Archives September 2023

Are you finding yourself with itchy, irritated skin that you can’t stop scratching? Or have you wondered why your child’s eczema is suddenly worse and so hard to control? Mounting evidence suggests that wildfires, which are increasing in intensity and frequency, contribute to skin problems, including eczema flares.

What is eczema?

Eczema is a common chronic skin condition that affects about one in 10 people in the US. Its hallmarks are inflamed and dry, itchy patches of skin.

Atopic dermatitis is the most common type of eczema. It can run in families, often beginning in childhood. Typically, in the northern hemisphere, it grows worse during the winter season when the weather is cold and drying. Now some experts are seeing that pattern change. At Massachusetts General Hospital, for example, one dermatologist noted an unusual spike last summer in patients with flare-ups of eczema.

Why is eczema getting worse during summer?

In 2023, Canada experienced more than 6,000 wildfires that burned over 16 million hectares of land — an area larger than the entire state of Georgia. While far away from the devastation, the smoke reached across the US and more than 2,000 miles to Europe. Poor air quality from these distant wildfires caused eye and throat irritation and difficulty breathing.

In Boston, Dr. Arianne Shadi Kourosh, a dermatologist at Massachusetts General Hospital, also began to notice skin symptoms. Normally the dermatology clinics would see fewer than 20 people during a summer month for eczema, including atopic dermatitis. Suddenly that jumped to 160.

Looking back at summer month records from the last four years, her research showed that the number of visits for these skin complaints tracked with the severity of air pollution. These findings are consistent with other research noting an uptick in eczema flares and psoriasis flares associated with wildfire pollution. But why?

Researchers theorize that airborne pollutants might set off a cascade of effects within the body by activating an oxidative stress pathway. This damages the skin barrier and prompts an inflammatory response. This cascade also may play a role in the development of eczema.

What can you do to protect your skin?

Air pollutants in wildfire smoke may harm multiple organs — not just your heart and lungs, but also our skin, it seems. So, when outdoor air quality is bad due to wildfires, limiting your exposure can help reduce health risks. While we can say the same for industrial air pollution, wildfire pollution is likely worse due to its additional toxic particles.

• Seek help if you’re itching. Check with a dermatologist or your health team if you think wildfire smoke or other forms of air pollution might be affecting your skin.
• Check local air quality.AirNow.gov shares local, real-time air quality information and activity guidance. When recommended, stay indoors if possible. Shut doors, windows, and any outdoor air intake vents.
• Protect your skin. When you’re outdoors, wear a mineral-based sunscreen containing zinc or titanium. While most other sunscreens work through a chemical reaction to absorb the ultraviolet (UV) rays that damage skin, zinc and titanium sunscreens help by forming a barrier over skin that reflects off UV rays. The barrier also reduces the amount of pollutant particles getting to the skin to set off the inflammatory cascade. Wearing sunscreen protects against skin cancer, as well.
• Wash up. After coming back inside, cleansing your skin and applying a hypoallergenic moisturizer will help keep it healthy. If you do have eczema, choose cleansers and moisturizing products recommended by your dermatologist or health care provider.

About the Author

Wynne Armand, MD, Contributor

Dr. Wynne Armand is a physician at Massachusetts General Hospital (MGH), where she provides primary care; an assistant professor in medicine at Harvard Medical School; and associate director of the MGH Center for the Environment and … See Full Bio View all posts by Wynne Armand, MD

On the Gulf Coast of Florida where I live, the telltale sign of summer is not an influx of beachcombers, afternoon storms that arrive exactly at 2 p.m., or the first hurricane warning, but the appearance of hundreds of paddleboarders dotting the inlet waters.

From afar, paddleboarding looks almost spiritual — people standing on nearly invisible boards and gliding across the surface as if walking on water.

But this popular water sport offers a serious workout, just as kayaking and canoeing do. While floating along and casually dipping a paddle in the water may look effortless, much goes on beneath the surface, so to speak.

As warm weather beckons and paddle season arrives, it pays to get key muscles in shape before heading out on the water.

Tuning up muscles: Focus on core, back, arms, and shoulders

“Paddling a kayak, canoe, or paddleboard relies on muscles that we likely haven’t used much during winter,” says Kathleen Salas, a physical therapist with Spaulding Adaptive Sports Centers at Harvard-affiliated Spaulding Rehabilitation Network. “Even if you regularly weight train, the continuous and repetitive motions involved in paddling require endurance and control of specific muscles that need to be properly stretched and strengthened.”

While paddling can be a whole-body effort (even your legs contribute), three areas do the most work and thus need the most conditioning: the core, back, and arms and shoulders.

• Core. Your core comprises several muscles, but the main ones for paddling include the rectus abdominis (that famed “six-pack”) and the obliques, located on the side and front of your abdomen. The core acts as the epicenter around which every movement revolves — from twisting to bending to stabilizing your trunk to generate power.
• Back: Paddling engages most of the back muscles, but the ones that carry the most load are the latissimus dorsi muscles, also known as the lats, and the erector spinae. The lats are the large V-shaped muscles that connect your arms to your vertebral column. They help protect and stabilize your spine while providing shoulder and back strength. The erector spinae, a group of muscles that runs the length of the spine on the left and right, helps with rotation.
• Arms and shoulders: Every paddle stroke engages the muscles in your arms (biceps) and the top of your shoulder (deltoids).

Many exercises specifically target these muscles, but here are three that can work multiple paddling muscles in one move. Add them to your workouts to help you get ready for paddling season. If you haven’t done these exercises before, try the first two without weights until you can do the movement smoothly and with good form.

Three great exercises to prep for paddling

Wood chop

Muscles worked: Deltoids, obliques, rectus abdominis, erector spinae
Reps: 8–12 on each side
Sets: 1–3
Rest: 30–90 seconds between sets

Starting position: Stand with your feet about shoulder-width apart and hold a dumbbell with both hands. Hinge forward at your hips and bend your knees to sit back into a slight squat. Rotate your torso to the right and extend your arms to hold the dumbbell on the outside of your right knee.

Movement: Straighten your legs to stand up as you rotate your torso to the left and raise the weight diagonally across your body and up to the left, above your shoulder, while keeping your arms extended. In a chopping motion, slowly bring the dumbbell down and across your body toward the outside of your right knee. This is one rep. Finish all reps, then repeat on the other side. This completes one set.

Tips and techniques:

• Keep your spine neutral and your shoulders down and back
• Reach only as far as is comfortable.
• Keep your knees no farther forward than your toes when you squat.

Make it easier: Do the exercise without a dumbbell.

Make it harder: Use a heavier dumbbell.

Bent-over row

Muscles worked: Latissimus dorsi, deltoids, biceps
Reps: 8–12
Sets: 1–3
Rest: 30–90 seconds between sets

Starting position: Stand with a weight in your left hand and a bench or sturdy chair on your right side. Place your right hand and knee on the bench or chair seat. Let your left arm hang directly under your left shoulder, fully extended toward the floor. Your spine should be neutral, and your shoulders and hips squared.

Movement: Squeeze your shoulder blades together, then bend your elbow to slowly lift the weight toward your ribs. Return to the starting position. Finish all reps, then repeat with the opposite arm. This completes one set.

Tips and techniques:

• Keep your shoulders squared throughout.
• Keep your elbow close to your side as you lift the weight.
• Keep your head in line with your spine.

Make it easier: Use a lighter weight.

Make it harder: Use a heavier weight.

Superman

Muscles worked: Deltoids, latissimus dorsi, erector spinae
Reps: 8–12
Sets: 1–3
Rest: 30–90 seconds between sets

Starting position: Lie face down on the floor with your arms extended, palms down, and legs extended.

Movement: Simultaneously lift your arms, head, chest, and legs off the floor as high as is comfortable. Hold. Return to the starting position.

Tips and techniques:

• Tighten your buttocks before lifting.
• Don’t look up.
• Keep your shoulders down, away from your ears.

Make it easier: Lift your right arm and left leg while keeping the opposite arm and leg on the floor. Switch sides with each rep.

Make it harder: Hold in the “up” position for three to five seconds before lowering.

About the Author

Matthew Solan, Executive Editor, Harvard Men's Health Watch

Matthew Solan is the executive editor of Harvard Men’s Health Watch. He previously served as executive editor for UCLA Health’s Healthy Years and as a contributor to Duke Medicine’s Health News and Weill Cornell Medical College’s … See Full Bio View all posts by Matthew Solan

About the Reviewer

Howard E. LeWine, MD, Chief Medical Editor, Harvard Health Publishing

Dr. Howard LeWine is a practicing internist at Brigham and Women’s Hospital in Boston, Chief Medical Editor at Harvard Health Publishing, and editor in chief of Harvard Men’s Health Watch. See Full Bio View all posts by Howard E. LeWine, MD