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For more information about skin conditions and their treatment, contact:


Gregory J. Wilmoth, MD
Eric D. Challgren, MD
Margaret B. Boyse, MD
Laura D. Briley, MD
Tracey Cloninger, PA-C

Stephanie Pascale, MSN, FNP-C

4201 Lake Boone Trail, #200
Raleigh, NC 27607
Telephone: (919) 782-2152


4201 Lake Boone Trail, #207

Raleigh, NC 27607
Telephone: (919) 863-0073

Environmental Skin Hazards Abound

When it comes to skin health, the “toxic world” we live in is both internal and external, observes dermatologist Dr. Laura Briley. “The skin is the body’s shield to the world around it,” she explains, “and it is under constant assault from a multitude of environmental products and events. At the same time, internal factors—such as stress, inflammation, or allergies—can have a huge impact on our skin and its effectiveness in protecting us from external toxins.”

Dr. Briley performs a routine skin check.

Environmental influences on skin health range from the mundane—such as irritants found in cleaning products and cosmetics—to occupational exposure or to broader environmental pollutants.

Allergies or sensitivities to cosmetics have definitely been on the rise over the past 10 years,” notes Dr. Briley. “That’s because we’re exposed to so many more irritants—often out of our awareness.

“For example,” she says, “according to the Environmental Working Group, women use an average of 12 products a day, containing 160 different chemicals—many of them causing irritation or creating a potential allergen. Men use fewer products, but they also are exposed to 85 chemicals daily.
“Other researchers suggest the problem is much greater—estimating that we’re exposed to over 500 different chemicals daily. But whatever the exact number, in our normal every-day lives we encounter many, many chemicals that are potentially irritating to our skin. Further, it can be difficult to determine what ingredients a product even contains, let alone which might bother you.” (see box)

Some toxins may be hard to avoid, acknowledges Dr. Briley. “But others, such as smoking and sun damage, pose a self-inflicted risk. And that combination—smoking and sun—really is a disaster for many people. In fact, I would argue that the sun is probably the most significant environmental threat. Sun damage is the source of skin cancers,” she says, “as well as the wrinkling, discoloration, and other problems typically associated with aging.”

Dr. Briley, along with the team of practitioners at Southern Dermatology and Skin Cancer Center, offers multi-faceted treatments to combat all of the elements—both those around us and those within us.

Common Skin Irritants

While most of us know that food allergies or certain plants can irritate the skin, other skin irritants may come as a surprise, notes Dr. Briley. “Fragrances are among the worst offenders, and they’re especially problematic because they’re created by combinations of thousands of possible ingredients. Isolating the irritating components of a specific fragrance can be almost impossible. Furthermore, while some fragrances may trigger irritation or allergic reactions, others act as endocrine disruptors and exert hormonal effects.

“Interestingly,” observes Dr. Briley, “soap tops the list for skin irritants. Even plain soaps can dry out the skin, particularly with excessive hand washing. Household cleaners, dryer sheets, facial creams, and even ingredients like PABA found in many sunscreens can also cause issues.”

Allergy and irritation are very separate entities, notes Dr. Briley. “If you get exposed to something and have an allergy, it’s usually an angrier rash and there’s a lot of swelling as well as the redness, itching, and discomfort. Irritation comes from using more and more products, and we all build a sensitivity over time.”

The everyday things that pose “toxic threats” are innumerable, says Dr. Briley. “And each of us is likely to interact with them differently. Often the key to addressing these skin problems is to do some sleuthing related to the products you use. For example, rashes in places covered by clothing can indicate a problem with detergent, dryer sheets, or even the clothing itself. Wool, for example, may be a problem for eczema sufferers.

“Simple practices are important:  avoiding heavily fragranced products, wearing gloves to handle certain household cleaning products, and keeping the skin hydrated to maintain a healthy protective barrier.”

Health&Healing: How do environmental hazards affect skin or skin aging?

DR. BRILEY: Cigarette smoke definitely ages the skin and prevents skin healing. Airborne pollutants also affect skin health. And, since those pollutants degrade the ozone, they cause more UV radiation to reach us, which itself is a big cause of skin aging.

Another growing problem is that, as we get exposed to more and more chemicals, our systems get more sensitive. What I’m finding is that, over time, people develop more and more allergies.

And they’re so surprised, because earlier in their lives they didn’t have eczema or sensitive skin. A baby’s eczema is more of a genetic thing, but as we get older, our environment plays a major role, and we develop sensitivities because of the number of products we get exposed to throughout our lives.

When you were 20, you could put six different creams on yourself. But when you’re 80, that combination might irritate your skin because you already have less moisture in your skin, and less tolerance to many different products.

Many patients suffering from allergic contact dermatitis are people who’ve never had an itch in their entire lives—until now! And when I tell them they have to use sensitive skin products and they can’t have laundry detergent with fragrance, it blows their mind. I have to explain that our environment is filled with a multitude of things that can set off your immune system.

H&H: Beyond aging or skin irritation, what do people with certain skin conditions have to be particularly concerned about?

DR. BRILEY: For acne, avoiding things that have a lot of preservatives in them, such as fast food or fatty processed foods. Smoking or second-hand smoke will make acne much worse; as will getting oily products on the face. And some air pollutants make it worse.

With eczema, there may be different triggers in different parts of the country—such as extreme heat or dry winters in Arizona, or even a terrible pollen season here in North Carolina. Extreme temperatures are always going to roughen the skin. The skin breaks, it’s dry, that leads to more problems with itching and sensitivity.

H&H: What do you offer to address these skin problems or accelerated skin aging?

DR. BRILEY: In our Aesthetics Center, we offer a wide variety of products and procedures that can dramatically improve the condition and appearance of aging skin. These include topical products to increase collagen or prevent the breakdown of the skin from the sun damage; fillers and Botox treatments to address wrinkles; chemical peels and lasers to treat all kinds of sun damage.

What’s critically important is that choices about aesthetic treatments are tailored to the needs and medical concerns of the individual patients. These vary considerably from patient to patient—affected by genetics, individual allergies and sensitivities, and other health care issues. So, coordination between medical and aesthetic care is important.