Babe, Your Body Acne Is From Your Plastic Clothing
I mean, it's obvious once you think about it, right? But science backs this up.
“For as long as I can remember, I always had a little bit of irritation on my back, some pimples, like, very oily skin. I live a healthy lifestyle. I eat properly. I exercise around five times per week. Even with scrubbing or whatever, still, my skin would break out. I couldn't really figure out what was the cause of it, and I just accepted it as it is.”
I first heard about Adriaan’s skin issues from his partner Olya. She and I were talking in the living room of their apartment in New York City. And because she’s a believer in healthy living, she was enthusiastically letting me ramble on about the main discoveries I made researching my book on toxic fashion.
One of my beliefs after reporting out that book, I told her, is that millions of people are walking around with skin issues, and they have no idea they’re linked to synthetic fashion.
After all, I used to get breakouts on my butt, the back of my legs, and back. I thought it was just a mysterious, unsolvable skin thing. Until I realized that it always happened the day after I wore black, synthetic yoga leggings, tights, or a sports bra.
The Common Skin Allergen You’ve Never Heard of
There’s a special type of azo dye used on synthetic clothing called azo disperse dyes — as in, they are dispersed in a water-based solution for dyeing the polyester or nylon.
These dyes are intense. I mean, polyester is the exact same plastic as the clear PET plastic used in water bottles. So, just imagine trying to dye a water bottle, and you see why these dyes have to contain some gnarly chemistry.
Dr. Heather Stapleton, an environmental chemist and exposure scientist at Duke University’s environmental policy division of the Nicholas School of the Environment, first became interested in disperse dyes when she bought a new polyester athletic shirt from a popular sports brand and took it home to her seven-year-old son, who developed a rash on his back in the exact pattern of the black areas of the shirt.
“That set my alarm bells off,” she told me in an interview in early 2022. She brought the offending T‑shirt to the lab, cut it up, and gave it to her colleague Dr. Lee Ferguson to analyze. It had disperse dyes, a new-to-her category of chemicals she hand’t studied before.
There wasn’t much scientific literature on these types of dyes. Very, very few disperse dyes have been tested for safety, because the fashion industry and the United States more broadly takes an innocent-until-proven-guilty approach to chemicals. So a PhD candidate, Kirsten Overdahl, took on the task of isolating, purifying, and cataloguing disperse dyes, which took two years.
Then she and the research team bought thirteen pieces of polyester children’s clothing from a local store and tested them. One kid’s shirt had more than 1.1% of the total weight of the shirt in azo disperse dye. That’s three hundred times higher than the EU’s limit for other azo dyes. (Textile products only have to list materials that make up more than 5% of their weight.)
Stapleton was infuriated by the results. “We found these in baby pajamas. There could be a good proportion of kids that do react to them. And what does that mean for the lifetime risk factors for that child as they grow and develop?” she asked. “Can that lead to other diseases that are more severe, or more vulnerabilities to viruses and asthma and other skin conditions?”
In Overdahl’s next experiment, she did some test-tube work to show that the twelve azobenzene disperse dyes she had isolated bind to nucleophilic proteins, which is the first step in initiating a skin allergy. In short, yes, azo disperse dyes, and not just the ones commonly used in skin patch tests or the ones that have been phased out (supposedly) by the fashion industry, have that potential. And her experiments showed that the more dye there was in a piece of fabric, the more reactive it could be.
She’s not the only researcher discovering this. The French Agency for Food, Environmental and Occupational Health & Safety (ANSES) ran a biomedical study in 2018 that connected skin reactions in fifty patients to specific chemicals found in their clothing. In 2022, based on these results, it called for disperse dyes to be banned.
It’s not just disperse dyes. According to Afirm Group’s list of restricted chemicals in fashion, synthetic fabrics are more likely than natural fabrics to have BPA and other endocrine-disrupting plasticizers, chlorinated benzenes, toluenes, organotins, and quinolines.
In my book, I tell the story of Karly Hiser, a pediatric nurse practitioner in Grand Rapids, Michigan, and her son, who developed severe eczema as a toddler. She switched her family to fragrance-free soaps and nontoxic cleaning products like baking soda and vinegar, and cut dairy out of their diet. After baths, she would do something called “soak and smear,” where she would cover her son head to toe in creams and Vaseline.
Nothing helped. The steroid cream he was prescribed irritated his skin more. The open wounds on his hands and behind his knees got infected.
He also wouldn’t get dressed in the morning, throwing screaming tantrums. That’s when she realized it was his clothing. Making him underwear and other clothes from certified non-toxic fabrics was what cleared up his skin issues. (She has since founded a children’s clothing brand.)
A few years later, in Manhattan, Olya told me a similar story of care for Adriaan. She had cut out sugar and dairy from their diet, and switched to different body washes and natural scrubs and brushes –– nothing had worked.
When you look at Adriaan, you can tell he’s the kind of guy that takes good care of his body, the kind of guy that fits high-intensity workouts in between his high-powered business meetings. So, I asked to see his workout shirts. She took me into the closet, and there they were: a stack of neatly-folded, black, nylon and polyester workout shirts. We both marched into the kitchen together, jubilant, to tell Adriaan (who was chopping vegetables for dinner and talking to my husband) about our finding.
When I caught up with Adriaan recently, he told me what happened next. Right around that time, he organized a charity walk called 24 the Planet, and he ended up with a half-dozen cotton t-shirts. So he started wearing those to the gym instead.
“My back is so much better,” he says. “I barely have breakouts.”
He told me that because the cotton is heavier and less breathable, he still wears synthetic shirts to run. And I told him to try out a merino wool lightweight tee and see how he likes it –– hopefully it vanquishes the problem completely.
Your Doctor Isn’t Helping
According to the Journal of the American Medical Association, up to one in five people have experienced contact dermatitis, with itchy, flaky skin that can develop oozing or blisters.
The cause can be maddeningly hard to pin down, since contact with a product as little as once a week can cause a constant rash, and sensitizing chemicals are so ubiquitous that you could encounter the offending substances in several different ways on any given day.
And doctors are not particularly helpful. Some allergists will give you a test to find out what might be causing your skin issues, and include disperse dyes in there. But most dermatologists won’t ask you what you’re wearing.
Take the story of Rachael Silverstein, a Denver-based sustainable florist and freelance photographer. For more than 10 years, every winter she would, “get these really ugly looking red bumps, basically all over my upper back,” she says.
She went to an allergist, who gave her a patch test. But everything came back negative. She changed out her shampoos, cleansers, and detergents to fragrance-free and gentle. She went to a series of dermatologists, who tried to prescribe her Accutane, which she refused. She tried salicylic acid body sprays, taking birth control, and taking spironolactone. She spent “a fortune” getting microdermabrasion treatments every three to four months. Nothing worked. In fact, it started showing up in the summer, too.
“Honestly, I gave up,” she says. “I was just like, Okay, I guess I'll just not wear cute, backless things. I carte blanche got rid of everything, because I felt so self conscious about it.” Then it spread to the back of her upper arms. “And I was just like, great. Now I can't even wear tank tops? Like, seriously?”
Her summer wedding was approaching. She had picked out a backless dress, and had a difficult conversation with her makeup artist about covering the red marks on her body.
Then she read my book, and started to wonder if it was synthetics doing this to her. After all, every winter she layered synthetic tops under her sweaters. So she started purging her closet of synthetics, switching to linen and cotton as the weather warmed up.
The bumps disappeared. “It was almost instantaneous,” she says. She thinks now it was worst where she get sweaty.
“I mean, I still have some hyper pigmentation, which I don't love, but that was just from years of incorrectly treating it as acne,” she says. “I feel like all dermatologists, not to knock them, they're never trying to figure out the root cause of something. It's like, let me just prescribe you something.”
Galen in Minneapolis had a similar experience with his dermatologist. He would ocassionally get some psoriasis or eczema-type skin reactions on his hands in the winter, but that was about it. That is, until he started practicing jiu jitsu in the summer of 2022.
He ordered a couple of rashguards off the internet, the stretchy, synthetic, long-sleeve tops a lot of people wear to practice the grappling sport. When he opened one, his partner remembers it smelling pungently of chemicals. Not long after, he got a terrible rash on his back.
In jiu jitsu, which is similar to wrestling, “You're on your back and you're just kind of getting mashed into the mat,” he says. “I think it was just the combination of that fabric being super sweaty and just getting macerated against my skin for a while.”
It got so bad he thought he had picked up ringworm from the gym. He went to his dermatologist who diagnosed him with “dermatitis,” which is essentially a fancy term for, “I see that you have a rash.”
Galen decided not to use the creams or medications the dermatologist offered. “All his solutions were just symptoms management,” he says. Instead, he stopped going to jiu jitsu, and his skin started getting better.
“And I thought, well, maybe I should try some not as tight fitting clothes.” So he pulled out two thirty-year-old, loose-fit, polyester Nike tops to wear instead.
It’s hard to say what exactly is different about the old synthetic shirts from Nike. Maybe they were manufactured before everything was outsourced to the cheapest factory available. Maybe they’ve been washed so many times nothing more is leaching out of them. Maybe it’s that they’re a loose fit.
I can’t say for sure. But he’s been wearing these two old shirts to jiu jitsu ever since with no symptoms.
Have you had a skin problem that you think is due to synthetic clothing? I want to hear about your journey: