowledge on the effect of air pollution on skin and the association of physiological mechanisms.¹ Air pollutants interfere with the integrity of the skin barrier and initiate inflammation in human skin.

Skin Health & Aging

Environmental factors like sunlight, air pollution, cigarette smoke, and diet cause extrinsic skin aging. This form of skin aging manifests as coarse wrinkles, solar elastosis, and pigmentary disorders. Both outdoor and indoor air pollution are considered environmental risk factors for extrinsic skin aging.

Research suggests strong correlations between air pollution and skin aging, especially in pigmentary changes and wrinkles. PM exposure links to skin aging, with heightened facial pigment spots by over 20% in areas with high PM concentrations. The review found that indoor cooking with solid fuels increases wrinkles on the hands and cheeks.

Exposure to certain PM levels adversely affects tight junctions, keratins, and filaggrins, resulting in elevated skin permeability and signs of premature aging. PM-induced reactive oxygen species (ROS) can expedite skin aging by degrading collagen and elastin while contributing to dermal collagen disruption and wrinkle formation. Researchers also found O₃ contributes to skin aging by showing a positive correlation between coarse wrinkles and exposure.

Atopic Dermatitis & Environmental Triggers

The pathophysiology of atopic dermatitis involves a compromised epidermal barrier integrity and immune system imbalance, but uncertainty remains. Some factors attribute atopic dermatitis to environmental interactions that can increase susceptibility to allergy-related diseases following exposure to air pollutants. The review included previous research that found levels of PM, toluene, and volatile organic compounds were higher on days individuals with atopic dermatitis reported symptoms compared with days without symptoms.

Air pollutants can promote atopic dermatitis by impairing the skin barrier, which increases allergen sensitization and causes irritations. Air pollutants can also increase cytokine levels, including IL-1α, IL-1β, TNF-α, and IL-8, which are all linked to an elevated atopic dermatitis risk. Ultimately, environmental conditions like humidity and temperature can amplify the harmful effects of various atmospheric particles and gaseous air pollutants on atopic dermatitis.

Environmental Link of Air Pollution & Acne Breakouts

The review highlighted previous research that associated air pollution with acne exacerbation. One study found elevated levels of ambient PM and nitrogen dioxide increased acne cases. Compiled research suggests ambient air pollution may aggravate acne by altering lipid composition or biophysical functions of the skin and triggering inflammation. Air pollution has also promoted sebum excretion, decreased vitamin E and squalene in the sebum, and elevated both lactic acid and erythema index in facial skin. Overall, PM exposure could exacerbate acne by promoting inflammatory responses.

Air Pollutants in Psoriasis Development

Previous research links air pollution exposure to increased psoriasis activity and a higher likelihood of flare-ups. O₃ could potentially activate the aryl hydrocarbon receptor (AhR), which might impact Th17 cell differentiation. Air pollutants may play a significant role in Th17 differentiation through AhR, and researchers consider AhR pivotal in psoriasis development.

Prior research linked PAHs to the ultrastructural degradation of hair fibers, altering hair quality and surface properties. Data suggests that PM can cause keratinocyte apoptosis within hair follicles, ultimately preventing hair growth. Other data showed alopecia flare-ups increased with PM concentrations. Evidence links PM to causing an amplified reaction from T cells by inducing oxidative stress within hair follicles.

Skin Cancer Incidence

The link between an increased incidence of skin cancer and the presence of air pollutants is clear. Pollutants like PM, PAHs, O₃, volatile organic compounds, and heavy metals promote skin tumor formation. Certain PM exposure increases skin cancer risk as well.

PAHs significantly contribute to the development of skin cancer, likely because increased ultraviolet (UV) irritation results from O₃ layer depletion combined with the synergistic effects of these air pollutants with carcinogenic potential. Changes in the O₃ layer caused by air pollution led to more UV irradiation reaching the earth’s surface, increasing the risk of skin cancer. The elevated levels of O₃ in the human environment can induce oxidative stress, leading to inflammation and compromising the epidermal barrier integrity.

Air pollutants also directly contribute to tumor formation by binding to cellular DNA through PAH-derived epoxides and diols. The activation of the AhR and subsequent promotion of downstream signals from chronic skin exposure to PAHs and UV radiation can contribute to skin cancer development.

“Further research is required to develop safe and effective therapeutic and preventive interventions,” the study authors concluded.

References

1. Han HS, Seok J, Park KY. Air pollution and skin diseases. Ann Dermatol. 2025;37(2):53. doi:10.5021/ad.24.159

2. Ambient (outdoor) air pollution. World Health Organization. October 24, 2024. Accessed May 23, 2025. https://www.who.int/news-room/fact-sheets/detail/ambient-(outdoor)-air-quality-and-health

3. Air pollution and your health. NIH. August 6, 2024. Accessed May 23, 2025. https://www.niehs.nih.gov/health/topics/agents/air-pollution