Taula de Continguts
- Which pollutants reach the skin in a large city
- Oxidative stress: the mechanism pollutants share
- Dark spots and extrinsic ageing: what the studies say
- Pores, shine and congestion: a less clear relationship
- Your home routine: cleansing at night, antioxidants and sunscreen
- In-clinic treatments for dark spots, pores and texture
- How we work at Santé Madrid
- Frequently asked questions
Air pollution can affect your skin: studies link it to more oxidative stress, to the appearance of pigment spots and to signs of extrinsic ageing, and in some people to more shine and blemishes. If you live in Madrid or another large city, you cannot control the air you breathe, but you can control how you cleanse, protect and treat your skin. In this guide we explain which pollutants are studied, what the evidence says about dark spots, pores and wrinkles, which routine makes sense and which in-clinic treatments can be considered after an assessment.
Key points
- Particulate matter, nitrogen dioxide and ozone are the urban pollutants most studied in relation to the skin.
- The common mechanism described by scientific reviews is oxidative stress, which can disrupt the skin barrier and promote inflammation.
- Cohort studies have associated exposure to traffic-related pollution with more pigment spots on the face; these are associations, not proof of direct cause.
- The basic routine is simple: gentle cleansing at night, topical antioxidants and broad-spectrum sunscreen every morning.
- For dark spots, pores and texture there are in-clinic options (laser, HydraFacial, peels, microneedling) that the medical team recommends after assessing your skin. Results vary from skin to skin.
Which pollutants reach the skin in a large city
Your skin is in direct contact with the air. A review published in the journal of the European Academy of Dermatology and Venereology explains that pollutants can reach the superficial and deeper layers of the skin, both through direct contact and by the systemic route (Araviiskaia et al., 2019).
The same review groups the main outdoor pollutants into gases, such as nitrogen dioxide, sulphur dioxide or carbon monoxide, and particulate matter, known by the abbreviation PM. Among the sources of nitrogen dioxide it lists fuel combustion and vehicle emissions. Ground-level ozone is a special case: it is not emitted directly, but forms when nitrogen oxides react with volatile organic compounds under ultraviolet light.
In a large city, with heavy traffic and many sunny days, the skin can be exposed to these pollutants and to solar radiation at the same time. Air-quality figures vary by area, season and day; here we focus on how they can affect your skin.
Oxidative stress: the mechanism pollutants share
The skin has its own antioxidant defences. The problem arises when the production of reactive oxygen species, unstable molecules that damage lipids, proteins and DNA, exceeds that defensive capacity. A systematic review on particulate matter concludes that these particles can cause skin barrier dysfunction and the formation of reactive oxygen species, leading to oxidative stress and activating the inflammatory cascade in human skin (Dijkhoff et al., 2020).
Something similar happens with ozone. The Araviiskaia review describes how, in experimental studies, ozone exposure reduced vitamin C and vitamin E in the superficial layers of the skin, first in animal models and then in the forearm stratum corneum of volunteers. These are antioxidants the skin uses to defend itself.
Another review on environmental ageing sums up the central idea: ultraviolet radiation, visible light, pollution and tobacco share a common mechanism, which is to disturb the redox balance of the cell until oxidative stress develops, and this accelerates skin ageing (Farris and Valacchi, 2022). That is why pollution and sun should not be thought of separately.
Dark spots and extrinsic ageing: what the studies say
Extrinsic ageing is the ageing that external factors add to the passage of time. For years almost all of it was attributed to the sun; today pollution is studied too. The Dijkhoff review summarises that, in healthy skin, exposure to urban particles has been associated with accelerated extrinsic ageing, whose clinical signs are the formation of pigment spots, coarse wrinkles and elastosis.
The study that opened this field is the one by Vierkötter and colleagues, from 2010. As summarised in the Araviiskaia review, it compared German women living in an area with more pollution, the Ruhr area, and women from a rural area with less. Higher exposure to traffic-related particles was associated with more lentigines, the age-associated pigment spots, on the forehead and cheeks, and with more marked nasolabial folds. Later, a specific association between nitrogen dioxide and lentigines on the cheeks was described, in a German cohort and a Chinese one.
These data should be read with caution. They are observational studies: they show associations, they do not prove that pollution alone causes each spot. Sun, genetics, hormones and age still weigh heavily. But they do support a practical idea: if dark spots worry you and you live in an urban environment, protection should not be limited to summer or the beach.
Pores, shine and congestion: a less clear relationship
Many people who live in cities say they notice their skin looking duller, shinier or with more visible pores at the end of the day. The evidence here is weaker than for dark spots, and it is worth saying so.
The Araviiskaia review includes two studies that compared the skin of people in urban and less polluted areas. In one of them, forehead sebum was higher in the urban group; in the other, that effect was not observed. In both, however, more dryness was seen in the skin of those who were more exposed. The same review mentions Asian studies that suggest a relationship between higher pollutant levels and acne, and cites pollution as one of the exposome factors of acne.
The sensible approach is not to blame pollution for every enlarged pore: other factors also influence how pores look, such as skin type or sebum production. What can help is removing each night what builds up on the surface and choosing products that do not clog pores. If there are breakouts of inflammatory acne, the right step is a medical assessment and, if it does not respond to aesthetic management, a consultation with a dermatologist.
Your home routine: cleansing at night, antioxidants and sunscreen
The basis of care is daily and does not require many steps. The American Academy of Dermatology recommends washing your face in the morning and at night, and also after heavy sweating, with a gentle, non-abrasive, alcohol-free cleanser (AAD, face washing). The evening cleanse is the one that removes the residue of the day: sunscreen, make-up, sebum and whatever has settled on the surface.
In the morning, sunscreen is essential, but it has a limit worth knowing: the Farris and Valacchi review points out that sunscreen does not protect against pollutants and proposes complementing it with topical antioxidants, such as vitamins C and E or ferulic acid. The AAD advises a broad-spectrum sunscreen with SPF 30 or higher and, if dark spots worry you, a tinted one containing iron oxide, which also protects against visible light (AAD, dark spots).
| Time | Step | What for |
|---|---|---|
| Morning | Gentle cleansing | Prepare the skin without irritating it |
| Morning | Antioxidant serum | Reinforce defences against oxidative stress |
| Morning | Broad-spectrum sunscreen, SPF 30 or higher | Protect from the sun; with iron oxide if you have dark spots |
| Night | Gentle, thorough cleansing | Remove sunscreen, make-up, sebum and the residue of the day |
| Night | Moisturiser suited to your skin | Support the skin barrier |
At the clinic we work with the cosmeceutical brands SkinCeuticals, ZO, ASM and Biotricología. The choice of product depends on your skin type and on what concerns you, and it is made in consultation. If you want to go deeper into ingredients, we have a guide to antioxidants for skin.
In-clinic treatments for dark spots, pores and texture
The routine is the foundation, but it is not always enough when dark spots are already established or texture has changed. In that case, the medical team may suggest in-clinic treatments. Here we only outline what may make sense for each concern.
Dark spots. We work with the Alma Harmony XL Pro platform. According to the manufacturer, the platform includes a Q-Switched laser aimed at removing pigmentation, a ClearLift applicator that delivers nanosecond pulses targeting different pigmentations and AFT light applicators optimised for pigmentation, vascular lesions and acne (Alma, Harmony XL Pro). Before treating a spot, the doctor assesses what type of lesion it is; melasma, for example, requires a more cautious approach. You can read more on our pigmentation laser treatment page.
Pores and congestion. The HydraFacial manufacturer describes an extraction step that clears pores and serums that can be aimed at congestion or uneven tone (HydraFacial). At Santé we offer it as a HydraFacial cleanse.
Texture. Chemical peels and microneedling are other options in the catalogue. A review describes microneedling as a minimally invasive technique traditionally used to induce collagen in facial scars and for rejuvenation (Singh and Yadav, 2016). With peels, the AAD warns that the result depends largely on the experience of the person performing them and that in darker skin there can be pigmentation problems if they are not done with the right knowledge (AAD, chemical peels).
How we work at Santé Madrid
Santé Clinics Madrid is at C. de Amador de los Ríos, 1, Chamberí, 28010 Madrid. We are open Monday to Friday from 9:00 to 21:00 and on Saturdays from 10:00 to 15:00; the clinic is closed on Sundays.
The first step is a free aesthetic consultation with a Beauty Coach. In it we review your skin, your routine and what concerns you: dark spots, pores, texture or a dull look. If there are spots that need a medical assessment, medication that makes your skin more sensitive or any clinical question, it is assessed in a medical consultation, which costs €50.
With that information, the Santé Madrid medical team proposes a step-by-step plan. First, the home routine, with cleansing, antioxidants and sunscreen adapted to your skin. Then, if it makes sense, one or more in-clinic treatments, in the order and at the interval your skin tolerates. All treatments are performed by the medical team after assessing your case.
We do not make promises about results. Results vary from skin to skin, and dark spots can come back if daily protection is abandoned. That is why we prefer to explain calmly what you can expect before you start.
Frequently asked questions
Can pollution cause dark spots on the face?
Observational studies have associated exposure to traffic-related particles and nitrogen dioxide with more pigment spots on the face. These are associations, not proof of direct cause, and the sun remains a key factor.
Does sunscreen protect me from pollution?
Not directly. Sunscreen protects against radiation, but not against pollutants. That is why it is usually recommended to combine it with an antioxidant serum and good cleansing at night.
Which topical antioxidants are usually recommended?
Reviews frequently cite vitamins C and E and ferulic acid, among others. The specific product depends on your skin type and is chosen in consultation.
Do I need to wash my face twice a day?
The AAD recommends washing it in the morning and at night, and after heavy sweating, with a gentle cleanser. The evening cleanse removes sunscreen, make-up and the residue of the day.
Does pollution enlarge pores?
The evidence is not conclusive. Some studies have found more sebum in urban areas and others have not. Skin type and sebum production also influence how pores look.
Which treatment is most suitable for pollution-related dark spots?
It depends on the type of spot. The doctor first assesses the lesion and, depending on the case, may suggest laser, peels or other options. Results vary from skin to skin.
Can I treat dark spots with laser in summer?
If your skin is tanned or you have had a lot of sun exposure, the medical team may recommend waiting. The timing is decided in consultation according to your skin and your sun exposure.
If dark spots, pores or duller skin from city life concern you, a consultation at Santé Madrid will help you organise your routine and find out whether any treatment makes sense for you. We will explain calmly what you can expect.
