Abstract
Objective: This study aimed to systematically review the existing evidence of the impact of air pollutants on acne vulgaris.
Materials and Methods: The studies assessed the relationship between air pollution and acne, in terms of the number of acne lesions, severity of acne, number of patients who visited the hospital with acne complaints, and impact on quality of life, which were the eligibility criteria for the outcome of this study. The studies that were not in the English language, case reports, conference abstracts, and studies with duplicate publication data were excluded. Risk of Bias in Non-randomized Studies (ROBINS-E) was used to assess the risk of bias. Descriptive analysis was conducted because of different outcomes reported among the studies.
Results: 226 articles were identified through the literature search. Four studies were included. El Haddad, et al, reported that NO₂ exposure aggravated acne vulgaris. Xiang Li, et al, presented that exposure to Particulate matter10 (PM10), sulfur dioxide (SO2), and nitrogen dioxide (NO2) in Xi’an, China, as well as PM2.5 in Chongqing, China showed inconclusive results regarding increases in outpatient visits of acne vulgaris. Wei Liu, et al. demonstrated that exposure to SO₂ decreases the outpatient visits of acne vulgaris.
Conclusion: PM2.5, PM10 and SO2 presented controversial outcomes. Since current studies had a risk of bias and methodological limitations, a prospective cohort or panel studies using personal or high-resolution exposure estimates, standardized measures of acne incidence and severity, prespecified lag periods, and adjustment of confounders were suggested for a better understanding of the correlation.