A new study from Johns Hopkins Medicine has found that certain chemicals often found in plastic bottles and ultra-processed foods may play a role in causing or making worse a painful skin condition called hidradenitis suppurativa (HS).
This is the first time researchers have shown clear evidence linking these hormone-disrupting chemicals to HS.
Hidradenitis suppurativa is a chronic skin disease that affects areas where skin rubs together, such as the thighs, armpits, and under the breasts. It causes painful lumps, infections, scars, and skin damage. About 2% to 3% of people in the U.S. have HS, and it is more commonly found in African American women.
Some people inherit the disease through a rare gene mutation, but for most, the cause is a mix of genes and environmental factors like diet and chemicals. No matter how it starts, people with HS often have similar symptoms and treatment responses.
The new research was published in the journal Nature Communications and involved 12 patients with HS between the ages of 22 and 67, from different racial and ethnic backgrounds.
Researchers compared skin samples from these patients to samples from eight people without HS. They were looking for clues about how HS develops at the cellular level.
They found that a gene called nicastrin (NCSTN), which is often mutated in inherited HS, was working at lower levels in all the patients with HS. This was true even in those without the mutation. The gene was especially low in skin cells called fibroblasts, which help maintain healthy tissue and control immune responses.
When NCSTN levels are too low, fibroblasts become overly sensitive to inflammation signals in the body. This leads to an overproduction of molecules that cause inflammation, which is a key feature of HS and other skin conditions like psoriasis.
Until now, most HS research focused on a different type of skin cell called keratinocytes. But in this study, the scientists were able to show that turning off the NCSTN gene in fibroblasts from healthy people made those cells act like the ones from HS patients. This means fibroblasts might be just as important in HS as keratinocytes.
The researchers also wanted to understand if hormone-disrupting chemicals in plastics, known as endocrine disruptors, could be affecting NCSTN levels. These chemicals are common in ultra-processed foods and plastic bottles. They include bisphenols like BPA and BPS, and phthalates like DEHP and MEP.
Using imaging tools, the team found higher levels of these plastic-related chemicals in the skin of HS patients compared to those without the disease. To dig deeper, they applied a mix of these chemicals to healthy fibroblasts in the lab.
The chemicals reduced NCSTN levels, mimicking what they saw in HS patient skin. This suggests that these environmental chemicals may contribute to HS by lowering NCSTN and triggering inflammation.
The team hopes future research will answer why these chemicals stay in the skin longer in some people and whether boosting NCSTN levels can reduce HS symptoms.
These findings offer new hope for patients who have few treatment options and point to lifestyle changes that might help, such as reducing contact with plastics and ultra-processed foods.
If you care about skin health, please read studies about eating fish linked to higher risk of skin cancer, and Vitamin B3 could help prevent skin cancers.
For more health information, please see recent studies about vegetable oil linked to spread of cancer, and results showing Vitamin D could help treat skin inflammation.
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