Allergens Causing Allergic Contact Dermatitis in Cosmetic Products: A Systematic Review

Abstract

Background: The increasing use of cosmetics worldwide has led to a rise in allergic reactions, particularly due to inadequate risk assessment. Identifying common allergens in cosmetic products causing dermatitis is crucial for effective prevention and management strategies. Objectives: This systematic review aims to determine the list of allergens that most commonly cause allergic contact dermatitis in cosmetic products and to find the patch test positivity rate for cosmetic products. Methods: This systematic review, following the PRISMA guidelines, investigated patch test results on cosmetic-induced contact dermatitis from January 2013 to September 2023 on PubMed, Cochrane, and Medline databases. Inclusion criteria comprised retrospective cohort and clinical trial studies reporting patch test positivity rates and positive allergens in cosmetics, with eligibility determined through independent screening, full-text evaluation, and data extraction. Exclusion criteria comprised abstract-only publications, non-English or Indonesian languages, review articles, and studies with incomplete text. Result: 13 studies were included out of 2,162 initially screened articles, involving 111,097 participants. The selected studies encompassed ten retrospective studies and three clinical trials conducted in various locations, including India, Brazil, North America, Korea, Sweden, and the Czech Republic. The patch test positivity rate ranged from 13% to 100%. The predominant allergens identified in cosmetics were nickel sulfate, fragrance mix I, cobalt chloride, para-phenylenediamine base, potassium dichromate, and balsam of Peru. Conclusion: This systematic review highlights the diversity in patch test positivity rates and identifies key allergens responsible for allergic contact dermatitis in cosmetic products, emphasizing the need for comprehensive evaluation and awareness of cosmetic safety.