Allergens in corticosteroid vehicles in Saudi Arabia

Abstract

Background: Both the active steroid compounds and vehicle ingredients of the topical corticosteroid products can cause allergic contact dermatitis. Purpose: The objective of the current study was to assess the presence of allergens in topical corticosteroid vehicles used in Saudi Arabia. Methods: Package inserts of topical corticosteroid products available through February 2022 were reviewed independently by two dermatologists. Topical corticosteroids were excluded if they were not approved by the Saudi Food and Drug Authority. Results: Out of 79 products examined, 49 (62%) were included in the study. Out of the 49 products, 29 (59%) had one or more allergens (a total of 38 allergens). Three topical corticosteroids were responsible for more than 80% of all allergens. These included mometasone furoate (n = 12), clobetasol propionate (n = 7), and betamethasone valerate (n = 5). The most frequent allergens were propylene glycol (66%), parabens (16%), sorbitan (13%), and lanolin (5%). Formaldehyde(s), methylchloro-isothiazolinone, and methyl-isothiazolinone were not detected in any product. Approximately 48% of the products with allergens were creams, 41% were ointments, and 10% were lotions. With two exceptions, there were no statistically significant differences in the overall presence of allergens by the type, formulation, and concentration of topical corticosteroid products. Conclusion: Almost 60% of topical corticosteroid products widely used in dermatologic clinics in Saudi Arabia had one or more vehicle allergens. Since the best treatment for contact allergy is avoidance, dermatologists should be aware of vehicle allergens in topical corticosteroids and consider the use of allergen-free products.