Chloracne
Chloracne is a skin condition that resembles acne and is caused by exposure to chlorine and chlorine-containing compounds, such as polychlorinated biphenyls (PCBs) and dioxins. This skin disease is characterized by dry skin and a decrease in sebum production, leading to lesions primarily on the face, neck, shoulders, chest, and back. Symptoms can include pustules, cysts, and other skin abnormalities, with onset occurring three to four weeks post-exposure. In some cases, chloracne can persist for up to fifteen years. Beyond skin symptoms, it may also be associated with systemic effects such as liver disease, nausea, bronchitis, and neurological symptoms like headaches and fatigue. Treatment options are limited, as chloracne does not respond well to antibiotics, but derivatives of vitamin A and isotretinoin have shown some effectiveness. The environmental and health risks posed by chlorinated compounds have raised concerns, with calls for the gradual phaseout of such chemicals, though they also play critical roles in public health, such as disinfecting water. The complexity of the issue reflects the ongoing tension between benefiting human health and protecting the environment.
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Chloracne
DEFINITION: Skin disease resembling acne that results from exposure to chlorine and chlorine-containing compounds
Environmentalists have grown increasingly concerned about the negative impacts, including chloracne, that exposure to chlorinated compounds can have on human life.
Chloracne involves an increase of dry skin and a reduction in the ability to produce sebum, which moistens and protects skin. This condition has been linked to to polychlorinated biphenyls (PCBs) and polychlorinated dioxins (PCDDs). PCBs, which are used in industry as lubricants, vacuum pump fluids, and electrical insulating fluids, harm the because they evaporate slowly and do not mix well with water. They are, therefore, widely dispersed in watercourses and in the atmosphere. Because they strongly resist degradation, PCBs remain and accumulate in the environment.
Dioxins are a group of chlorinated aromatic that are formed in trace amounts during production of the many chlorinated compounds used throughout industry. They are highly persistent in the environment. One commonly linked to chloracne is 2,3,7,8-tetrachlorodibenzodioxin (TCDD), which is a known human carcinogen. The primary source of dioxin in the environment is the burning of chlorine-containing compounds. Since dioxins are also formed in the production of chlorinated compounds used as herbicides, chlorine-compound exposure occurs in workplaces and in the environment.
Concern about the health risks posed to humans and wildlife by dioxin and related chlorine compounds in the environment was brought to public attention in 1962 with the publication of Rachel Carson’s Silent Spring, which condemns the widespread use of chlorinated pesticides. Direct skin contact, inhalation, or ingestion of such compounds can result in chloracne, which produces skin lesions on the face, with more severe cases involving lesions on the shoulders, chest, and back. Symptoms may include small, colored, blisterlike pimples (pustules) and straw-colored cysts. Chloracne can develop from three to four weeks after exposure and can last up to fifteen years. Also related to the disease are nausea, bronchitis, and liver disease. It can also have a poisoning effect on the nervous system, which results in extended symptoms such as headache, fatigue, sweaty palms, and numbness in the legs. Chloracne does not respond well to antibiotics. Derivatives of vitamin A (such as gels) and retinoic acid creams may help, and isotretinoin (sold under such trade names as Roaccutane and Claravis) may also be an effective treatment.
In October 1993, the American Health Association approved a resolution for the gradual phaseout of chlorine. The issue is not a simple one, however, because chlorine is used to benefit humans in disinfecting drinking water and making many medicines. Regardless, environmentalists are worried that chlorinated compounds are slowly poisoning the earth by working their way through the air, groundwater, and the food chain, as well as destroying wildlife and causing many diseases such as chloracne in humans.
Bibliography
"Chloracne or Acneform Disease and Agent Orange." US Department of Veterans Affairs, 20 Sept. 2023, www.publichealth.va.gov/exposures/agentorange/conditions/chloracne.asp. Accessed 15 July 2024.
Friis, Robert H. “Pesticides and Other Organic Chemicals.” In Essentials of Environmental Health. Sudbury, Mass.: Jones and Bartlett, 2007.
Hill, Marquita K. “Pesticides.” In Understanding Environmental Pollution. 3d ed. New York: Cambridge University Press, 2010.
Manley, Alice, Sofia Labbouz, and David Gawkrodger. "H01 Chloracne: Historical Perspectives on an Occupational Disease, Often the Result of Notorious Environmental Poisoning." British Journal of Dermatology, vol. 188, no. 4, 26 June 2023, doi.org/10.1093/bjd/ljad113.283. Accessed 15 July 2024.