When climate change gets under your skin

You’ve probably heard of climate anxiety by now, but here’s something else that might be keeping you up at night: climate eczema. 

Severe eczema is the most common chronic skin disease — about one in five children and one in ten adults suffer from its maddeningly itchy rashes.

Some triggers of eczema are well documented already, including pollen and changing weather, which can cause the immune system to overreact and create irritations on the skin. But on top of those environmental triggers, an international team of researchers and doctors are arguing that climate change is contributing to the disease’s increasing prevalence. 

Their review, published in the journal Allergy, is the first to put together how climatic hazards such as droughts, floods and wildfires are combining to drive up cases.  

California dermatologist Dr. Katrina Abuabara and colleagues analyzed 18 previous studies connecting 10 climate hazards to eczema. They found a slew of factors that add up to worsen eczema: global warming, loss of green spaces, wildfires, precipitation, storms and droughts. Climate hazards like these can increase stress, stir up air pollutants and increase sweat production — all of which can trigger eczema. Patients who were affected more strongly by these environmental factors visited the doctor more frequently and experienced more frequent flare-ups. 

Surprisingly, the researchers did note that a few climatic hazards actually improved people’s experience with eczema: Warmer temperatures, reduced air pollutants after rain and increased humidity all correlated to positive trends in eczema. 

“It’s complex,” says Abuabara, but “overall, this is bad news.”

Those few positive outcomes are not consistent everywhere. Hotter temperatures, for example, were correlated with reduced eczema severity in Italy and Denmark, but actually made things worse in the United States. The normal temperature and climate of a given location likely affect how eczema responds to heat, according to the study. For example, if a climate is usually very cold, increased heat could increase humidity and reduce dry skin, easing eczema. But if a climate is already humid, hotter weather could instead worsen eczema. 

Overall, eczema cases are increasing across the globe — they are between two and three times as high as they were in the 1970s, impacting millions more people. The skin condition can mean occasional discomfort, or, at its worst, living with swollen, red and itchy skin for weeks at a time.

Climate disasters have tangible environmental effects, but they also have more hidden consequences, Abuabara emphasizes. Floods, storms and wildfires create climate refugees who have been driven from their homes. Without a stable place to stay, people are more likely to live in lower quality housing and breathe air of worse quality. Dusty homes and poor ventilation can trigger eczema. It can also be harder to access showers or clean and sanitary spaces, all of which can lead to eczema — not to mention other diseases.

Genetically, eczema happens when people have mutations associated with lower production of proteins that help with skin moisture. The conditions that lead to eczema can also be caused by a trigger-happy immune system that thinks harmless things, like pollen, are actually dangerous. Stress has also been correlated to eczema, but it’s not clear how it impacts the immune system. 

Then, once the body is in a vulnerable state (due to an impaired immune system, high stress or genetics), a flare-up can easily occur, triggered by an allergen (like pollen, dust mites or pet fur), dry conditions or even the wrong laundry detergent. During a flare-up, the skin itches and burns, and is visibly red. It can keep people up at night, causing a severe lack of sleep, and impact self-esteem from the presence of a visible skin rash. 

As an eczema trigger, wildfires are a special kind of climate disaster. Like other exposures, they can cause flare-ups, but have also been shown to cause eczema in people who did not previously have any symptoms, explains Dr. Ian Myles of the National Institute of Allergy and Infectious Diseases, who studies how environmental factors influence allergies. In 2021, after the California wildfires, there were significantly more doctor’s visits related to eczema, in both adults and children.

Myles is most worried about young children, whose bodies are still developing and are less able to fight off new environmental hazards. Being exposed to wildfires at such a young age could also have worse impacts on kids’ future health. We might not see the true effects of these disasters until the next generation of children grows up, he says. 

It’s not just climate hazards that have been shown to impact eczema, but also harmful chemicals in the air, Myles notes. He recently published a study linking eczema to exposure to diisocyanates, byproducts of plastics manufacturing that are also found in automobile exhaust. Even if we somehow prevented the natural disasters caused by climate change, we still would see increases in eczema cases from the other harmful pollutants in the air, Myles says. 

Eczema is just one example of the ways human health is being impacted by climate change right now, Myles says, even if not everyone sees the connection. Sadly, he adds, “it’s only at the point where these wildfires are apocalyptic that people start paying attention.”

For researchers, a shortage of good information about environmental triggers for diseases is a critical problem. “There are more gaps than there are data,” Abuabara says. One way you can help, if you do have eczema, is by contributing to research. On the National Eczema Association’s website, you can see a list of current clinical trials for eczema and sign up to be notified of studies occurring near you. It’s not intensive or scary, Abuabara says — many studies just involve participants reporting the severity of their disease over time. 

Another hopeful note is that eczema treatment has actually come a long way, according to Dr. Carmen Castilla, a New York-based dermatologist. There are new injectable medications, pills and phototherapy treatments that can greatly reduce eczema symptoms. So while climate eczema is getting worse, those suffering from eczema may be comforted to know that treatment options are continually getting better and more accessible.