The past few years in Delhi have witnessed rising cases of skin disorders like acne and eczema, the cause mainly attributed to the rising air pollution. Though people in the city are more aware of diseases like Asthma, Bronchitis, heart disease, high blood pressure, diabetes and chronic obstructive pulmonary disease (COPD) due to the pollutants, skin disorders are rarely seen as a result of pollution.
A WHO study conducted in 2016 shows Delhi as the second most polluted city in the world, next to Riyadh. The city’s air condition has been deteriorating in the last few years with the quality reaching at alarming levels in the last few years. Frost & Sullivan, a Growth Partnership Company in 2014 estimated that around 19 Crore Indians would suffer from skin diseases by 2015. The figure calculated for 2015 could be higher for the present year and even more for the next years.
The dermatology department of the All India Institute of Medical Science (AIIMS) registered a rise in cases with skin disorders. The total number of the cases in the OPD rose from 62,633 in 2010 to 84,464 in 2016, a rise of 34.8%. A similar pattern of rise has been registered in private hospitals too. The new cases in the Dermatology department of the Swami Dayanand Hospital in Dilshad Garden, has increased from 17,503 in 2012 to 21,415 in 2016, a rise of 22.3% over just four years. Apart from the AIIMS there are various other government hospitals and private clinics in Delhi registering a similar growth.
A study conducted by Jean Krutmann, Dominique Moyal, and others in 2017 indicate a link between skin problems and exposure to airborne pollutants, such as particulate matter (PM), pollutants such as ozone, Nitrogen dioxide and Sulphur dioxide. The rising cases of skin disorders are more found more in polluted cities like Delhi than in other cities and interior areas. Mumbai and Kolkata inspite of having high population density are less polluting since the two cities are located near sea whereas Delhi remains landlocked.
A similar study conducted by Nouveau-Richard S, Zhu W and others in 2007 suggested that people in the polluted area had more greasy skin than the people in non-polluted area. Therefore people in polluted areas were more prone to abnormal skin conditions. The study also said, “Skin condition changes with chronic exposure to ambient pollution”.
Common physiological disorders are sometimes prolonged over the specified period and leads to some disease. Kirti Arora (24) and a resident of Delhi, has been suffering from acne since the last three years. She says, “When I first saw acne on my face I thought I won’t need a medical attention since it is dependent on age factor. But in the last three years it has worsened and I cannot bear it anymore. I think probably the worsening is because of the pollution”. According to Dr Sidharth Sonthalia, a renowned dermatologist in Gurgaon, the cases of skin disorders has increased in the capital in the recent years, and pollution has been a major force behind the rise.
The tremendous rise in skin disorder is not only a cause for worry for the people in Delhi. According to a study by Green Peace India in 2015, apart from Delhi the cities with a high pollution includes neighbouring Faridabad, Bhiwadi in Rajasthan, Bihar’s Patna, and Dehradun in Uttarakhand. The widespread of such cases of skin disorders could be equally prevalent in other cities across India.
Rise of Acne
Acne is the most common physiological skin disorder that starts at the age of 13 and can go on till the age of 30. According to Dr Sidharth, Acne is the most common skin disorder in India as well as abroad. The cause of increasing acne is also seen in the oxidation of natural skin oil, Squalene, due to pollutants present in the air. Dr Sidharth adds, “Pollutants like Sulphur dioxide increases the acne and cause itchiness in acne while Nitrogen dioxide is responsible for black marks and skin pigmentation”. A survey in the International Dermatology Conference in Beijing, revealed that 67% of responders agreed that acne prevalence increases with pollution.
The Annual report of Delhi’s Department of Health and Family Welfare collected from the OPDs in different hospitals shows that the cases of acne rose from 46,749 in 2013 to 63,535 in 2016, a rise of 35.9%.
Eczema, getting more prevalent
Apart from acne, eczema is one of the most common skin disorder that has registered a rise too. Flexural eczema is associated with traffic‑related air pollutants, including nitrogen oxides and carbon monoxide. Seeing the level of pollutants in the city, Dr Neeraj Kumar, a dermatologist says, “There has been rise of skin diseases like acne and eczema in Delhi, which are mainly due to pollution”.
The quality of water also affects the skin disorders. Doctors suggest the use of clean water to be used for washing the skin, and face in particular. According to Dr Sidharth says, “The water being used to wash the face affects the skin conditions. The use of polluted water sometimes results in skin disorders”. Apart from the pollutants, the exposure to Ozone is also causing in the cases of eczema.
According to the record of Delhi’s Department of Health and Family Welfare, the cases of eczema have risen from 56,373 in 2013 to 1,46,199 in 2016, an exorbitant height of 159%.
The rising cases of skin disorder are a cause for worry. Dermatologists believe that the immediate solution to check the skin disorders could be reducing the pollution. The more one gets exposed to the polluted air, higher is the risk of skin disorders. Apart from controlling the pollution doctors believe that awareness and proper medication could result in lowering the cases since a lot of patients resort to quackery or self medication. Dr Sidharth express his concern that a lot of patients either go to quack that does not have any knowledge or experience, the quacks often prescribe traditional medicine composing of metals like nickel, copper, silver, which results in damage to kidney and liver.
The use of steroids is a common case of self medication. In India, topical steroids are easily available in pharma stores and patients usually use them in cases of eczema and acne. According to Dr Sidharth says, “The use of topical steroids by patients without consulting doctor results in adverse skin condition like thinning of skin layers, and preatrophy, where blood vessels become visible on the skin surface.”
Neglect of skin disorders could lead to other diseases. Acne, after persisting beyond the age 25 could result is adult acne, which could increase the chances of heart diseases. Dr Neeraj, says, “Skin disorders affect the patients by leading to other diseases like diabetes and heart diseases”. In many cases, patients do suffer from depression and anxiety due to their skin disorders.