A generalized, acne-like rash, or dermatitis, that may occur in persons exposed to chemicals containing chlorine. Dioxin, a toxic chemical containing chlorine, was present in the defoliant known as Agent Orange used extensively by U.S. military forces in the Vietnam War. Chloracne is considered a clinical sign of exposure to dioxin, and is the only well-established, long-term effect of exposure to the chemical.

The condition is caused exposure to chemicals containing chlorine with a specific molecular shape, including dioxin, which is related to chlorinated aromatic hydrocarbons. Dioxin is an undesirable contaminant in widely used herbicides and preservatives. Chloracne is the first and most constant finding in chronic dioxin poisoning. Exposure to dioxin may also produce liver injury, peripheral neuropathy, central nervous system changes, and psychiatric difficulties.

Chloracne is characterized by excessive oiliness of the skin. It may occur with, or be followed by, an acne-like eruption of many blackheads along with small, straw-colored cysts and comedones. The lesions are usually located on the malar area (cheek bones) of the face and behind the ears. The eruptions may or may not spread beyond these areas, and there may be associated itching. The severity and onset of the condition depend on the amount of exposure to the chemical. Inflammatory pustules, abscesses, and large cysts may be seen in severe cases. Variable findings may include: hyperpigmentation; increased or darker hair growth of the forehead, cheeks and forearms; central and peripheral nervous system effects; alteration of lipid metabolism; and mild hepatotoxicity.

Thorough history and complete physical examination are necessary to diagnose the condition.

There is no cure or specific treatment for chloracne. With this condition, the lesions are persistent and resistant to the usual treatments for acne. Time is the only treatment. If exposure to the causative agent is discontinued, over time enough of the chemical will leave the body, and the lesions may slowly resolve. However, there may be scarring.

Dioxin is one of the most toxic substances to which workers in industrial and agricultural environments can be exposed. The possibility that dioxin causes cancer in humans is being investigated. Minor cases of chloracne may disappear. However, more severe cases of the condition may last for many years after exposure to the chemical, and scarring may occur.

Consider service connection on a presumptive basis as a condition associated with herbicide exposure (38 CFR 3.307(a)(6); § 3.307(d); § 3.309(e)) if chloracne or other acne-form disease consistent with chloracne manifests to a degree of 10 percent or more within one year of the last date of exposure to herbicides. 

Rate as disfigurement of the head, face, or neck (DC 7800) or scars (DCs 7801, 7802, 7804, or 7805), depending upon the predominant disability.