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Your climate disaster zone is ruining your skin.
If you’ve been avoiding making your annual skin screening appointment for, like, years, rest assured that some things never change: Dermatologists are still obsessed with telling you to wear sunscreen, and your mole probably isn't cancerous (you should get it tested, anyway). But while paper robes with confusing openings aren’t going anywhere, conversations about climate change don’t typically make it into the examination room.
Some doctors think maybe they should. Our skin is our largest organ as well as the one that interacts most immediately with our environment, serving as the first line of defense against harmful microbes; a barrier against UV radiation and pollution; and a regulator of our body temperature via sweat glands. It is, as a result, on the frontline of how our bodies handle their increasingly extreme environments.
Though the International Journal of Women’s Dermatologydevoted an entire 2020 issue to climate change, which ran over 120 pages, looking at dermatology through a climate lens is still gaining traction in the medical community.
“When I lecture about climate change, I invariably get lower grades and more negative comments, including hate mail,” Dr. Misha Rosenbach, an associate professor of dermatology at the University of Pennsylvania, co-founder of the American Academy of Dermatology’s climate change and environmental issues expert resource group, and the co-author of the Women's Dermatology introduction told me, speaking in the capacity as an individual. “And every time I give a lecture, someone will stand up and say it’s a hoax from China — like literally, without fail, no matter what venue, some doctor says it’s a hoax.”
At the same time, the dermatologic response shouldn’t be limited to “wear more sunscreen” and “limit your time in wildfire smoke.” Since our skin is our primary defense against the external world, it is also being impacted in as many ways as there are expressions of climate change. Here are just a few, broken down loosely by American geography.
The northeastern United States is warming faster than the rest of the country, and unlike the southern U.S., where climbing temperatures will make regions far less habitable, winters and shoulder seasons in the East are becoming, well, pretty pleasant!
But the good weather also means people are spending more time outside. And remember the ozone layer? Though the Montreal Protocol in 1987 helped eliminate the chemicals that were causing its depletion and consequently exposing people to higher levels of UV radiation, its full recovery isn’t expected “until 2050,” the World Health Organization warns. Skin cancer rates, partially as a result, have been rising: Between 2000 and 2010, the overall rates of basal cell carcinoma rose 145 percent and squamous cell carcinoma rose 263 percent, the American Academy of Dermatology reports.
More time outside also means more exposure to pollutants generally. “I grew up in Harlem,” Dr. Lynn McKinley-Grant, the current president of the Skin of Color Society and an associate professor of dermatology at Howard University College of Medicine, told me. “The people who grew up there have a lot of these diseases that affect the skin like sarcoidosis and lupus” — an inflammatory disease that can cause small growths on the skin, and an autoimmune disease that can cause rashes — and “there are some people who have had mycosis fungoides,” a skin cancer that often begins its presentation with a rash.“It’s something we’ve seen for a while,” McKinley-Grant went on, “unrelated to the sun but related environmentally to things that affect us.”
“Urban air stagnation events” — four or more days of low wind speeds and little precipitation, when pollutants can settle — are also a risk, the International Journal of Women’s Dermatology’s introduction adds. Those pollutants can trigger autoimmune skin diseases like lupus, and a blistering disease called pemphigus vulgaris also has “increased hospitalizations if there’s high pollution in the environment,” Rosenbach told me.
There are small annoyances, too: Apparently more CO2 also means more poison ivy.
Pollen seasons across the country are getting worse due to climate change, but particularly so in places like Wisconsin, Minnesota, North Dakota, and parts of Canada — something any sufferer of seasonal hay fever will tell you can quickly develop into a nasty dermatology concern.
Speaking of nasty, research also shows that increased rainfall in the Great Lakes region due to climate change is resulting in a runoff of “metals, pesticides, pathogens, and fecal indicator bacteria” into recreational waters. “Summertime bacteria concentrations in an inland lake in Wisconsin,” for example, exhibited “positive, significant correlations” with the amount and duration of seasonal rainfall. Swimmer’s itch also appears to be on the rise due to warming temperatures. Fun!
Then there’s Lyme disease, which causes a rash that, if addressed quickly with antibiotics, can head off the development of more serious post-treatment Lyme disease syndrome. The concern is, ticks are now moving into areas where they haven’t been seen before — “dermatologists in Canada went their whole careers without ever encountering Lyme disease,” Rosenbach said — as well as emerging earlier in the season and hanging around through the late fall. “And that ... can mean that you’re not expecting Lyme disease [when] it walks in the door,” Rosenbach said. “And if you don’t recognize that, you can have severe consequences.”
Alaska, meanwhile, gets to enjoy thinking about a “worst-case scenario” of smallpox re-emerging from the melting permafrost.
When a fire burns through the West, it doesn’t just burn trees — there are cars, houses, and other not-great-to-breathe-in materials being incinerated and ending up in the air. Our skin doesn’t love that. Last year, a study that looked at the 2018 Camp Fire near San Francisco found that instances of eczema rose in local health clinics compared to 2015 and 2016. “Fully 89% of the patients that had itch during the time of the Camp Fire did not have a known diagnosis of [eczema], suggesting that folks with normal skin also experienced irritation and/or absorption of toxins within a very short period of time,” one of the authors said.
Skin is also affected by pollution, which disproportionately affects Black and Latino neighborhoods. Due to historic redlining, these areas are often “low-income, densely populated urban areas adjacent to industrial activities and lacking green spaces,” conditions that compound “health impacts such as chronic dermatitis exacerbations and carcinogenic skin damage,” the International Journal of Women’s Dermatology found. One study that looked at pemphigus flares — that’s the blistering autoimmune disease — “found an association between UV index and hospital admissions only in the subset of Hispanic/Latino patients,” despite using a representative U.S. sample.
The high heat in the West is also a concern since being unable to properly cool off via sweat can cause heat-related illnesses, currently the leading cause of death from extreme climate events in the United States. “The laborers who are out there working in the sun, not only do they get skin cancer, but they end up getting very dehydrated,” McKinley-Grant said, citing studies that have found high rates of kidney failure in agricultural workers and construction workers who labor in high heat conditions.
If you’re taking a dermatology board exam and the question mentions that a patient went camping in Costa Rica, “everyone knows the answer is leishmaniasis,” Rosenbach said. “The key word is ‘Costa Rica.’”
Leishmaniasis is a parasitic disease spread by sand flies that can cause skin sores and impact internal organs, but it’s taught to aspiring doctors as being a tropical and subtropical disease. Yet parts of the United States are now subtropical too, including Texas and Oklahoma — where, indeed, endemic leishmaniasis cases have begun to appear. But if dermatologists aren’t looking for leishmaniasis in patients with no travel history, they could miss a crucial diagnosis.
Speaking of new diseases, “chikungunya and dengue are now reported within the southern United States, with Zika on the horizon,” one of the papers in the Women’s Dermatology special issue found. And with more powerful storms and flooding slamming southern coasts, “there is terrible dermatitis,” said McKinley-Grant, who has seen firsthand how unidentified infections arose in patients in North Carolina after they waded through waters up to their waists. In extreme environmental conditions such as we live in now, infections of any kind “need to be addressed immediately,” McKinley-Grant went on to stress, even if they seem as innocuous as a bug bite.
Skin problems are actually the “most common issues” medics see after major storms, Rosenbach said. Part of the reason is simple things, “like laceration from flying debris,” he went on. Part of it is that when water rises, “humans and animals are in closer contact, you get animal bites and things like that.” And part of it is that when “you get standing water [...] it releases some of these vector-borne things.”
Oh yeah, and then there are jellyfish. Seabather eruption, an itchy skin reaction caused by jellyfish larvae, “has become increasingly common potentially because of increased ocean temperatures,” the Women’s Dermatology paper found. “This eruption can occur in up to 16% of patients swimming during peak seasons in southeast Florida.”
If you go to the hospital for a broken hip, a doctor might suggest a home safety search. Someone will come to your house, tape down your carpets, and move low-hanging objects in order to prevent future trips and falls.
Rosenbach envisions a future where doctors would do the same for something like repeated childhood asthma hospitalizations. “What if someone at your house was like, ‘Hey, you have a gas-burning stove, and you have mold here, and you’re actually losing a lot of heat through these single pane windows and no insulation. And what we should do is, get rid of your gas stove, rip out this mold, and make your environment better and have some air filters, or whatever,” he mused. “Imagine you could go and make these changes, and suddenly this kid never had asthma anymore, never [needed to be] admitted to the hospital.”
Rather than play whack-a-mole with medical symptoms, then, Rosenbach is thinking like a dermatologist — that is, we ought to cut out the real cancer, which is our dependence on fossil fuels.
Admittedly, that’s daunting to tackle if you’re more immediately concerned with the weird rash you keep getting at the beach. But beyond “eating less meat, flying less, electrifying everything,” from a health-care standpoint, “I don’t think a lot of people think about talking about climate change with their medical team,” Rosenbach said. “And if they do, it pushes the medical team to educate themselves and educate the field.”
Good news for oversharers — talking about your weird rash with friends and acquaintances is also praxis. “No one should be afraid to say, ‘I saw my doctor and they said I got Lyme. I got bit by the tick in February, because of climate change! That’s kind of crazy!’” Rosenbach added. “Just having those conversations and showing people that these are real-time impacts that they’re experiencing I think is important.”
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On the environmental reviews, Microsoft’s emissions, and solar on farmland
Current conditions: Enormous wildfires in Manitoba, Canada, will send smoke into the Midwestern U.S. and Great Plains this weekend • Northwest England is officially experiencing a drought after receiving its third lowest rainfall since 1871 • Thunderstorms are brewing in Washington, D.C., where the Federal Court of Appeals paused an earlier ruling throwing out much of Trump’s tariff agenda.
The Supreme Court ruled Thursday that courts should show more deference to agencies when hearing lawsuits over environmental reviews.
The case concerned a proposed 88-mile train line in Utah that would connect its Uinta Basin (and its oil resources) with the national rail network. Environmental groups and local governments claimed that the environmental impact statement submitted by the federal Surface Transportation Board did not pay enough attention to the effects of increased oil drilling and refining that the rail line could induce. The D.C. Circuit agreed, vacating the EIS; the Supreme Court did not, overturning the D.C. Circuit in an 8-0 decision.
The National Environmental Policy Act, or NEPA, requires the federal government to study the environmental impact of its actions. The D.C. Circuit “failed to afford the Board the substantial judicial deference required in NEPA cases and incorrectly interpreted NEPA to require the Board to consider the environmental effects of upstream and downstream projects that are separate in time or place,” Justice Brett Kavanaugh wrote for the court.
The court’s decision could sharply limit the ability of the judicial branch to question environmental reviews by agencies under NEPA, and could pave the way for more certain and faster approvals for infrastructure projects.
At least, that’s what Kavanaugh hopes. The current NEPA process, he writes, foists “delay upon delay” on developers and agencies, so “fewer projects make it to the finish line. Indeed, fewer projects make it to the starting line.”
Map of the approved railway route.Source: Uinta Basin Railway Final Environmental Impact Statement
The Department of Agriculture is planning to retool a popular financing program, Rural Energy for America, to discourage solar development on agricultural land, Heatmap’s Jael Holzman exclusively reported.
“Farmland should be for agricultural production, not solar production,” a USDA spokesperson told Heatmap. The comments echoed a USDA report released last week criticizing the use of solar on agricultural land. The report said that the USDA will “disincentivize the use of federal funding at USDA for solar panels to be installed on productive farmland through prioritization points and regulatory action.” The USDA will also “call on state and local governments to work alongside USDA on local solutions.”
The daughter of a woman who died during the Pacific Northwest “Heat Dome” in 2021 sued seven oil and companies for wrongful death in Washington state court, The New York Times reported Thursday.
“The suit alleges that they failed to warn the public of the dangers of the planet-warming emissions produced by their products and that they funded decades-long campaigns to obscure the scientific consensus on global warming,” according to Times reporter David Gelles.
Several cities and states have brought suits making similar claims that oil and gas companies misled the public about the threat of climate change. Earlier this week, a German court threw out a suit from a Peruvian farmer against a German utility, which claimed that the utility’s commissions helped put his town at risk from glacial flooding.
The seven companies named in the lawsuit are Exxon Mobil, Chevron, Shell, BP, ConocoPhillips, Phillips 66, and Olympic Pipeline Company, a subsidiary managed by BP. None of them commented on the suit.
Tech giant Microsoft disclosed in its annual sustainability report that its carbon emissions have grown by 23.4% since 2020, even as the company has a goal to become “carbon negative” by 2030. The upside to the figures is that the growth in emissions was due to a much larger increase in energy use and business activity, not from using dirtier energy. In that same time period, Microsoft’s revenue has grown 71%, and its energy use has grown 168%.
“It has become clear that our journey towards being carbon negative is a marathon,” the report read. The company said it had contracted 34 gigawatts of non-emitting power generation and had agreements to procure 30 million metric tons of carbon removal.
The company has set out to reduce its indirect Scope 3 emissions “by more than half” by 2030 from the 11.5 million metric tons it reported in 2020, as its Scope 1 and Scope 2 emissions fall to close to zero. It will become “carbon negative,” it hopes, by purchasing carbon removal.
Microsoft attempts to reduce emissions in its supply chain by procuring low- or no-carbon fuels and construction materials. Last week the tech giant signed a purchasing agreement with Sublime Systems for 600,000 tons of low-carbon cement.
The Nuclear Regulatory Commission announced it had approved a 77-megawatt small modular reactor design. This is the second SMR design approved by the NRC, following approval of a smaller design in 2020. Both are products of the SMR company NuScale, and neither has yet been deployed. A project to build the earlier design in Idaho was abandoned in 2023.
The NRC review was set to be completed in July of this year. Coming in ahead of scheduled demonstrates “the agency’s commitment to safely and efficiently enable new, advanced reactor technology,” the Commission said in a press release.
Congress and the Biden and Trump administrations have pushed the NRC to move faster and to encourage the development of small modular reactors. No SMR has been built in the United States, nor is there any current plan to do so that has been publicly disclosed. NuScale’s chief executive told Bloomberg that he hopes to have a deal signed by the end of the year and an operational plant by the end of the decade.
Tesla veteran Drew Baglino’s Heron Power raised a $38 million round of Series A funding for a new product designed to replace “legacy transformers and power converters by directly connecting rapidly growing megawatt-scale solar, batteries, and AI data centers to medium voltage transmission,” Baglino wrote on X.
A conversation with Mike Hall of Anza.
This week’s conversation is with Mike Hall, CEO of the solar and battery storage data company Anza. I rang him because, in my book, the more insights into the ways renewables companies are responding to the war on the Inflation Reduction Act, the better.
The following chat was lightly edited for clarity. Let’s jump in!
How much do we know about developers’ reactions to the anti-IRA bill that was passed out of the House last week?
So it’s only been a few days. What I can tell you is there’s a lot of surprise about what came out of the House. Industries mobilized in trying to improve the bill from here and I think a lot of the industry is hopeful because, for many reasons, the bill doesn’t seem to make sense for the country. Not just the renewable energy industry. There’s hope that the voices in Congress — House members and senators — who already understand the impact of this on the economy will in the coming weeks understand how bad this is.
I spoke to a tax attorney last week that her clients had been preparing for a worst case scenario like this and preparing contingency plans of some kind. Have you seen anything so far to indicate people have been preparing for a worst case scenario?
Yeah. There’s a subset of the market that has prepared and already executed plans.
In Q4 [of 2024] and Q1 [of this year] with a number of companies to procure material from projects in order to safe harbor those projects. What that means is, typically if you commence construction by a certain date, the date on which you commence construction is the date you lock in tax credit eligibility, and we worked with companies to help them meet that criteria. It hedged them on a number of fronts. I don’t think most of them thought we’d get what came out of the House but there were a lot of concerns about stepdowns for the credit.
After Trump was elected, there were also companies who wanted to hedge against tariffs so they bought equipment ahead of that, too. We were helping companies do deals the night before Liberation Day. There was a lot of activity.
We saw less after April 2nd because the trade landscape has been changing so quickly that it’s been hard for people to act but now we’re seeing people act again to try and hit that commencement milestone.
It’s not lost on me that there’s an irony here – the attempts to erode these credits might lead to a rush of projects moving faster, actually. Is that your sense?
There’s a slug of projects that would get accelerated and in fact just having this bill come out of the House is already going to accelerate a number of projects. But there’s limits to what you can do there. The bill also has a placed-in-service criteria and really problematic language with regard to the “foreign entity of concern” provisions.
Are you seeing any increase in opposition against solar projects? And is that the biggest hurdle you see to meeting that “placed-in-service” requirement?
What I have here is qualitative, not quantitative, but I was in the development business for 20 years, and what I have seen qualitatively is that it is increasingly harder to develop projects. Local opposition is one of the headwinds. Interconnection is another really big one and that’s the biggest concern I have with regards to the “placed-in-service” requirement. Most of these large projects, even if you overcome the NIMBY issues, and you get your permitting, and you do everything else you need to do, you get your permits and construction… In the end if you’re talking about projects at scale, there is a requirement that utilities do work. And there’s no requirement that utilities do that work on time [to meet that deadline]. This is a risk they need to manage.
And more of the week’s top news in renewable energy conflicts.
1. Columbia County, New York – A Hecate Energy solar project in upstate New York blessed by Governor Kathy Hochul is now getting local blowback.
2. Sussex County, Delaware – The battle between a Bethany Beach landowner and a major offshore wind project came to a head earlier this week after Delaware regulators decided to comply with a massive government records request.
3. Fayette County, Pennsylvania – A Bollinger Solar project in rural Pennsylvania that was approved last year now faces fresh local opposition.
4. Cleveland County, North Carolina – Brookcliff Solar has settled with a county that was legally challenging the developer over the validity of its permits, reaching what by all appearances is an amicable resolution.
5. Adams County, Illinois – The solar project in Quincy, Illinois, we told you about last week has been rejected by the city’s planning commission.
6. Pierce County, Wisconsin – AES’ Isabelle Creek solar project is facing new issues as the developer seeks to actually talk more to residents on the ground.
7. Austin County, Texas – We have a couple of fresh battery storage wars to report this week, including a danger alert in this rural Texas county west of Houston.
8. Esmeralda County, Nevada – The Trump administration this week approved the final proposed plan for NV Energy’s Greenlink North, a massive transmission line that will help the state expand its renewable energy capacity.
9. Merced County, California – The Moss Landing battery fire is having aftershocks in Merced County as residents seek to undo progress made on Longroad’s Zeta battery project south of Los Banos.