Abstract
The relationship between endocrine disrupting chemicals (EDCs) and the pathogenesis of acne vulgaris has yet to be explored in the literature. Acne vulgaris is a chronic inflammatory skin disease of the pilosebaceous unit. The pathogenesis of acne involves several hormonal pathways, including androgens, insulin-like growth factor 1(IGF-1), estrogens, and corticosteroids. EDCs influence these pathways primarily through two mechanisms: altering endogenous hormone levels and interfering with hormone receptor function. This review article describes the mechanistic links between EDCs and the development of acne lesions. Highlighted is the contributory role of androgen receptor ligands, such as bisphenol A (BPA) and mono-2-ethylhexyl Phthalate (MEHP), via upregulation of lipogenic genes and resultant exacerbation of cholesterol synthesis. Additionally discussed is the protective role of phytoestrogen EDCs in counteracting androgen-induced sebocyte maturation through attenuation of PPARy transcriptional activity (i.e., resveratrol) and restoration of estrogen-regulated TGF-B expression in skin cells (i.e., genistein). Examination of the relationship between EDCs and acne vulgaris may inform adjunctive avenues of treatment such as limiting environmental exposures, and increasing low-glycemic, plant-rich foods in the diet. With a better understanding of the cumulative role that EDCs play in acne, clinicians can be better equipped to treat and ultimately improve the lives of their patients.
Highlights
Endocrine disrupting chemicals (EDCs) are exogenous chemicals found in the environment that interfere with hormone function
Due to the ubiquitous exposure to endocrine disrupting chemicals (EDCs) and their ability to alter key hormone functions, we propose that EDCs may be relevant in the development of acne
This review examines the potential contribution of EDCs to the pathogenesis of acne vulgaris
Summary
Publisher’s Note: MDPI stays neutral with regard to jurisdictional claims in published maps and institutional affiliations. The role of androgens in the pathogenesis of acne has been documented and covered in many reviews. Hormonal treatment of acne in female patients may involve spironolactone, a drug that suppresses androgen receptor signaling [7]. Endocrine disrupting chemicals (EDCs) are exogenous chemicals found in the environment that interfere with hormone function. They are present in many consumer items, plasticizers, pharmaceuticals, groundwater, and agricultural products. This review examines the potential contribution of EDCs to the pathogenesis of acne vulgaris. Included is the current understanding of acne pathogenesis and its relationship with hormones, and the known effects of EDCs on endogenous hormones. Evidence of human exposures to EDCs is discussed as well as potential mechanisms in which EDCs can contribute to the development of acne. We conclude with a brief discussion of therapeutics, practical suggestions for clinical practice, and avenues for future research
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