Incense burning (agarbatti/dhoop) is deeply rooted in Indian cultural, spiritual, and Ayurvedic
traditions, where it symbolizes purification, devotion, and tranquillity. However, increasing
scientific evidence suggests that habitual use may pose significant health hazards. This
correspondence highlights the overlooked toxicological burden of incense smoke. A clinical case of
allergic contact dermatitis with depigmentation, induced by prolonged incense exposure,
exemplifies its dermatological risks. Beyond fragrance, burning incense generates a complex
mixture of gases and particulate matter, including carbon monoxide, nitrogen oxides, volatile
organic compounds, aldehydes, and polycyclic aromatic hydrocarbons—many with known irritant,
mutagenic, or carcinogenic potential. Fine particulates (PM₂.₅, PM₁₀) contribute to oxidative stress,
airway inflammation, and systemic absorption. Epidemiological studies from Asian and Middle
Eastern populations link long-term incense use to asthma, chronic bronchitis, cardiovascular
dysfunction, and elevated risks of respiratory and nasopharyngeal cancers. Vulnerable groups such
as children, elderly individuals, and pregnant women are particularly at risk due to prolonged indoor
exposure. While Ayurveda prescribes dhoopana karma using natural resins, modern incense
products often incorporate synthetic binders and perfumes, magnifying hazards. Mitigation
strategies include improved ventilation, reduced frequency, safer formulations, and regulatory
oversight. Balancing cultural continuity with scientific caution is essential for safeguarding public
health.