America’s Best and Worst Cities for Skin Revealed as 73% Say Skin Concerns Affect Their Lives
Skin Concerns Drive Consumer Spending as City Ranking Puts Orlando at Bottom
Americans surveyed spend an average of $325 a year attempting to improve their skin, while nearly three-quarters say skin concerns negatively affected at least one aspect of their lives over the past year.
A study by residential water-treatment information site Water Filter Guru ranked Orlando, Florida, as the U.S. city with the highest “skin stress” score, followed by Miami and Atlanta. The index combines air-quality and solar-exposure measures with Google search activity related to breakouts, irritation, water and skin treatments. It does not measure diagnosed skin conditions.
Orlando received a Skin Stress Score of 77.83, ahead of Miami at 75.52 and Atlanta at 74.79. Las Vegas, ranked fourth, had a substantially lower score of 57.38. Minneapolis ranked fifth, followed by Scottsdale, Arizona; St. Louis; Tampa; Riverside, California; and Denver.
Lincoln, Nebraska, ranked as the lowest-stress city in the analysis with a score of 16.31. Toledo, Ohio, and Fort Wayne, Indiana, followed, with scores of 16.94 and 18.63, respectively. Lexington, Kentucky; Chesapeake, Virginia; Milwaukee; Louisville, Kentucky; Madison, Wisconsin; Tulsa, Oklahoma; and Wichita, Kansas, rounded out the 10 lowest-ranked cities.
The study weighted environmental factors at 40% of its index and search activity at 60%. Water Filter Guru used Environmental Protection Agency air-quality data, National Cancer Institute solar-exposure data as a proxy for UV exposure, and Google searches per 100,000 residents.
Search behavior was a major differentiator among high-ranking cities. Atlanta recorded the highest breakout-related search rate, at 1,948 searches per 100,000 residents, compared with 315 in Mesa, Arizona, the lowest rate in the study. Orlando led the ranking in searches involving irritation, water and treatments, reporting 20,737 irritation searches, 9,105 water-related searches and 83,018 treatment searches per 100,000 people.
Florida had three cities in the 10 highest-stress markets—Orlando, Miami and Tampa—while California accounted for seven of the 25 highest-ranked cities, according to the study.
A separate survey of 1,000 U.S. adults found that 77% felt less confident when their skin was not at its best. Seventy-three percent said skin concerns had affected at least one part of their lives in the prior year, including mood or mental health for 31% and willingness to appear on camera for 30%.
The reported confidence effect was more pronounced among younger respondents and women. Eighty-four percent of Gen Z participants said poor skin reduced their confidence, compared with 60% of baby boomers. The figure was also 84% among women and 68% among men.
Friends and family were respondents’ most commonly cited source of skincare advice, at 38%, followed by Reddit and other online forums at 32%. Dermatologists were cited by 29% of respondents. Among Gen Z participants, 32% named TikTok as an advice source, slightly more than the 31% who cited dermatologists.
Stress was the most frequently perceived cause of worsening skin, cited by 54% of respondents, followed by diet at 37% and hormones at 35%. Only 5% blamed tap water. While 94% said they would pay for a water filter if it guaranteed clear skin, the survey measured consumer attitudes and did not establish that filtration produces that outcome.