Toxic conjunctivitis due to cosmetics: Description of the pathology and evaluation of topical treatment with unpreserved hydrocortisone 3.35 mg/ml and ketotifen 0.25 mg/ml

Abstract

AbstractPurpose: To describe the frequently misdiagnosed condition of toxic conjunctivitis due to facial cosmetics' use and to evaluate the effectiveness of our topical anti‐inflammatory treatment.Methods: Over a one‐year period (2021) we recorded 28 patients (26 females and 2 males) with toxic conjunctivitis due to the use of facial cosmetic creams. The clinical presentation involves burning sensation, epiphora, redness and edema of palpebral conjunctiva with follicular response, edema of punctum and contact dermatitis of the medial lid skin. We advised cessation of facial creams and administered artificial tears with HA, topical unpreserved hydrocortisone 3.35 mg/ml (4 times daily for 2 weeks) and ketotifen 0.25 mg/ml (twice daily for 4 weeks). Follow up was in 2 and 4 weeks.Results: All patients had symptoms for over 2 months and received more than 3 different treatments. In 4 weeks, 23/28 (82%) patients had full recovery, whereas 5/28 (18%) although improved required reaffirming of cosmetic cessation and continued topical ketotifen for two more weeks until complete resolution of symptoms.Conclusions: Toxic conjunctivitis due to facial creams is a frequent condition, especially in women, and is often misdiagnosed as allergic conjunctivitis. Cessation of facial creams for the duration of the treatment is mandatory. Topical treatment with HA artificial tears, topical unpreserved hydrocortisone 3.35 mg/ml and ketotifen 0.25 mg/ml offers highly effective anti‐inflammatory action with no increase in intraocular pressure or other side effects.