DoctorSpeak: Saving your skin from cold and pollution

Sonia (23) dreads winter months. For the past three-four years, her skin starts itching as winter approaches, and she develops dark red patches on her face and other exposed skin areas disrupting her routine activities.

Poonam (25), too, faces similar skin problems when winter begins. So much so that she has to take leave from work.

Every year around Diwali and after, as winter starts intensifying, a dense grey haze covers the sky in North India for a few months. This continuous, extremely polluted atmosphere sees a surge in patients in various OPDs across the region, not only complaining of respiratory issues but also of itchy skin rashes, pigmentation problems, dry dark rough skin, hair loss, acne or skin eruptions, etc. The crisis is serious for those who already have skin psoriasis, eczemas, etc.

Dry and cold weather conditions are responsible for most of these skin conditions. However, in the last decade or so, air pollution in winter has posed even a greater risk to skin health, exacerbating existing conditions and accelerating ageing due to a combination of cold, dry air and high pollutant concentrations.

As the body’s outermost barrier and first line of defence, our skin and hair usually bear the brunt of exposure to this dry, cold air. In recent years, skin and hair problems have increased manifold due to the rising pollution levels. The polluted winter air is a cocktail of particulate matter, industrial chemicals and toxins.

Effects on skin

In winter, as the air is relatively dense, it traps pollutants closer to the ground. This polluted cold, dry air weakens the skin’s natural moisture barrier, which in turn creates a ‘double burden’ on the skin, making it more vulnerable to damage.

Skin barrier impairment: Pollutants like particulate matter (PM2.5) and nitrogen dioxide (NO2) disrupt the skin barrier, leading to increased water loss from the skin’s surface or outer layer, resulting in extreme dryness, flakiness and a tightness of skin that standard moisturisers are not able to resolve.

Oxidative stress and inflammation: Air pollutants generate free radicals that trigger oxidative stress and inflammatory responses in the skin. This can lead to increased sensitivity, redness and irritation, particularly for those with sensitive skin.

Aggravation of pre-existing conditions: Individuals with inflammatory skin diseases like eczema, psoriasis, rosacea, etc, often experience significant flare-ups and worsening symptoms during periods of high air pollution due to compromised skin barrier function and increased inflammation.

Acne and clogged pores: Fine air particles can mix with sebum (oil) and sweat, clogging pores, leading to acne breakouts and blackheads. These breakouts can worsen for those with oily skin, as excess oil traps even more particles.

Premature ageing and hyperpigmentation: Free radicals break down collagen and elastin fibres, leading to fine lines, wrinkles and loss of elasticity at an unusually rapid pace. Exposure to pollutants or polluted air, especially in combination with UV radiation, also stimulates melanin overproduction, resulting in dark spots and uneven skin tone.

Expert recommendations

Dermatologists advise a proactive skincare routine focusing on cleansing, moisturising, and barrier repair to mitigate these effects.

Gentle cleansing: Double cleansing the face in the evening — first with an oil-based cleanser, then with a water-based cleanser — is crucial so as to remove all traces of pollutants, sunscreen, makeup, etc, without stripping the skin’s natural oils.

Antioxidant protection: Incorporate topical antioxidants like Vitamins C, E and B3 (niacinamide) serums and creams into your morning and night skincare routine so as to neutralise free radicals and strengthen skin’s barrier against daily environmental aggressors.

Barrier-strengthening moisturisers: Use face moisturisers/creams and body lotions containing ingredients like ceramides, hyaluronic acid and squalene (skin lipid) to repair the damaged skin barrier and lock-in moisture. Always apply moisturiser to a slightly damp skin immediately after washing your face and bathing for better absorption. Avoid using hot water as it strips the skin of natural oils.

Regular sunscreen use: Apply a broad-spectrum sunscreen with at least SPF 30 or higher SPF every day, even on cloudy days, as UV rays can still penetrate clouds and interact with pollutants to cause damage.

Mild exfoliation: Exfoliate gently once or twice a week with mild chemical exfoliates (like AHAs or PHAs) to remove dead skin cells and unclog pores. Avoid using harsh physical scrubs that can cause micro-tears in skin, especially on the face.

Lifestyle adjustments

— Monitor air quality index (AQI) in the polluted winter months regularly and minimise outdoor exposure when pollution levels are high.

— Use an indoor air purifier to improve air quality at home. Also use a humidifier to counter dry air. Avoid using blowers or heaters indoors as these suck moisture from the air, causing dryness. If you have to use these, keep a wide-mouth vessel of water to maintain moisture or use oil heaters.

— Stay well-hydrated and consume a diet rich in antioxidants, fruits and vegetables and good fats to support skin repair from within.

— Wear a scarf or face mask when outdoors in highly-polluted areas to create a physical barrier and avoid direct exposure of the skin to cold, dry and polluted air.

Some basic precautions can save you from extreme skin problems.

— The writer is head, dermatology, National Skin Hospital, Panchkula

Factcheck: Some studies have found that a 10 µg/m³ (micrograms per cubic meter) increase in PM2.5 potentially increases atopic dermatitis patients by 7.7%. Overall, skin diseases constitute a significant portion of the health burden in India, affecting roughly 6.3 per cent to 11.2 per cent of the general population, a burden potentially worsened by environmental factors like pollution.