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Wrinkles and sleep troubles are among the odd symptoms linked to poor air quality

The wildfire smoke that has blanketed much of the Northeast can cause a number of unexpected symptoms.
Image: The Statue of Liberty, covered in a haze-filled sky, from the Staten Island Ferry, on June 7, 2023, in New York.
The Statue of Liberty, covered in a haze-filled sky, seen Wednesday from the Staten Island Ferry.Yuki Iwamura / AP

Itchy eyes, a scratchy throat and a cough probably come as no surprise when the air is thick with wildfire smoke. But poor air quality can contribute to less expected symptoms, too.

It is not uncommon for people to also experience chest pain, headaches and dizziness, according to Dr. Gregory Wu, a critical care medicine physician at Albany Medical Center in Albany, New York. 

“We do encourage folks, if they’re having chest pain or chest tightness, that they should be seeking care,” Wu said. “And similarly, if folks are having headaches or dizziness, that’s another good reason to seek care, or at least get indoors.”

Persistent headaches should prompt medical attention, he added, especially if someone is not normally prone to headaches or the headache feels worse than usual.

Follow live coverage of U.S. air quality conditions and Canada’s wildfires

Chest pain, in particular, may be an indicator of something more serious, like a heart attack, he said. 

It’s not entirely clear why poor air quality increases heart attack risk. One hypothesis, according to the American Heart Association, is that, because wildfire smoke contains fine particulate matter that can constrict blood vessels and increase blood pressure, it could potentially lead to heart attack.

A study published in 2020 in the Journal of the American Heart Association found that exposure to heavy smoke during wildfires raised the risk of out-of-hospital cardiac arrests by up to 70%. 

The headaches or dizziness may be the direct result of breathing in pollution, like carbon monoxide, from the smoke, said Dr. Panagis Galiatsatos, a pulmonologist with the American Lung Association. It’s also possible for people to pass out or experience nausea from inhaling the toxic fumes, he said.

Sleep can also be thrown off because of exposure to wildfire smoke, according to Galiatsatos. That fine particulate matter, he said, can enter the bloodstream, causing inflammation in and around the brain as well as other parts of the body, making it difficult to get rest.

“Even if you’re healthy, you may feel some effects,” he said. 

Parents should also keep an eye on how their kids are feeling. Young children are known to become irritable, angry or just overall more moody because of exposure to poor air quality, including from wildfire smoke, Galiatsatos said, adding that the same occurrence is not seen as much with adults.

“The biological reason is not fully understood,” he said. “If children are exposed to things that are toxic, they tend to get more irritable. It’s the same thing seen with a respiratory virus. Maybe they can’t breathe as well or maybe they’re just congested.”

Dr. Maria Wei, a professor of dermatology at the University of California, San Francisco, said that wildfire smoke can also cause skin problems. 

Wei published a study in JAMA Dermatology in 2021 that found short-term exposure to wildfire smoke can cause flare-ups of skin disorders, such as psoriasis and eczema, including in people who did not previously have a diagnosis. The flare-ups are not always immediate, she added — they can show up four or five weeks later. 

People have also reported itchy skin, acne and rashes on their hands and face from poor air quality, she said. 

Long-term exposure can also cause wrinkles. “It’s well known that air pollution can cause premature aging of the skin,” she said.

Particulate matter from smoke can penetrate the skin, but Wei also expects there may be an overactive immune response from the pollution that kicks in, causing flare-ups. 

Air purifiers may be effective in preventing skin irritation from air pollution, Wei said. Wearing long sleeves and pants as well as moisturizers can also act as barriers for the skin.  

Galiatsatos recommended that people stay indoors as much as possible to prevent symptoms from wildfire smoke. If people need to go outside, they should wear a tight-fitting mask, like an N95 respirator, he said.

CORRECTION (June 8, 2023, 4:30 p.m. ET): A previous version of this article misattributed comments about air quality and heart health. They are from Dr. Gregory Wu, a critical care medicine physician at Albany Medical Center in Albany, New York, not Dr. Benjamin Wu, a pulmonologist and critical care physician at NYU Langone Health in New York City.

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