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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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Today’s conversation is with Chris Moyer of Echo Communications, a D.C.-based communications firm that focuses on defending zero- and low-carbon energy and federal investments in climate action. Moyer, a veteran communications adviser who previously worked on Capitol Hill, has some hot takes as of late about how he believes industry and political leaders have in his view failed to properly rebut attacks on solar and wind energy, in addition to the Inflation Reduction Act. On Tuesday he sent an email blast out to his listserv – which I am on – that boldly declared: “The Wind Industry’s Strategy is Failing.”
Of course after getting that email, it shouldn’t surprise readers of The Fight to hear I had to understand what he meant by that, and share it with all of you. So here goes. The following conversation has been abridged and lightly edited for clarity.
What are you referencing when you say, ‘the wind industry’s strategy is failing’?
Anyone in the climate space, in the clean energy space, the worst thing you can do is go silent and pretend that this is just going to go away. Even if it’s the president and the administration delivering the attacks, I think there’s an important strategy that’s been lacking in the wind and other sectors that I don’t think has been effective. There was a recent E&E News story that noted a couple of wind developers when asked for comment just say, “No comment.” This to me misses a really big opportunity to not get in a fight with people but talk about the benefits of wind.
Not taking advantage of milestones like ground breaking or construction starting is a missed opportunity to drive public opinion. If you lose support in public opinion, you’re going to lose support from public officials, because they largely follow public opinion.
And there’s no way that’s going to change if you don’t take the opportunities to talk about the benefits that wind can provide, in terms of good-paying local jobs or supplying more electrons to the grid. By almost any measure the strategy employed so far has not really worked.
Okay, but what is the wind industry strategy that isn’t working? What are they doing to rebut attacks on the technology, on property values, on the environment?
We’re not hearing them. We’re not hearing those arguments.
You can’t let criticisms go unanswered.It would better serve the industry and these companies to push back against criticisms. It’s not like you can’t anticipate what they are. And what do you have to lose? You’re in the worst position of any energy sector in this political moment. It would be nice to see some fight and sharp campaign skills and strategic effort in terms of communication. And there’s no strategic value from what I can tell in [being silent].
I understand not wanting to pick a fight with folks who hold your fate in their hands, but there’s a way to thread a needle that isn’t antagonizing anybody but also making sure the facts have been heard. And that’s been missing.
You’d specifically said the industry should stop ‘being paralyzed in fear and start going on offense.’ What does that look like to you?
Taking every opportunity to get your message out there. The lowest hanging fruit is when a reporter comes and asks you, What do you think about this criticism? You should definitely reply. It’s lifting up third-party voices that are benefiting from a specific project, talking about the economic impacts more broadly, talking about the benefits to the grid.
There’s a whole number of tools in the toolbox to put to use but the toolboxes remain shut thus far. Targeted paid media, elevating the different voices and communities that are going to resonate with different legislators, and certainly the facts are helpful. Also having materials prepared, like validators and frequently asked questions and answers.
You’re trying to win. You’re trying to get your project to be successful and deliver jobs and tax revenue. And I think it would be wise for companies to look at the playbooks of electoral campaigns, because there’s lots of tools that campaigns use.
How do renewable energy developers get around the problem of partisanship? How do you get outta that through a campaign approach?
These projects are decided locally. It’s deciding who the decision-makers are and not just letting opponents who are getting talking points through right-wing media show up and reiterate these talking points. Oftentimes, there’s no one on the pro side even showing up at all, and it makes it really easy for city councils to oppose projects. They’re losing by forfeit. We can’t keep doing that.
And more on this week’s most important conflicts around renewable energy.
1. Chautauqua, New York – More rural New York towns are banning renewable energy.
2. Virginia Beach, Virginia – Dominion Energy’s Coastal Virginia offshore wind project will learn its fate under the Trump administration by this fall, after a federal judge ruled that the Justice Department must come to a decision on how it’ll handle a court challenge against its permits by September.
3. Bedford County, Pennsylvania – Arena Renewables is trying to thread a needle through development in one of the riskiest Pennsylvania counties for development, with an agriculture-fueled opposition risk score of 89.
4. Knox County, Ohio – The Ohio Power Siting Board has given the green light to Open Road Renewables’ much-watched Frasier Solar project.
5. Clay County, Missouri – We’ll find out next week if rural Missouri can still take it easy on a large solar project.
6. Clark County, Nevada – President Trump’s Bureau of Land Management has pushed back the permitting process for EDF Renewables’ Bonanza solar project by at least two months and possibly longer .
7. Klickitat County, Washington – Washington State has now formally overridden local opposition to Cypress Creek’s Carriger solar project after teeing up the decision in May.
It’s governor versus secretary of state, with the fate of the local clean energy industry hanging in the balance.
I’m seeing signs that the fight over a hydrogen project in Wyoming is fracturing the state’s Republican political leadership over wind energy, threatening to trigger a war over the future of the sector in a historically friendly state for development.
At issue is the Pronghorn Clean Energy hydrogen project, proposed in the small town of Glenrock in rural Converse County, which would receive power from one wind farm nearby and another in neighboring Niobrara County. If completed, Pronghorn is expected to produce “green” hydrogen that would be transported to airports for commercial use in jet fuel. It is backed by a consortium of U.S. and international companies including Acconia and Nordex.
One can guess why investors thought this rural Wyoming expanse would be an easier place to build: it’s an energy community situated in the middle of the Powder River Basin and the state’s Republican governor Mark Gordon has supported wind projects in the state publicly, not just with rhetoric but votes in favor of them on the State Board of Land Commissioners.
Wind is also often proposed on private land in Wyoming, which is supposed to make things easier. You may remember the Lucky Star and Twin Rivers wind farms, a pair of projects whose progress I’ve watched like a hawk because they’re tied to the future of wind permitting at the national level. As we first reported, the Trump administration is proceeding with potentially approving the transmission line for Lucky Star, a project that would be sited entirely on private land, and Twin Rivers received its final environmental review in the last days of the Biden administration, making it difficult for anti-wind advocates to curtail.
Unlike those projects, Pronghorn has created a fork in the road for wind in Wyoming. It’s because the people in its host community don’t seem to want it, the wind projects were on state land, and there’s politics at play.
Despite being considered an energy community, Converse and Niobrara are both areas with especially high opposition risk, according to Heatmap Pro, largely due to its low support for renewable energy, its demographics, and concerns about impacts to the local ranching economy. After Gordon and other members of the state land use board approved two wind facilities for the hydrogen project, a rancher living nearby sued the board with public support from the mayor of Glenrock and the area’s legislators in the statehouse. A member of the Converse County zoning board even published a “manifesto” against the project, detailing local concerns that are myriad and rooted in fears of overburden, ranging from water use and property value woes to a general resentment toward an overall rise in wind turbines across the county and state.
What’s probably most concerning to wind supporters is that this local fight is bubbling up into a statewide political fracture between Gordon and his secretary of state Chuck Gray, who is believed to be a future candidate for governor. Grey was the lone dissenting vote against the two wind projects for Pronghorn, saying he did not support the projects because they would be assisted by federal tax credits Trump is trying to gut. Gray then took to mocking the governor on social media for his stance on wind while posting photos of broken wind turbines. Gordon wound up responding to his secretary of state accusing him of being the “only member of the state land board to vote against individual property rights and Wyoming schools.”
“That is his prerogative to be sure, but it demonstrates his disregard for the duties of his office and a determination to impose his personal preferences on others, no matter the cost,” Gordon stated.
I’ve been reaching out to Pronghorn and its founder Paul Martin to try and chat about what’s happening in Wyoming. I haven’t heard back, and if I do I’ll gladly follow this story up, but there’s a sign here of an issue in Wyoming whether Pronghorn gets built or not – areas of Wyoming may be on the verge of a breaking point on wind energy.
I heard about the Pronghorn project in conversations this week with folks who work on wind permitting issues in Wyoming and learned that the Gordon-Gray feud is emblematic of how the wind industry’s growth in the state is making local officials more wary of greenlighting projects. Whether Gordon’s position on private property wins out over Gray taking up the mantle of the anti-wind conservative critic may be the touchstone for the future of local planning decisions, too.
At least, that’s the sense I got talking to Sue Jones, a commissioner in Carbon County, directly southwest of Converse County. Jones admits she personally doesn’t care for wind farms and that it’s “no secret with the county, or the developers.” But so far, she hasn’t voted that way as a commissioner.
“If they meet all our rules and regs, then I’ve voted to give them a permit,” she told me. “You can’t just say no to anything. It’s a good thing that we value private property rights.”
Jones said the problem in Carbon County and other areas of Wyoming is “saturation level.” Areas of the state where only a handful of landowners hold thousands of acres? That’s probably fine for wind projects because there’s a low likelihood of a neighbor or two having a genuine grievance. But as wind has grown into population-denser areas of the state the dissent is becoming more frequent.
My gut feeling is that, as we’ve seen in many other instances, this resentment will bubble up and manifest as sweeping reform – unless the wind industry is able to properly address these growing concerns head on.