Visits to Dermatologists Increased After California Wildfires

Wildfires in the United States are increasing in frequency, intensity and size. The smoke from the fires is having widespread health effect on people with and without skin conditions, according to new research presented at the annual meeting of the American Academy of Dermatology Association in New Orleans.

Maria Wei, M.D., Ph.D.

“We found that the air pollution from California wildfire was associated with an increase in patient visits to dermatologists for both eczema and psoriasis,” said Maria Wei, M.D., Ph.D., professor of dermatology at the University of California, San Francisco, at a presentation on Friday.

Wei and colleagues conducted a study assessing the short-term dermatological impact of the 2018 Camp Fire in Paradise, Calif. The Camp Fire was one of the deadliest and most destructive wildfires ever in the state. The 17-day fire caused 85 civilian deaths and destroyed more than 18,000 structures over 240 square miles, an area 10 times the area of Manhattan. It only stopped burning after a rainstorm.

Wei and her colleagues tallied the number of dermatology visits for atopic dermatitis and itch during and after the air pollution spike that resulted from the fire.

The researchers found that the number of visits for atopic dermatitis spiked by 50% during the fire and remained abormally high for four weeks afterwards. In total, there were 66,642 clinic visits, including 6,439 visits for atopic dermatitis and 1,610 for itch. They also saw an 80% increase in the number of itch visits for pediatric patients that also was sustained for four weeks afterwards. There was a similar increase among adult patients.

Additionally, prescriptions for systemic medications, including prednisone, increased by 50% during this time.

Many of these patients did not have a diagnosis prior to the fire. “We think this means that the wildfire was unmasking previously undiagnosed atopic dermatitis that was irritated by the pollution,” Wei said.

Wei and her colleagues also noted that people with eczema were more likely to visit a dermatologist during the wildfire, while those with psoriasis were more likely to seek care five to nine weeks after the fire started. “This difference in timing may suggest that there are differences in how air pollution triggers flares for eczema compared with psoriasis,” she said.

Wei and her colleagues also reviewed web searches during the 2022 Lightning Complex fire that burned through 192,000 acres across the wine country area in Northern California and destroyed nearly 1,500 structures. They found searches for skin conditions increased at a time when the air pollution was high. “This suggests that as wildfires increase, we might see an influx in the number of people seeking care for pollution-related skin conditions.”