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Polychlorinated biphenyls (PCB) are well known persistent and toxic environmental pollutants.Our aim was to identify effects of moderate-high exposure to dioxin-like (dl) and non-dioxin-like (ndl)-PCBs on the skin in order to provide more insight in the pathophysiological effects of these compounds.We performed a dermatological examination on 92 former workers from a transformer recycling company with known elevated serum PCB and/or dioxin (polychlorinated dibenzo-p-dioxin/polychlorinated dibenzo-p-furan (PCDD/F)) levels. In addition, we performed a skin cancer screening over a period of seven years (2010–2016) on resp. 268, 271, 210, 149, 92, 129 and 79 participants.We found a higher incidence of acne and malignancies of the skin (malignant melanoma, basal cell carcinoma and mycosis fungoides) in the workers compared to normal population.The probability of having hyperpigmentation on the skin was statistically significantly higher in workers with higher sumPCBs- (OR:1.09(1.12–2.17)), dioxin-like (dl)-PCBs- (OR:1.56(1.12–2.17)) and dioxin (PCDD/Fs) (OR:1.09(1.02–1.16)) levels. Age was a confounding factor in this model.Formation of hyperpigmentation could be an indicator for (moderate-high) exposure to toxic compounds like PCBs.The higher incidence of cutaneous malignancies found in the workers might be associated with PCB- and dioxin exposure, warranting further investigation on larger cohorts.Elevated blood levels of PCBs and dioxins were found in workers of a transformer recycling company.Higher incidence of acne and malignancies of the skin in PCB- and dioxin exposed workers.A correlation between hyperpigmentation on the skin and exposure levels in the workers.