[Per- and polyfluoroalkyl substances-"forever chemicals" and skin]

Per- and polyfluoroalkyl substances (PFAS) are a large group of anthropogenic chemicals that have been widely used in industrial manufacturing for decades. Due to their persistence in both the biotic and abiotic environment over many years, PFAS are also referred to as "forever chemicals." Some PFAS exhibit toxic properties and can harm both the environment and human health.

To describe the chemical properties, adverse health effects, and main exposure sources of PFAS, with a particular focus on the skin and inflammatory skin diseases.

An unrestricted literature search was conducted in PubMed and Google Scholar to prepare a narrative review. The search terms included the following: atopic dermatitis, cutaneous, forever chemicals, PFAS, PFOA, psoriasis, skin, skin cancer, skin disease.

Human skin exposure to PFAS occurs either through direct contact with contaminated cosmetics, personal care products, and textiles, or indirectly through the redistribution of systemically absorbed PFAS. Depending on the specific PFAS compound, as well as the duration and level of exposure, these substances can suppress cutaneous immune responses, induce oxidative stress, and trigger proinflammatory tissue reactions. Epidemiological studies have shown an association between PFAS exposure and atopic dermatitis, particularly among female study participants.

The currently available epidemiological and experimental evidence regarding the effects of PFAS on skin health remains limited in scope and strength. Given the near-ubiquitous presence of PFAS in the environment, further research is urgently needed to better understand the associated risks to the skin and to develop targeted preventive strategies.