Pollution and skin: From epidemiological and mechanistic studies to clinical implications

• Pollution-induced skin damage is a global problem with particular relevance in China and India.
• Ambient particulate matter exposure contributes to premature skin aging.
• Ozone depletes antioxidants from skin.
• Air pollution exerts detrimental effects on healthy and diseased skin.
• The arylhydrocarbon receptor is key in mediating air pollution-induced skin damage.
• Individuals with sensitive skin may represent a susceptible subgroup.
• Specific cosmetic products are required to protect skin from air pollution-induced damage.

In recent years, the health effects associated with air pollution have been intensively studied. Most studies focus on air pollution effects on the lung and the cardiovascular system. More recently, however, epidemiological and mechanistic studies suggest that air pollution is also affecting skin integrity.This state-of-the-art review focuses on this latter aspect; it was developed with the collaboration of European and Chinese board of experts with specific interests in environmental health, clinical and basic research in dermatology and cosmetic dermatology. A literature review limited to pollution and health effects and (sensitive) skin was performed using PubMed. Review and original articles were chosen.We summarize the existing scientific evidence that air pollution exerts detrimental effects on human skin, discuss potential clinical implications and suggest specific and unspecific cosmetic protective measures.