USA’s Best and Worst Cities for Your Skin (According to One Epic Study)

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When you’re packing your bags for a holiday somewhere—whether it’s a road trip or a week-long beach escape—you never forget the sunscreen, right?

(I won’t hold it against you if you do, but it really should be at the top of your list!)

The thing is:

Have you ever thought about how where you live impacts your skin?

I mean, it’s kind of odd that a lot of us (myself included!) go ham on the sunscreen at the beach in the name of skin protection, but when it comes to day-to-day life, sunscreen gets the ‘meh’ treatment. 

The fact is, skin cancer is diagnosed in the US more frequently than lung, colon, breast, and prostate cancers combined—and in most cases, could have been easily prevented by avoiding skin’s worst enemy:

The sun.

uv radiation

And that’s not even the worst part—

There are three crucial other factors that potentially affect skin: overall climate, pollution, and accessibility to appropriate skincare health facilities.

For example: 

How accessible is a dermatologist appointment in a certain area? When it comes to most skin cancers, identifying it in time is crucial for swift diagnosis and treatment—does everyone get that same opportunity across the nation?

Six skincare experts put together a very illuminating study with WalletHub to understand exactly what factors make a city the best, and also the worst to live in for your skin, comparing 150 cities across the nation.

They looked at everything, and I mean everything:

From how many beauty supply stores there are in a given area to the incidence of melanoma—literally, no stone was left unturned. 

Let’s dive into the details!

diving in

To break down the study, the researchers looked at four major parameter groups:

  • Skin Cancer Prevalence & Contributing Factors
  • Pollution & Smoking
  • Climate
  • Skin & Health Care

These four basically go over everything that contributes to how your skin looks, except for your genetics. There’s nothing you can do to help those, unfortunately!

Added up, all of the factors considered make a total of 100—100 being the best, most ideal conditions for healthy skin, and 1 meaning that, well, conditions were far less than ideal for healthy skin. Yikes!

Let’s break down the parameters the researchers used to understand the study completely before planning any cross-country moves, alright?

Skin Cancer Prevalence + Contributing Factors (40 points)

When it comes to skin cancer, there’s just no beating around the bush—sun exposure is directly linked to incidences of melanomas and carcinomas. The three key points that researchers used linked to Skin Cancer Prevalence are 1) Melanoma Incidence Rate, 2) Skin-Cancer Death Rate, and 3) Number of Tanning Salons—all per 100,000 residents of each city. 

What’s crucially important is factoring in tanning salon use—while indoor tanning beds are not a popular as they used to be, there’s a huge overlap between folks who started tanning young and the rates of skin cancers.

In 2009, a study done at San Diego State University found that there were more tanning salons than Starbucks in most cities across the nation—I don’t know about you, but I think that’s absolutely bizarre.

It gets even better, though—in Florida specifically, there were more tanning beds than McDonald’s branches in 2013.



That makes this next tidbit of information quite relevant though—three of the five cities with the most skin cancer-related deaths per capita are in Florida.

Pollution + Smoking (20 Points)

You might be sitting there thinking that you know how air quality and smoking affects the skin—but did you know that poor Water Quality is a top contributor, too?

Hard water is found in 85% of American homes and impacts skin health and quality, compromising the skin’s natural acid mantle. This causes at best a bit of dryness, but at worst can be directly related to chronic irritation and eczema—obviously, something that nobody wants.

That’s not even the worst part—

It can contribute to brittle hair and nails too. So if you’ve been trying to grow your hair, but it just won’t, your water could be part of the problem.

If all of this is sounding oddly familiar, you might be living in a hard water area and not even know it.

The solution?

I mean, I guess you could pack up and live somewhere where water quality is notably better (tip: Eldorado Springs, CO apparently has the best municipal water in the States!) but otherwise, there isn’t really one, short of installing a full water-softening system.

The other three factors that the researchers considered were 1) Air Pollution, 2) Smoking Rate, and 3) Smoke-Free Laws.

Because Air Pollution is just so pervasive in our environment (meaning, it’s not a choice like smoking) the researchers decided to give it a triple weighting, which I agree with. Remember that article I wrote about how the air around you could be your worst enemy? The air quality in your environment totally affects you way more than you realize—let’s hope that your city isn’t one of the worst offenders on this list!

air pollution

Santa Rosa, CA, and Honolulu, HI tie for first—but ironically, the bottom five cities for pollution are all also in California.

…After this, I have a feeling a lot of people will want to plan a cross country move!

We’ve known for years and years now that smoking doesn’t just impact our health—it’s consistently linked with premature aging and countries all over the world have different campaigns to discourage their citizens from smoking.

The top five cities for highest rates of non-smokers are in California, which doesn’t come as a surprise as it’s both stereotypically and literally the healthiest state in the country. Açai bowl, anybody?

Climate (20 Points)

Okay, while this category definitely has some overlap with the very first category, it goes far more in-depth into the environmental factors that affect our skin.

Other than the obvious UV Index and Humidity, did you know that the Average Wind Speeds and frequency of Extreme Temperature Days were taken into account by the researchers?

So let’s start at the top—UV Index is a measure of the strength of the sun’s radiation, depending on cloud cover, ozone thickness, and time of year.

Humidity is a pretty obvious one, and according to the study, 40% was the optimum levels. However, there really isn’t much that you can do about this if you happen to live somewhere incredibly humid like Florida, or super dry like Arizona.

A study by Japanese researchers suggested that drier climates cause the skin to age faster, so I think a lot of people I know would prefer somewhere that’s a little more humid than average—myself included.

Extreme Temperature Days goes both ways—that is, how many days are extremely cold plus how many days are extremely hot. Temperature excesses, either way, can compromise skin, leaving it vulnerable to damage over time.

With all this in mind, which regions came out on top?

Again, California was a winner!

Skin Health & Care (20 Points)

Okay, so these are kind of the make-or-break subcategories when it comes to which cities are the best for your skin—it takes a long hard look at the number of Dermatologists, Skin Care Specialists, Skin Care Centers, and Beauty Supply Stores per 100,000, plus the cost to see a Dermatologist and the cost of Cosmetic Medicine.

Fun fact: Orlando, FL has the most beauty supply stores per capita nationwide—so if you’re into all things skincare, you’ve hit the jackpot!

For real though—

Having access to the right treatment at the right time makes a world of difference when it comes to ensuring the skin-friendliest city.

And I’m not just talking dermatologists, this covers skin spas and estheticians as well.

So, where are the most skin-friendly cities?

I assumed that the most skin-friendly cities were going to be in either Hawai’i or California—imagine my surprise when it turns out that all three are in Texas! Don’t mess with Texas—or at least, with Texan’s skin.

1. El Paso, TX

When it comes to El Paso, this city ranks above the rest for being skin-friendly—especially when it comes to the first three parameters. Respectively, it ranks 2, 14, and 11. These are not numbers to turn your nose up at, especially when you consider that this is a pool of 150 cities across the country!

However, this West Texas city ranked lower for Skin Health & Care at 119—so if you like a lot of reassurance from skincare professionals or can’t live without a Beauty Supply store in the area, this might not be the city for you.

2. San Antonio TX

I promise these aren’t biased results, guys—seriously, the numbers don’t lie. Interestingly, San Antonio doesn’t rank highly for the same things as El Paso, but still high enough to rank second overall.

So where does San Antonio win?

Clearly, Texans don’t smoke as much as the Marlboro Man would have us believe since again San Antonio ranks well for smoking and pollution—in fact, it ranks even better than El Paso at 11 out of 150. It tails El Paso for a respectable rank of 4 in regards to Skin Cancer and Contributions—sounds like Texans are really onto their sunscreen usage, then? It’s in the middle of the pack at 61 for overall Skin Health, which isn’t the best but isn’t the worst either.

Where does this city lose?

Climate. I’ve never been so I can’t speak for the city, but San Antonio ranks 115 out of 150 in this study—however, the other factors rank well enough for that to be (mostly) overlooked. 

3. Austin TX

The Texan trifecta is rounded out with Austin, which only loses out to San Antonio by a very, very slim margin for the number two spot—it ranks better for both Climate and Skin Health, but just slightly worse in Smoking and Pollution and Skin Cancer Prevalence.

All three of these southern cities rank very similarly, there’s no denying that—is anyone planning a move down south anytime soon?

Where are the LEAST skin-friendly cities?

Just like some cities were the best, there inevitably would be some that were the worst—so which were they?

1. Port St Lucie, FL

This city in the Sunshine State ranked the worst out of all the cities for Skin Cancer Prevalence, which is what brought it down so low in the rankings. However, I guess that this is actually due to how common fake-n-bake indoor tanning is—remember that there were more tanning beds than Micky D’s in Florida?

The one redeeming quality about Port St Lucie was that it ranked kind of okay for smoking and pollution—but again, like indoor tanning, it’s a personal choice thing, rather than being completely of the environment. Would I still move here? Heck no!

2. Akron, OH

Poor, poor Akron—I weep for the skin of its residents’. Okay, not really but this Ohio city ranked horrifically across the board. There’s nothing good I can salvage out of these rankings—if you live here, I hope that you can get out ASAP for the sake of your skin!

3. Shreveport, LA

If you’re thinking of taking that job in Shreveport, think again my friend. This is the most skin-unfriendly city in Louisiana—skip it and head to NOLA instead, which sits at a pretty respectable 24 for a reasonably skin-friendly city. 

The Key Takeaways

While we often plan and think about how to take care of our skin when it comes to special occasions and trips abroad, never underestimate how much your home city and even your regular routine there affects your skin. It’s something that you (and I!) should be conscious of and react accordingly.


Weekly sports practice out in the sun? Exposes you to sun damage—so don’t forget the SPF.

Haven’t put down the smokes yet? Ages your skin faster than you can say ‘nicotine’.

Living in a dry, arid climate? Careful—if you don’t use the right skincare, moisture (and youthfulness) are literally evaporating away.

Or, if you’re looking for a change of scenery but haven’t picked anywhere yet, I hope this list has helped decide on the best skin-friendly cities in the USA! 

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