The Dermatologic Burden of Flooding: A Systematic Review of Epidemiology, Clinical Manifestations, and Management in a Warming World.

In 30 seconds

This systematic review synthesized 12 epidemiological studies, including retrospective cohorts, time-series, and case-crossover designs, covering more than 71 million patient encounters across nine countries. It organized flood-associated skin conditions into water-contact injuries, displacement-related conditions, and aeroallergen-related exacerbations. Findings included no significant increase in Staphylococcus aureus infections in high-resource settings, while flood-associated humidity and wind were linked to acute atopic dermatitis flares (odds ratio [OR] 1.14). Shelter overcrowding was associated with a delayed rise in communicable infestations approximately 1 week after disaster.

Key findings

• Across high-resource settings, studies found no significant increase in Staphylococcus aureus infections after flooding.
• Flood-associated humidity and wind independently drove acute atopic dermatitis flares (OR 1.14) and allergic rhinitis.
• Shelter overcrowding was associated with a delayed surge in scabies and pediculosis approximately 1 week post-disaster.
• Water-contact risks included mucosal infections such as leptospirosis and Aeromonas, as well as chemical irritant dermatitis.

Why it matters

Flood-related dermatologic morbidity is not limited to direct water exposure or acute injury. The review highlights distinct risks arising from environmental conditions and displacement, with implications for surveillance across the post-disaster period. Recognizing these differing patterns can help public health responses address mucosal risks, shelter-associated infestations, and inflammatory exacerbations rather than treating all skin complaints as a single problem.

What to keep in mind

The review synthesized heterogeneous observational designs and settings, so findings may not be directly comparable across populations or flood contexts.