Transepidermal water loss (TEWL): Environment and pollution—A systematic review
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Introduction: Transepidermal water loss (TEWL) is an objective measurement of skin integrity measured as the amount of water lost across the stratum corneum. TEWL varies greatly across variables such as age and anatomic location, and disruptions in the skin barrier have been linked to inflammatory dermatoses such as psoriasis and atopic dermatitis. Impact of environmental conditions and pollution on TEWL has yet to be determined. Accordingly, this review summarizes effects of environmental conditions and pollution on TEWL. Methods: A comprehensive literature search was performed using Embase, PubMed, and Web of Science to find human studies that provided data on environmental conditions and/or pollution and TEWL. Results: In total, 15 studies were included, with 11 studies examining environmental and seasonal conditions on TEWL and four examining pollution. All studies examining pollution showed increased TEWL in people exposed to particulate matter or NO2. Contradictory results were found on the effects of season and climate across the 11 studies, with no consensus reached. Conclusion: Exposure to pollution is reported to cause increases in TEWL, likely through free radical damage. Significant discrepancies exist among current literature as to the effects of season and climate on TEWL. There is a need to continue examining environmental variables other than temperature and relative humidity, such as atmospheric and steam pressure, that may impact TEWL.
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Exposure to airborne pollutants can lead to transepidermal water loss and impair water retention, resulting in dryness, flaking, and heightened skin sensitivity.
“Moreover, exposure to airborne pollutants can lead to transepidermal water loss and impair water retention, resulting in dryness, flaking, and heightened skin sensitivity [61].”
From The Environmental Determinants of Skin Health: Linking Climate Change, Air Pollution, and the Dermatologic Disease Burden (2025) · cites this paper as [61]
The Conclusion (page not provided) says particulate matter and NO2 increase transepidermal water loss through epithelial damage, supporting the pollution–water-loss link. The paper does not establish that this leads to impaired water retention, dryness, flaking, or heightened skin sensitivity. (LLM, conf=0.86)
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“TEWL measurements are made by placing a probe at the surface of the skin that is able to measure any changes in water vapour density across a determined area of skin over time by sensing changes in local humidity above ambient humidity values.1 Disruptions in the skin barrier have been linked to increased TEWL values…”
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- Authors
- Green, M., Kashetsky, N., Feschuk, A., & Maibach, H. I.
- Affiliations
- Tulane University (US)
- Memorial University of Newfoundland (CA)
- Department of Dermatology, University of California San Francisco , San Francisco, California ,
- Corresponding author
- Green, Maxwell
- Venue
- Skin Health and Disease
- Publisher
- Oxford University Press (OUP)
- Published
- 2022-02-25
- Volume
- 2
- Issue
- 2
- Pages
- e104-e104
- ISSN
- 2690-442X (ISSN-L)
- PMC
- PMC9168018
- OpenAlex
- W4214600812
- Cited by
- 86
- References
- 35
- Citations by year
- 2026: 19 · 2025: 30 · 2024: 21 · 2023: 11 · 2022: 4
- FWCI
- 2.94
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Locations
- Skin Health and Disease (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- eScholarship (California Digital Library) (submittedVersion)
- Funders
- UCSF Open Access Fund
- Topics
- Health Sciences › Medicine › Dermatology › Dermatology and Skin Diseases
- Health Sciences › Medicine › Dermatology › Contact Dermatitis and Allergies
- Life Sciences › Pharmacology, Toxicology and Pharmaceutics › Pharmaceutical Science › Advancements in Transdermal Drug Delivery
- Keywords
- transepidermal water loss, skin barrier integrity, particulate matter, nitrogen dioxide, air pollution, seasonal variation, oxidative damage, stratum corneum, psoriasis, atopic dermatitis
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