Sustainable Eczema Care
Environmental degradation is leaving its mark on our skin. From worsening eczema to rising skin cancer rates, dermatology has become an increasingly climate-sensitive field. The environmental drivers include irritant pollutants, rising temperatures, humidity, flooding, and the spread of infectious diseases.
Wildfires and air pollution are now recognised as major contributors to dermatological disease. Airborne particles and carcinogens released during wildfires can trigger or exacerbate conditions such as atopic dermatitis, psoriasis, acne, skin cancer and pemphigus. Polluted air not only affects respiratory health but also compromises the skin barrier, causing inflammation, oxidative stress, and premature ageing.
Rising global temperatures have a direct impact on skin health. Elevated heat increases the amount of ultraviolet (UV) damage the skin sustains from the same dose of radiation. It is estimated that a global temperature rise of just 2°C could increase skin cancer rates by 10%. Heatwaves and prolonged exposure to high temperatures also encourage bacterial and fungal growth, providing ideal conditions for infections and inflammatory skin conditions to flourish.
Increased heat and humidity have been linked to higher rates of atopic dermatitis and more frequent acne exacerbations. Flooding compounds these effects by creating environments in which infection thrive. Such conditions promote bacterial infections like cellulitis, fungal infections such as coccidioidomycosis (Park et. al, 2005), and viral infections including herpangina (Urashima et. al, 2003). Warmer temperatures also expand the geographical range of vector-borne diseases such as zika, chikungunya, and dengue. Dermatologists must therefore be familiar with the cutaneous manifestations of these infections (Kaffenberger et. al, 2016; Silva and Rosenbach, 2021).
As with many health impacts of climate change, not all populations are affected equally. Children, older adults, outdoor workers, unhoused individuals, and marginalised communities are disproportionately at risk due to higher exposure levels, fewer protective resources, and limited access to healthcare. Addressing these inequities is essential to achieving both climate resilience and dermatological health equity.
Sustainable dermatology: what is it?
The British Society of Dermatological Surgery Sustainability Guide recognises dermatologists’ role in today’s skin health needs as well as advocates for future health through socially, environmentally and financially responsible practice. This aligns with the idea of sustainable value in healthcare as maximising health outcomes while minimising environmental harm and costs, and increasing social benefit for patients, carers, staff and communities.
Members of the British Association of Dermatologists (BAD) can join the organisation’s Environment and Sustainability Sub-Committee – British Association of Dermatologists, which promotes research, collaboration, and innovation in sustainable dermatology.
Sustainable eczema and atopic dermatitis care
Eczema and psoriasis are among the most common chronic skin conditions, yet they are often overlooked because they are not perceived as life-threatening. Nonetheless, they significantly affect quality of life and contribute substantially to the healthcare. Integrating sustainability into management can improve patient outcomes while reducing environmental impact.
Preventive care is the most powerful first step. Educating patients about how climate change and environmental factors influence skin health can help them understand why their symptoms fluctuate with weather, humidity, or pollution levels. Encouraging avoidance of environmental triggers, such as synthetic fabrics, fragranced products, excessive sweating, and exposure to extreme weather, can reduce flare frequency and severity.
Empowering patients to manage their condition is another vital element of sustainable care. Correct use of emollients helps maintain the skin barrier, prevent flares, and reduce the need for stronger treatments that carry higher carbon and resource costs. Directing patients to evidence-based resources such as Eczema Care Online can promote self-management and improve long-term outcomes. Supporting patient-initiated follow-up pathways also gives individuals greater control over their care, reducing unnecessary clinic visits and associated travel emissions.
At a systems level, lean and efficient care pathways are a cornerstone of sustainability. Expanding teledermatology for routine monitoring and early flare intervention, potentially supported by artificial intelligence triage tools, can minimise travel and optimise clinician time. Developing community-based dermatology clinics similarly reduces the environmental burden of travel while bringing care closer to patients. Streamlined, one-stop clinics that combine assessment and prescribing can further improve efficiency and patient experience.
Low-carbon alternatives within dermatology are another area of opportunity. E-prescribing of emollients and topical treatments reduces paper waste and eliminates unnecessary face-to-face appointments. Offering in-clinic samples or pump dispensers for trial use before prescribing full quantities helps to minimise product waste. Pump dispensers themselves can also be a more sustainable choice, as they reduce contamination risk, improve dosing accuracy, and may enhance patient adherence, thereby reducing overall treatment waste.
What can eczema specialists do?
Sustainable eczema care aims to reduce the carbon emissions of healthcare while ensuring resilient, equitable, and effective care in a changing world. By embedding environmental awareness into every level of practice, from patient education to service design, eczema specialists can play a vital role in protecting both skin health and planetary health.
You can take practical steps to embed sustainability in your work by:
- Educate yourself and your team about the links between climate change and skin health, and by initiating conversations within clinics about reducing environmental impact.
- Join a CPD training course on sustainable healthcare for primary care or secondary care.
- Learn how to set up a quality improvement project for environmental, social and financial sustainability using a free self-study guide or with personal mentoring in the Sustainability in Quality Improvement certificate course.
- Join a sustainable healthcare peer network and find new ideas by searching the resource library for ‘dermatology’.
- Become a champion. Check whether your organisation has a Green Plan or Sustainability Action Plan to align your clinical practice with NHS Net Zero ambitions. Join or establish a Green Impact team to drive triple bottom line quality improvement in dermatology services.
- Use every patient interaction as an opportunity to promote behaviours that benefit both skin and the planet. For example, encourage active travel, healthy, plant-rich diets, and use of green spaces, which can improve both eczema symptoms and overall wellbeing.
- Reduce the environmental footprint of eczema care by choosing low-carbon treatment options, minimising waste in prescribing and packaging, and favouring reusable or recyclable consumables where safe and appropriate.
- Support patients vulnerable to temperature changes, such as those whose eczema flares with heat or cold, by ensuring they understand how to maintain a comfortable home environment and access support for energy efficiency when needed.
- Use digital communication where suitable for follow-ups and education, reducing unnecessary travel for staff and patients.