We heard about Miguel Sánchez Viera, dermatologist and director of the INSTITUTO DE DERMATOLOGÍA INTEGRAL in Madrid through a study that was published on the effects of contamination on the skin. Wildland firefighters are exposed to an endless number of contaminants. We recently found a graph posted on social media clearly and visually explaining the dangers they face beyond burns and the immediate risk involved with firefighting emergency situations.
vft: Doctor, what are the consequences of continuous exposure to environmental pollution?
Dr. S.V: Before answering that question, we should define what exactly we mean by environmental pollution.
vft: So, let’s go back to that.
Dr. S.V: By environmental pollution, we mean that which is generated by traffic, heating, waste and rubbish incineration, industrial systems, herbicides and pesticides, the ozone and, of course, wildland fire. We should also include that which is caused by agents that may be found indoors: solvents, paint, cleaning products and smoke from tobacco, kitchens and BBQ grills.
Environmental contamination is made up of micro-particles. So, they can penetrate our organism when we breathe and reach the bloodstream, remaining in the deepest layers of the skin as well as the superficial layers of the skin, accumulating without being noticed.
vft: And what type of pathologies derive from direct contact with the skin? Have dermatologists found out what type of damage it can cause with case studies?
Dr. S.V: In places with higher environmental contamination, especially in dry climates like in inland cities, there’s a greater prevalence of patients with acne as well as a worsening of the symptoms of psoriasis, atopic dermatitis and eczemas. Continuous exposure to environmental pollution results in the development and worsening of inflammatory diseases of the skin and premature aging.
vft: Besides worse dermatological problems as mentioned and causing esthetic damage, does contamination have deeper effects on the skin?
Dr. S.V: Another possible negative effect would occur when the skin is subject to ultraviolet rays from the sun. Damage to the skin from contamination added to damage from ultraviolet radiation could increase the risk of skin cancer. However, more studies are needed to prove this link. For this reason, dermatologists recommend always using sunscreen whether you’re in the city, at the beach or in the mountains and whether it’s summer or winter. People who live in big cities with high levels of pollution like Madrid or Barcelona or those who due to their jobs are constantly exposed to contaminating elements should use sunscreen every day.
Environmental contamination may also alter the skin microbiota.
vft: Would that be something like changing “the pH of the skin flora”?
Dr. S.V: Skin microbiota are all the bacteria and microorganisms that live in our skin, helping to protect the organism from external aggressions. They play an important role in the look of the skin but also help produce vitamins, hormones and chemical substances that may influence people’s moods, metabolism and even their immune system. When there’s an alteration, inflammatory disease may occur in the skin such as psoriasis and atopic dermatitis, skin dehydration and even lower skin protection from ultraviolet rays.
vft: That is actually deduced from the report ‘NTP 336, Absorption of Chemical Substances by the Skin’ published by the INSHT (Spanish National Workplace Health & Safety Institute). It states that many detergents are capable of altering the skin, causing an increase in permeability to chemical substances. Other information of interest in the document highlights how the skin absorption capacity is different depending on the body part exposed and how the permeability time varies based on the composition of the contaminating agent. More liposoluble substances are generally absorbed. What are the worst contaminants for the skin?
Dr. S.V: The contaminants that damage the skin the most are not only found outdoors, but also inside homes. They include: carbon monoxide, nitrogen dioxide, ozone, heavy metals, dioxins, polyaromatic hydrocarbons and volatile and semi-volatile organic compounds. Other contaminants that harm the skin are herbicides and pesticides, solvents, paint and cleaning products.
vft: Almost all the substances mentioned are present in wildland fires...
Dr. S.V: Exactly. They are also produced by the fumes from traffic, heating, waste incineration and the smoke from cigarettes and kitchens.
vft: How can we stop the effects of pollution on the skin?
Dr. S.V: Daily personal care is essential; in the morning and at night. It will prevent the contaminating microparticles from remaining in the skin. Let’s go back to the beginning to understand how the integumentary system works.
The skin is the largest organ of the body. Its main purpose is protection from potentially pathogenic microorganisms (bacteria and viruses) and environmental contamination, the cellular damage that comes from ultraviolet radiation and trauma in addition to helping regulate body temperature. It also recognizes pain, notifying us of the danger and preventing harmful chemical substances from penetrating the body.
The skin has three layers: the epidermis, the dermis and the subcutaneous layer. The epidermis is made up of cells known as keratinocytes which create a hydrolipidic film which is what prevents the entry of external agents. These keratinocytes form in the deepest layer of the epidermis (basal layer) and gradually rise to the most superficial layer of the epidermis so there are always young and resistant cells in this layer to protect the body from external aggressions. In order for the epidermis to remain healthy, you have to care for it with personal hygiene, moisturization, nourishment and by using sunscreen.
vft: As far as hygiene, is any particular product necessary for this?
Dr. S.V: To prevent the skin from suffering further, you can choose “syn-free” products (no synthetic detergents or soap) as they have a pH that’s similar to the skin and this prevents any alteration in the hydrolipidic barrier protecting the skin.
vft: Firefighting operations can sometimes last an entire day and even several days. Wildland firefighters do not always have immediate access to water and soap. But, we do know that contaminant absorption through the skin is imminently fast and abundant. One study conducted by US, German and Danish scientists published in the journal Environmental Health Perspectives confirmed that some toxic substances get through the skin in similar quantities as when they enter our body through the lungs. The same study says that clean clothing on protection units creates a barrier to contaminating agents. However, when exposed to the air, dirty clothing actually amplifies the absorption through the skin. That’s why the greatest possible protection is recommended (gloves, masks, neck shields, etc.) while working and vehicle cleaning and ventilation, proper clothes washing and skin decontamination are essential after every single operation.
Decontaminating wipes have proven to be very effective for instant cleaning after fires. They remove 99% of the contaminants on the skin and are an essential solution before proper washing is available, preferably with neutral soap. What other measures would you recommend to wildland firefighters?
Dr. S.V: Besides hygiene, another important point is skin moisturization. You must drink plenty of water as it helps improve cellular function and use moisturizing lotions after cleansing (choosing solutions with hyaluronic acid and antioxidants with resveratrol, vitamins A, C and E, ferulic acid, genistein, etc. are also advisable). Taking detox infusions is also recommended for the most effective elimination of toxins by the body.
Using sunscreen is fundamental. They should also be used during extinguishing operations and burns as they’ll be exposed to contamination as well as ultraviolet rays, the combination of which is even more harmful to the skin. Continuously applying them will minimize the damage.
To compensate for the increase in free radicals (which are responsible for skin aging and lower cellular regeneration), it’s important to include antioxidants in your diet like broccoli, tomatoes, berries, legumes, grapes and nuts.
Using purifiers and humidifiers at home can help decrease the presence of contaminants inevitably inside the house.
Microdermabrasion is a treatment that can be done to eliminate any contamination stored in the skin. It eliminates the most superficial layers of the skin without aggression as the doctor uses a wand with a diamond-encrusted tip. It’s a painless process that contributes to cellular regeneration, stimulates the production of collagen and elastin, and facilitates the penetration of active ingredients in the skin such as alpha hydroxy acids, beta hydroxy acids and retinoic acid, which are applied immediately afterwards.