A Time-Series Study of the Effect of Air Pollution on Outpatient Visits for Acne Vulgaris in Beijing

Abstract

Background/Aims: There is increasing evidence that exposure to air pollutants, including particulate matter (PM_2.5, PM₁₀), nitrogen dioxide (NO₂), and sulfur dioxide (SO₂), might aggravate preexisting skin diseases such as eczema and urticaria. Here we investigated if a possible link exists between air pollution and acne vulgaris. We assessed the association between ambient air pollutant concentrations and the number of visits of patients for acne vulgaris to a dermatological outpatient clinic in Beijing, China, from April 1, 2012 to April 30, 2014. Methods: In this time period, 59,325 outpatient visits were recorded because of acne vulgaris. Daily air pollution parameters for PM₁₀, PM_2.5, SO₂, and NO₂ were obtained from the Beijing Municipal Environmental Monitoring Center. Results: Increased concentrations of ambient PM_2.5, PM₁₀, and NO₂ were significantly associated with increased numbers of outpatient visits for acne vulgaris over the 2 years. These effects could be observed for NO₂ in a single-pollutant model and for PM_2.5, PM₁₀, and NO₂ in 2-pollutant models, which are closer to real-life exposure. Of note, these effects were specific because they were not observed for increased SO₂ concentrations, which even showed negative correlations in all test models. Conclusion: This study provides indirect evidence for a link between acne vulgaris and air pollution.

The impact of airborne pollution on skin

“…recently reviewed three Asian studies that suggested a pollutant‐specific relationship between elevated levels of airborne pollutants and an increased prevalence of acne. Elevated levels of PM 2.5 , PM 10 and NO 2 were associated with an increase in the number of acne‐related outpatient visits to a dermatology clinic in Beijing . Pollutants were also listed as one of the acne exposome factors in a recent review by Dreno et al …”

A severe chronic outdoor urban pollution alters some facial aging signs in Chinese women. A tale of two cities

“…However, these two studies did not compare the possible differences in facial signs (pigmented spots, wrinkles, sagging, vascular disorders…), linked to combined aging and photo‐aging processes, that could be UP‐related. Epidemiological studies, related to outdoor or indoor conditions, pinpoint UP as a triggering factor of some cutaneous disorders and skin aging .…”

Microbiome in Healthy Women Between Two Districts With Different Air Quality Index

“…Skin, as the first line to interface with the air, is the target of various environmental stressors (Valacchi et al, 2012;Dong et al, 2019). Basic and clinical studies have provided growing evidence that airborne pollutants exacerbate skin aging (Vierktter et al, 2010;Ding et al, 2017) and even some chronic inflammatory skin diseases (Ahn, 2014;Pesce et al, 2015;Liu et al, 2018), which also exists when there is microbiome imbalance (He et al, 2006;Nielsen and Jiang, 2019). However, whether airborne pollutants have an impact on microbial communities of healthy skin, especially facial microbiome, still needs to be further explored.…”

“…It was reported that accumulation of SO 2 and NO x could result in a lower pH value of rainwater (Li et al, 2019), and difference of pH would further lead to composition change in local microbiota (Vongsa et al, 2019). Available evidence indicate that long-term air pollution could accelerate skin aging (Vierktter et al, 2010;Ding et al, 2017), and some human skin diseases, such as acne (Liu et al, 2018), atopic dermatitis (AD; Ahn, 2014), and eczema (Pesce et al, 2015), were also reported to be associated with dysbiosis of skin microbiota (Fitz-Gibbon et al, 2013;Chng et al, 2016;Dybboe et al, 2017;Shibagaki et al, 2017;Kim et al, 2019;Reiger et al, 2020). On the one hand, it was uncovered that exposure to atmospheric-equivalent O 3 levels for 2 h could halve the skin microbiome of women's forearm (He et al, 2006).…”