As China’s latest fashion trend, it has shown up on the official Paris Fashion Week runway. It’s sold alongside Givenchy pumps, Chloé handbags, and Lanvin dresses in a high-end online boutique. It appears in stylish selfies on social media. It’s sometimes made with luxe materials such as satin and crystals, and fashionistas have been known to buy several in different colors and patterns to match their individual outfits.

It’s not the newest designer handbag, shoe brand, or pair of “it” sunglasses. Rather, decidedly unglamorous smog conditions in Chinese cities have spurred the growing popularity of this accessory: the pollution mask.

For this season’s Paris Fashion Week, Chinese designer Masha Ma sent several models down the runway donning Swarovski-studded face masks to match the outfits in her urban-chic collection. That same week, Ma teamed up with luxury e-tailer Yoox to unveil a special-edition pollution mask as part of a new collection being sold on its Chinese site featuring masks by some of China’s most prestigious fashion labels including Qiu Hao, Sankuanz, and Xander Zhou.

These are just a few examples of the growing high-fashion spin on a trend that originally took hold as a matter of protection against China’s dangerously high air pollution levels.

When last year’s Beijing “airpocalypse” saw pollution levels soar off the charts—literally surpassing the maximum possible air particle measurement—Chinese consumers increasingly turned to respiratory face masks made by companies such as Totobobo and 3M, which market themselves solely based on scientific proof of protection rather than aesthetic considerations. The importance of wearing a mask that effectively filters out dangerous pollutants can’t be understated: air pollution contributed to 1.2 million premature deaths in China in 2010 alone, and air quality levels have only gotten worse since then.

Despite the dangers (and high-fashion hype), however, there are certain obstacles to getting everyone to wear a mask. In the past few weeks, Beijing has seen many days where PM2.5 readings exceeded the “hazardous” level based on EPA gradation in Beijing (greater than 300), but mask-wearers on the streets were conspicuously a minority. Many need to be educated about the dangers of pollution, but it’s also hard to blame those who already know better for not wanting to put them on: they look like they’re part of a medical uniform, they’re stuffy, they’re hot, and wearing one on a day surround by oppressive, looming buildings enveloped by smog can make one feel trapped in a dystopian, sci-fi nightmare come true.

Companies are working to change that perception, however, by marketing the masks based on both aesthetics and safety. Two-year-old company Vogmask offers protective masks in a variety of colors and patterns, and staged a runway show featuring them at this year’s Hong Kong Fashion Week as part of a collaboration with designer Nina Griffee.

“We had done the medical side of the masks really well, so people knew it functioned and that we had all the testing and scientific proof that our masks worked and filtered,” says Vogmask China Director Christopher Dobbing. “The second challenge was making people aware that it can be a fashion product and it’s something that can look good on you.”

Another brand targeting the Chinese consumer market is Respro, a 20-year-old UK mask company that was first available in the UK and Europe and geared toward those in extreme situations like athletes, firefighters, allergy sufferers, or those working in cold environments around powdered ice. The company began distributing in China in 2002 focusing on cyclists, but experienced more mass-market demand as pollution worsened. In June 2014, it collaborated with designer Marcelo Burlon when it launched a line of masks that were shown at his Spring/Summer 2015 collection fashion show in Florence, aiming for broader appeal. “As our products are effective, high-end pollution masks for the fashion-conscious, professional, and informed Chinese consumers, we have seen a significant rise in those who have adopted our masks,” says Respro Design Director Harry Cole, who noted that the past three years had seen especially large China growth for the company.

The portion of time when wearing a mask is advisable is alarmingly high: the U.S. State Department found that Beijing only had 25 days between April 2008 and March 2014 in which the air quality was considered “good” by U.S. standards. According to Dobbing, it’s vital for more people to be willing to wear the masks regularly on dangerous days. “People are wearing them every day during the winter. Before you leave the house you check: phone, keys, wallet, face mask,” he says. “It’s really important that people feel comfortable wearing them and that it’s—I wouldn’t go as far as saying enjoyable—but something that doesn’t have to make you feel depressed or like you’re standing out.”

Rather than viewing the new designs as a way to make something inherently unfashionable more tolerable, brands aim to create a virtue of necessity by turning the masks into trendy accessories in their own right. “On a mid-winter day in Beijing, pollution masks are an essential part of the wardrobe,” says Cole. “Of course, they serve an essential function, filtering the air we breathe, but they’re also a fashion accessory—just like a handbag, or a pair of shoes.” According to Dobbing, “You’ve got your handbags, your purses; I don’t see any reason you can’t match your face mask with the outfit you’re wearing.” He says he knows friends who have several different masks and pair them with their outfits. “It can completely become a fashion item.”

The influence of top fashion designers is likely to play a part in this transition by giving the masks an edgy, urban aesthetic. In addition to Masha Ma’s recent Paris show, pollution masks have shown up in other runway shows in recent years: Shanghai-based label Blackgateone featured them in its Fall/Winter 2014 collection shown at Shanghai Fashion Week, while Chinese designer Chi Zhang is famous for his high-fashion gas masks, some of which come encrusted with crystals.

Thanks to widespread demand for both fashion and function, the morbid-chic look has made its way to the mass market. Dobbing says that Vogmask’s most popular color is black (he notes it’s like the “little black dress” of pollution masks), while a skull-and-crossbones pattern is also quite popular. China’s craze over all things cute also plays a role with consumer favorites: while cheerful, bright colors are particularly popular with children, he says that panda-face masks have done well with adults as well. There are other signs that the masks are slowly becoming accepted as a mainstream fashion accessory. Last March, cosmetics company Max Factor sponsored a pollution mask selfie contest to promote its eye makeup that generated around 33,000 replies.

Given the vast number of cities suffering pollution problems, the potential market for the masks is—sadly—huge. In June 2013, China’s Ministry of Environmental Protection said that only one quarter of 113 major Chinese cities last year recorded air quality that was deemed safe to breathe. In addition to first-tier cities, Vogmask has distribution in smaller cities including Qingdao, Taiyuan, Shenyang, Nanjing, and Suzhou, and is planning on more expansion. “The ripple has started in these first-tier cities where people are very well-networked and they’re able to access the information about health,” says Dobbing. “In the second- and third-tier cities, a lot of people still think the pollution is fog, as they’ve been told by the local authorities for some time. As they start to realize that actually it’s not fog; it’s particulate emissions from cars, factories, and power plants—and that there’s a real danger from the health effects of this—those people will start consuming pollution-related products like masks and purifiers as well. We’re starting to see that trend beginning this year, and it can only increase.”

Unlike a handbag or shoes, the demand for these new accessories could dry up if China clears up its pollution issues. Dobbing is pessimistic that this will happen anytime soon, meaning that sales will only continue to increase as the masks become more popular. “Everyone knows the government is pushing really hard to get rid of the pollution,” he says, but given China’s rapid urbanization and growing demand for coal power, “all they can do is stabilize it or maybe slightly reduce. It’s not going to have any radical changes in the next few years.”