Notebook

Skin and the city

 

I was recently asked in an interview how living in a busy city, like London, can impact the health of our skin. Of course, there are multiple lifestyle and environmental factors to consider, but I think that pollution and stress are worthy of particular mention. If you'd like to know my thoughts on the matter, keep reading below:

Can you explain exactly how external factors like pollution, commuting, city air, stress etc contribute to skin damage?

We all know that UV rays from sunlight accelerate skin ageing and increase our risk of skin cancer, but city smoke and pollution have also been shown to trigger formation of free radicals in the skin leading to collagen destruction which results in loss of firmness and elasticity, wrinkles and sagging.

City air can also leave a layer of dust, grease and grime on the skin which, if not removed effectively when cleansing the skin, can lead to breakouts. You may have noticed this visibly after a busy commute on the underground in rush hour.

Stress has been shown to alter the immune functions of the skin and skin barrier function which can lead to increased oil production, pore clogging and growth of the bacteria that predispose us to spots.

The bottom line is that city aggressors such as pollution and stress can negatively impact skin health.

How much do you think working in a city contributes to the state of our skin?

Stress lowers our threshold for getting breakouts. This may be from deadlines looming, working long hours, contending with a difficult commute or not getting enough sleep.

Pollution from motor vehicles and factories has been proven to accelerate skin ageing through dark spot and wrinkle formation. A lot of this evidence comes from heavily industrialised areas, such as China.

Does avoiding the city centre on the weekend make any difference whatsoever in terms of improving skin health?

We know that pollution, smoking and stress can cause skin problems to flare-up and are detrimental to long-term skin health, so it would seem to make sense that being in a cleaner, less polluted environment and getting some respite from our hectic working lives should mean radiant, healthy-looking skin. I'm not sure that a weekend is long enough for this repair and recovery to take place, but it may be a good place to start!

Why when we go on holiday does skin tend to improve? People wear less make-up - is that part of the reason?

There are a few possible reasons why our skin improves on holiday. Firstly, removing ourselves from the daily grind and actively finding time to relax reduces stress levels which is beneficial for skin health. Many skin problems, including acne, eczema and psoriasis have been shown to improve when we take ourselves out of a stressful environment.

Wearing less makeup may lead to an improvement in spots or blackheads if you typically use heavy or long-wearing products to work because you need them to have the staying power to provide coverage from early in the morning till you get home at night. These sorts of products are often occlusive or comedogenic, meaning that they can trigger breakouts. Having a break from them whilst you’re on holiday may give your skin a chance to recover.

Finally, gentle sun exposure on holiday can lead to an improvement in certain skin conditions, such as psoriasis, but we are all too aware that lack of UV protection is associated with a higher risk of skin cancer so common sense and the usual sun precautions should still apply.

Do you think it is a placebo effect that people think their skin feels better by wearing less makeup at the weekend?

I think we would all like the freedom to wear less makeup if we wanted to. In reality, most people with an active skin condition, like acne, don't feel like they really have any choice because they are embarrassed about how they look and are afraid of being rejected by others. Going make-up free is often seen as the exclusive privilege of those with blemish-free skin, so you can easily understand why we all want to join the club!

I try to reassure my patients who are embarking on a course of acne treatment that it is okay to wear makeup if it makes them feel more comfortable, as long as the products are suitable for acne-prone skin. The best bet in this situation is to look for the words "non-comedogenic" on the product label for reassurance that a particular foundation, concealer or powder won't make breakouts worse. The hope and expectation is that once treatment starts to work, skin confidence increases and the possibility of wearing less makeup becomes a reality.
 

 

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