Atopic Dermatitis and Environmental Chemical Exposures
Atopic dermatitis (eczema) affects approximately 20% of children and 10% of adults worldwide. Skin barrier dysfunction and immune dysregulation are central mechanisms, both of which can be triggered or worsened by environmental chemical exposures including PFAS.
Filaggrin and Skin Barrier
PFAS compounds reduce filaggrin expression—a critical structural protein maintaining skin barrier integrity. Impaired filaggrin leads to increased transepidermal water loss and enhanced penetration of environmental allergens that drive atopic sensitization.
IgE-Mediated Immune Dysregulation
PFAS exposure promotes Th2 immune polarization and elevated IgE production. Elevated total IgE and specific IgE to common allergens are more prevalent in PFAS-exposed children, creating an atopic march toward eczema, allergic rhinitis, and asthma.
Practical Management
Dermatologists treating pediatric eczema in PFAS-contaminated regions should consider environmental history. Replacing PFAS-containing household products—including stain-resistant textile treatments and some sunscreens—may reduce skin contact exposure.