To test the hypothesis that plant sterols found in the skin surface lipids of humans originated from diet after their absorption from intestine into plasma and then transferred to skin, we studied the 24-h excretion of plant sterols and cholesterol from skin and in feces in a hyperlipoproteinemic (type IIa) patient fed formula diets providing varying quantities of plant sterols (0-30 g/day) and cholesterol (0-1000 g/day). Upon feeding a sterol-free diet, the beta-sitosterol excretion from the skin decreased progressively, from about 6 mg/day to 0.08 mg/day by 83 days and then completely disappeared. With addition of plant sterols (about 30 g/day) to the diet, beta-sitosterol reappeared in the skin surface lipids and rose to nearly 5 mg/day by 6 weeks. With feeding of the sterol-free diet, the fecal excretion of beta-sitosterol and the 2 other plant sterols decreased gradually and by week 4 disappeared completely from the feces and continued to be absent from the feces as long as the diet was free of plant sterols. The results demonstrated clearly that plant sterols which were absorbed into the plasma from the diet were excreted into the skin surface lipids after being transferred from the plasma to the skin.