The author, an AD and KP patient, and future pediatric dermatologist, shares why she is so passionate about how climate change may affect skin disease.

The morning news warned us of a heatwave, but that didn’t stop 8-year-old me from putting on my usual red hoodie. The avoidance of prying eyes or hearing “is it contagious?” another time made the sweating worth it. Atopic dermatitis (AD) had claimed my skin as its home, marking its territory through red, itchy patches on any crease it could get its hands on. Serving as its roommate, keratosis pilaris (KP) claimed the remaining surfaces. That hoodie became my best friend, and regardless of the infections and worsening summer flares, I was grateful to have it. 

Now, as a 23-year-old, I experience life very differently. Walking to my medical school campus, I still think about my retired hoodie. As the sweat hits my overheated phone screen, I can’t help but to think about how different things would be if I was still that 8-year-old girl – how unbearable it would be considering the continuously rising Arizona temperatures. I’ve always reflected on the large-scale implications of climate change, but I’ve never stopped to really think about the individual impact it can have on someone. 

In an effort to learn more, I typed “the effects of climate change on cutaneous conditions” into my search bar. Research studies and articles flooded my screen. 

• Did you know climate change affects the prevalence of skin diseases?¹ 
• Did you know geographic distributions of various microbe-caused infections and illnesses are expanding?²
• Did you know we are at an increased risk for skin cancer because of the diminishing ozone and increasing ultraviolet radiation exposure?³
• Did you know the increased air pollution is associated with an increased incidence and severity of atopic dermatitis?⁴

I didn’t. 

My medical school does a phenomenal job at highlighting the humanitarian side of medicine, with social determinants of health being a major focus in our curriculum. It’s one of the reasons I chose my school. However, I’m not sure if we’ve ever really dived into the impact of climate change. I might be experiencing memory bias with STEP¹ creeping to the forefront of my mind, but I think the only real times we’ve talked about climate was in relation to sun exposure, temperature, and geographic distributions. And even then, we didn’t really touch on the impacts a changing climate could have on conditions or populations. Thankfully, however, my school offers optional talks highlighting important topics like this, one in which I am signed up for next week. 

The more I learn about climate change, the more I find myself drawing connections to experiences I’ve had in the clinic. A few weeks ago, a patient came in out of breath, complaining of worsening asthma. It never crossed my mind before that the changing climate might be playing a role in this. While I acknowledge the multifactorial nature of asthma, I can’t help but to wonder if things like heightened air pollution may be associated with these exacerbations like they are with atopic dermatitis. Amid the chaos that is medical education, it is so easy for environmental and social factors to fade into the background, especially when there are days you are just trying to remember if staph aureus is catalase positive or not.

As I embark on my medical career, I promise to continue educating myself about important social topics that impact my future patients. Climate change is one of them, and I refuse to be naïve about its health implications. I came into medicine with hopes of being an advocate for children who are still discovering their voice. Being a pediatric dermatologist has always meant so much more to me than simply diagnosing and treating skin diseases. It’s about educating myself about the intricate web of factors affecting my patients’ health and speaking out for each and every one of them. 

References:

1. Silva GS, Rosenbach M. Climate change and dermatology: An introduction to a special topic, for this special issue. Int J Womens Dermatol. 2021;7(1):3-7. doi:10.1016/j.ijwd.2020.08.002. 

2. Coates SJ, McCalmont TH, Williams ML. Adapting to the Effects of Climate Change in the Practice of Dermatology-A Call to Action. JAMA Dermatol. 2019;155(4):415-416. doi:10.1001/jamadermatol.2018.5863. 

3. Diffey B. Climate change, ozone depletion and the impact on ultraviolet exposure of human skin. Phys Med Biol. 2004;49(1):R1-R11. doi:10.1088/0031-9155/49/1/r01. 

4. Schachtel A, Dyer JA, Boos MD. Climate change and pediatric skin health. Int J Women’s Dermatol, 2021;7(1):79–84 https://doi.org/10.1016/j.ijwd.2020.07.006.

About the author

Kennedy Sparling, BS, is a second-year medical student at the University of Arizona, College of Medicine – Phoenix. 

Conflict of Interest: None to disclose.

Funding: No funding.