Advances in research on the association between global air pollution and atopic dermatitis

Abstract

Background Escalating global air pollution poses severe threats to public health. Beyond respiratory and cardiovascular damage, air pollutants adversely affect cutaneous health. Atopic dermatitis (AD), a common chronic inflammatory skin disease, has been closely linked to environmental pollutant exposure in recent research, arousing widespread academic concern. Objective This narrative review aimed to comprehensively summarize current evidence on the correlation between air pollution and AD, and further elaborate the epidemiological features, potential pathogenic mechanisms, as well as targeted prevention and therapeutic strategies for pollution-related AD. Methods Literature was retrieved from PubMed, Web of Science and CNKI databases covering April 2021 to December 2025, with core keywords related to air pollutants, AD, pathogenesis, exposure and climate change. Following narrative review guidelines, high-quality peer-reviewed studies with an impact factor ≥ 3.0 were included, focusing on cutting-edge evidence regarding air pollutant-AD associations, climatic and geographical disparities, microbiome interactions, and novel therapies. Results Exposure to particulate matter, nitrogen dioxide, ozone and cigarette smoke significantly increases AD incidence and severity. Key mechanisms include skin barrier damage, skin microbiota dysbiosis, oxidative inflammatory stress, aryl hydrocarbon receptor pathway activation, and epigenetic gene–environment interactions. Urban residents, children, pregnant women and outdoor workers are high-risk populations. Biologics and JAK inhibitors effectively relieve AD symptoms, while antioxidants and medical ozone therapy are promising adjuvant or emerging interventions. Conclusion Air pollution is a critical modifiable risk factor for AD onset and exacerbation via multi-pathway mechanisms. Integrated prevention, skincare and clinical treatment can reduce AD burden. Current evidence is limited to observational studies, lacking definitive causal verification. Future multicenter prospective cohort studies, standardized novel therapy application and AI-assisted precise management will facilitate systematic AD prevention and control.