Could endocrine disruptors be a new player for acne pathogenesis? The effect of bisphenol A on the formation and severity of acne vulgaris: A prospective, case-controlled study

J Cosmet Dermatol. 2021 Nov;20(11):3573-3579. doi: 10.1111/jocd.14364. Epub 2021 Aug 11.


Background: Acne is one of the most common skin diseases in the adolescent period. Bisphenol A (BPA) is the most frequently observed endocrine-disrupting chemicals that we are exposed to in daily life. BPA can affect acne pathogenesis with similar biological activity on androgenic receptors.

Aims: To investigate whether BPA levels play a role in the development and severity of acne in adults.

Methods: Fifty-one adults with acne and 50 healthy controls, whose ages varied between 18 and 25 years and applied to our dermatology outpatient clinic, were evaluated. A questionnaire containing dietary and lifestyle habits for BPA exposure was filled. BPA and BPA glucuronides were analyzed in the LC-MS/MS system in the first-morning urine samples of the patients. Statistical significance was set at p < 0.05.

Results: The median levels of total BPA were significantly higher in the acne group compared with the control group (7.94 (4.69-20.32) vs. 5.62 (1.52-21.05) µg/g creatinine, respectively; p = 0.04)). The acne severity was positively associated with the BPA values (p = 0.00 rs = 0.534). Higher BPA level was noticed in younger acne onset age (p = 0.012 r = -0.349) When the inquiry questions were evaluated, no difference was found between the study groups regarding BPA exposure risk (p > 0.05).

Conclusion: BPA could be a factor in acne development and its severity. Therefore, it may be beneficial to prevent BPA exposure and raise awareness in the adolescence and post-adolescence period, in which industrial products such as junk food and plastic bottled water are used more frequently.

Keywords: Acne vulgaris; acne severity; adult; bisphenol A; endocrine disruptors.

MeSH terms

  • Acne Vulgaris*
  • Adolescent
  • Adult
  • Benzhydryl Compounds / adverse effects
  • Benzhydryl Compounds / analysis
  • Chromatography, Liquid
  • Endocrine Disruptors* / adverse effects
  • Endocrine Disruptors* / analysis
  • Humans
  • Phenols
  • Prospective Studies
  • Tandem Mass Spectrometry
  • Young Adult


  • Benzhydryl Compounds
  • Endocrine Disruptors
  • Phenols
  • bisphenol A