Parabens are aliphatic esters of p-hydroxybenzoic acid and have been widely used as preservatives in cosmetics, pharmaceuticals and food industry for many decades. Breakthrough reaserch, which linked them to estrogenic activity and development of cancer, has led to conflicting opinions about their safety. As a result, the intensity of their reaserch increases year by year, as shown by an increasing number of published scientific papers. Due to controversies about their toxicity, we reviewed the published literature covering the absorption and metabolism of parabens following different routes of application with an emphasis on dermal application. To this end, we developed a search strategy based on the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines and used it in the PubMed and ScienceDirect databases. We selected the literature according to our criteria and included the obtained data in our research. We concluded that parabens are readily absorbed and metabolized regardless of the route of exposure. Absorption after dermal exposure is lower compared to other routes, moreover it depends on the formulation. Through all routes of exposure, parabens are metabolised by esterases and conjugation enzymes such as UDP-glucuronosyltransferase, sulfotransferase and N acetyltransferase. The resulting metabolites are predominantly p-hydroxybenzoic acid and its conjugates and to a lesser extent conjugates of the parent compound. In addition systemic concentration of the parent compound is affected by presystemic metabolism, mainly in liver and intestine and to a smaller degree in the skin. Due to the extensive metabolism, very little or no unchanged parent compound is excreted. Therefore, exposure to metabolically unchanged parabens, which are supposed to express toxicological effects, is low regardless of the route of application. Parabens are excreted rapidly, predominantly in the urine. Bioaccumulation was not observed in the studies. Existing toxicological research do not answer the question of whether parabens can be harmful in long-term human exposure to permitted concentrations. We concluded that pharmacokinetic researches do not answer the question whether they reach an active site in organism in toxicologically important concentrations, mainly due to their extensive metabolism.
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