Please login or create an account. If you do not have access to this content, you will be shown a 30 second preview and licensing options.
- Presentation
Forever Chemicals and Human Health: An Introduction to PFAS for Dermatologists
Description
This talk introduces PFAS, or perfluoroalkyl and polyfluoroalkyl substances, as a large class of persistent “forever chemicals” widely used in industry, medicine, cosmetics, and personal care products. It reviews the history of PFAS manufacturing and regulation, noting early internal health concerns, later environmental and blood-detection studies, and recent EPA actions on drinking water standards, hazardous substance designation, and reporting rules, alongside proposed rollbacks. PFAS are highlighted as environmentally stable, bioaccumulative, and capable of exposure through inhalation, ingestion, dermal absorption, and maternal-fetal transfer, with contamination documented in water, food, packaging, cookware, textiles, and many consumer products, including some dermatology-recommended items. The presentation summarizes evidence linking PFAS to thyroid disease, hypercholesterolemia, liver injury, kidney and testicular cancer, immune dysregulation, reduced vaccine response, and adverse fetal outcomes, while emphasizing that most data concern legacy compounds like PFOA and PFOS rather than newer emerging PFAS. For dermatology, the talk discusses possible mechanisms affecting skin barrier function and inflammation, and reviews mixed but concerning associations with atopic dermatitis, psoriasis, and melanoma, including studies suggesting barrier-gene suppression and altered vitamin D signaling. It concludes with practical exposure-reduction advice, such as avoiding PFAS-laden packaging, nonstick cookware, waterproof or stain-proof products, and seeking water filtration and PFAS-free certifications, while emphasizing the need for more research and stronger public health policy.
View moreConclusions
- PFAS are widespread, persistent chemicals to which humans are exposed through multiple pathways, including inhalation, ingestion, dermal absorption, and maternal-fetal transfer.
- Legacy PFAS such as PFOA and PFOS have the strongest evidence for harm, while emerging PFAS are increasingly used but remain poorly studied.
- Environmental and regulatory actions have reduced some legacy PFAS use, but production has shifted toward newer compounds with limited toxicity data.
- PFAS contamination is common in drinking water, consumer products, and personal care items, creating broad opportunities for exposure.
- Exposure appears to be unequally distributed, with communities of color and other marginalized groups facing higher PFAS burdens in some settings.
- The best-supported health effects of PFAS include immune dysregulation, thyroid disease, hypercholesterolemia, liver injury, kidney cancer, and testicular cancer.
- PFAS exposure is also linked to adverse reproductive and developmental outcomes, including low birth weight, delayed mammary development, and reduced vaccine response.
- Dermatologic evidence is emerging but incomplete, suggesting possible links between PFAS and atopic dermatitis, psoriasis, melanoma, skin barrier disruption, and premature skin aging.
- Mechanistically, PFAS may affect skin through inflammation, oxidative stress, vitamin D signaling disruption, and reduced barrier gene expression such as filaggrin and loricrin.
- The overall conclusion is that PFAS likely pose meaningful public health and dermatologic risks, but much more research is needed, especially on emerging PFAS and cutaneous disease.
- Dhora R, Murthy GS. Per/polyfluoroalkyl substances production, applications and environmental impacts. Bioresource Technology. 2021;341:125808.#10.1016/j.biortech.2021.125808
- Whitehead HD, Venier M, Wu Y, et al. Fluorinated Compounds in North American Cosmetics. Environmental Science & Technology Letters. 2021;8(7):538-544.#10.1021/acs.estlett.1c00240
- Fenton et al. Environmental Toxicology and Chemistry. March 2021.
- von Holst H, Nayak P, Dembek Z, et al. Perfluoroalkyl substances exposure and immunity, allergic response, infection, and asthma in children: review of epidemiologic studies. Heliyon. 2021;7(10):e08160.#10.1016/j.heliyon.2021.e08160
- Mousavi SE, Delgado-Saborit JM, Godderis L. Exposure to per- and polyfluoroalkyl substances and premature skin aging. Journal of Hazardous Materials. 2021;405:124256.#10.1016/j.jhazmat.2020.124256
- Kim J, et al. Per- and Polyfluoroalkyl Substance-Induced Skin Barrier Disruption and the Potential Role of Calcitriol in Atopic Dermatitis. International Journal of Molecular Sciences. 2025.#10.3390/ijms26157085