Climate Change’s Impact on Skin Disease and Vulnerable Populations

The skin is highly climate sensitive. Exposure to extreme weather conditions poses a significant risk in dermatological health, especially in marginalized populations.

A review at the Department of Dermatology, Center for Biomedical Ethics and Society at Vanderbilt University Medical Center identified extreme weather conditions—flooding, wildfire, and heat-related health risks—likely to expand in magnitude, prevalence, and geographic area, as well as the dermatological manifestations related to these events. Their findings appear in The Journal of Climate Change and Health.

“We wanted to provide dermatologists and other practitioners with a comprehensive overview of extreme weather-related skin disease as a foundation for patient education, implementation of early treatment interventions, and improved disease outcomes,” said lead author Eva Rawlings Parker, MD, in a press release.

In nearly 200 documentations of extreme weather conditions, flooding was associated with health risks such as traumatic wounds, infectious dermatosis, bacterial infections, fungal infections, non-infectious skin conditions, cutaneous inflammatory processes, irritant contact dermatitis, immersion foot syndrome, pernio, and insect and animal bites.

Inland flood risks are likely to increase especially in parts of southeast Asia, east Africa, India, and the South American Andes region, according to an updated from the International Society of Dermatology Climate Change Committee. More than 50 million people were affected by flooding and storms worldwide in 2018 alone, according to The Center for Research on the Epidemiology of Disasters.

Wildfires are a serious threat as a result of climate change. From 2016-2019, 114 nations experienced an increase in the number of days with a high risk of wildfire. Additionally, there were 194,000 more daily exposures to wildfires annually worldwide, according to a 2020 report by Lancet.

Dermatological implications of wildfires include skin cancer, atopic dermatitis, and other inflammatory disorders.

Similarly, extreme heat conditions are associated with cutaneous thermoregulation and acute heat-related illness, heat-related dermatoses, exacerbation of chronic inflammatory dermatoses, and infections.

Additionally, extreme heat events influence behavior. Temperature increases have been associated with more time spent outdoors while wearing less clothing, which presents greater exposure to air pollution, ultraviolet radiation, and insects.

Black and Hispanic populations living in low-income areas were found more likely to be exposed to health risks as a result of climate change.

Children, older adults, pregnant women, people with underlying respiratory diseases, and people experiencing homelessness were also found more at risk as a result of extreme weather events (EWE).

Traumatic effects, such as losing loved ones and possessions, housing instability, and lack of access to health care services are common among victims of natural disasters. These victims have been observed with a range of mental health conditions, such as posttraumatic stress disorder, grief, sleep disturbances, and anxiety.

Forced migration also has direct and indirect effects on mental health, “accompanied by a deep sense of loss of place and origin in migrant populations,” the researchers wrote.

The researchers of this review believe further population-based, clinical and occupational health studies are needed to better understand the effects of EWE and the high-risk populations, in the hopes of mitigating these effects using equitable health policies and interventions.

Floods, wildfires, and extreme heat events are likely to continue to expand in magnitude, prevalence, and geographic area. Therefore, clinicians, policymakers, environmental advocates, and researchers across the globe should be acutely aware of the current and future disruptions that climate change and EWE pose to human health and aggressively address ongoing [greenhouse gases] emissions to mitigate the impact of the climate crisis,” the researchers concluded.

References

Parker ER, Mo J, Goodman RS. The Dermatological Manifestations of Extreme Weather Events: A Comprehensive Review of Skin Disease and Vulnerability. The Journal of Climate Change and Health. 10.1016/j.joclim.2022.100162