Ann Dermatol.  2014 Dec;26(6):688-692. 10.5021/ad.2014.26.6.688.

The Effect of Environmentally Friendly Wallpaper and Flooring Material on Indoor Air Quality and Atopic Dermatitis: A Pilot Study

  • 1Department of Dermatology, Seoul National University Bundang Hospital, Seongnam, Korea.


Formaldehyde (FA) and other volatile organic compounds (VOCs) are considered among the main causes of atopic aggravation. Their main sources include wallpapers, paints, adhesives, and flooring materials.
To assess the effects of environmentally friendly wallpaper and flooring material on indoor air quality and atopic dermatitis severity.
Thirty patients with atopic dermatitis were enrolled in this study. To improve air quality, the wallpaper and flooring in the homes of the subjects were replaced with plant- or silica-based materials. The indoor air concentration of FA and the total VOCs (TVOCs) were measured before remodeling and 2, 6, and 10 weeks thereafter. Pruritus and the severity of atopic eczema were evaluated by using a questionnaire and the eczema area and severity index (EASI) score before and at 4, 8, and 12 weeks after remodeling. The subjects were instructed to continue their therapy for atopic dermatitis.
The houses of 24 subjects were remodeled; all subjects completed the study. The concentration of FA in ambient air significantly decreased within 2 weeks after remodeling. The TVOC level showed a decrease at week 2 but increased again at weeks 6 and 10. The reduction of pruritus and EASI score was statistically significant in patients whose baseline EASI score was >3.
Replacing the wallpaper and flooring of houses with environmentally friendly material reduced FA in ambient air and improved pruritus and the severity of atopic eczema. The improvement of pruritus and eczema was statistically significant in patients whose baseline EASI score was >3.


Atopic dermatitis; Formaldehyde; Housing; Indoor air quality; Volatile organic compounds

MeSH Terms

Air Pollution, Indoor*
Dermatitis, Atopic*
Pilot Projects*
Volatile Organic Compounds
Surveys and Questionnaires
Volatile Organic Compounds


  • Fig. 1 Indoor air quality after the replacement of wallpaper and flooring material. (A) After replacement with environmentally friendly wallpaper and flooring materials, the formaldehyde concentration in indoor air statistically significantly decreased at 2 weeks and kept decreasing until week 10. (B) The concentration of total volatile organic compounds (TVOCs) decreased at week 2; however, a re-increase was observed at weeks 6 and 10. *p<0.05, **p<0.005.

  • Fig. 2 Change of pruritus and eczema area and severity index (EASI) score after replacement of wall paper and flooring material. **p<0.005. (A) EASI score showed a gradual decrease, but the difference was not statistically significant. (B) Pruritus score showed a statistically significant reduction from week 4 and it kept decreasing until week 12.

  • Fig. 3 Change of pruritus and eczema area and severity index (EASI) score after the replacement of wallpaper and flooring materials. (A) In subjects whose baseline EASI (bEASI) score was ≥3, a statistically significant reduction of EASI score was observed. The change of EASI score was insignificant in subjects whose bEASI was <3. (B) In subjects whose bEASI score was ≥3, the level of pruritus was reduced significantly at week 4 and kept decreasing until week 12. The reduction of pruritus was not significant in subjects whose bEASI score was <3. *p<0.05, **p<0.005.


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