Cosmetic Contact Dermatitis Research Articles

Adverse Cosmetic Reactions in a Pediatric Population Reported to the Chongqing Drug Administration in China From 2017 to 2021.

Background: Despite their ubiquitous use and several safety incidents involving cosmetics for children in China, there is little research on adverse reactions to cosmetics in children. Objectives: We assessed the cosmetic adverse reactions (CARs) reports submitted to the Chongqing Drug Administration in China for children, to understand the characteristics of CARs in a pediatric population and determine whether useful insights can be derived. Methods: We extracted the data file of the Chongqing Drug Administration's cosmetic adverse events reporting system from 2017 to 2021, and screened the information of people under the age of 18 years for analysis. Results: A total of 589 children were reported; of them, 475 female children and 114 male children, aged 1-17 years, and 89.6% were diagnosed with cosmetic contact Dermatitis. Itching and burning were the most prominent symptoms and accounted for 83.4% and 40.2%, respectively. The most frequently reported clinical sign was erythema (73.3%) followed by papule (37.9%). The face is the most vulnerable location to lesions, accounting for 80.8% of all areas, with girls having a significantly higher rate of facial and scalp damage than boys. The majority of the CARs were reported with cream, lotion, and toner for the skin (45.9%) and facial or body cleansing products (15.4%), and most of these products were purchased from authoritative shops. Conclusion: Although adults are the main group of people who use cosmetics, due to the special physiological structure of children, the safety of children's cosmetics should be given more attention. In addition, pediatricians and dermatologists should be active in submitting reports of adverse cosmetic events and encouraging consumers to do so likewise in situations in which a product adversely affects a child's health.

Analysis of Adverse Reactions of Cosmetics in Chinese Han Population in Recent Five Years.

There are still some gaps in the summary and generalization of cosmetic-related adverse reaction reports. The aim of this study is to summarize and analyze the occurrence of cosmetic adverse reactions in Shanghai Han population by using available survey data. Collection, statistics and analysis of patients with cosmetic adverse reactions in Shanghai Huashan Hospital from 2017 to 2021. Among the 1004 patients, most of them (96.71%) were diagnosed as cosmetic contact dermatitis, which often occurred within 3 days of using cosmetics (51.79%). A total of 260 patients were tested with patch test, but the compliance rate was only 18.08%. Among them, 240 patients underwent additional European standard allergen tests, and positive allergens were detected in 210 cases (87.5%). Univariate analysis revealed that dosage form (emulsion and cream), age (≤25 years) and the allergic ingredients triethanolamine, rose oil, propylene glycol, thiomersal and musk ambrette are associated with the occurrence of cosmetic adverse reactions within seven days. A logit prediction model was also successfully constructed: Logit (P) = 1.710-0.796×1+ 1.185×2 -3.650X3-1.335X4. This study complements the data reported on cosmetic adverse reactions in the Chinese Han population and suggests that in future clinical diagnosis and data collection, emphasis should be placed on patch testing, combining the patch test with cosmetic protoplast with the European standard allergen test to improve the detection rate.

Artículo traducido] Alergia de contacto a shellac. Estudio transversal retrospectivo con datos del Registro Español de Investigación en Dermatitis de Contacto y Alergia Cutánea (REIDAC)

IntroductionShellac is a known allergen present mainly in cosmetics used on the eyelids and lips, although new sources of exposure have recently been described. Our objective was to assess the use of shellac as a contact allergen in Spain and the clinical profile of patients allergic to shellac. MethodsThis retrospective cross-sectional study included patients patch tested for shellac between 2018 and 2021 from the Spanish Registry of Contact Dermatitis and Cutaneous Allergy (REIDAC). ResultsA total of 980 patients were patch tested for shellac (20% in ethanol), and 37 (3.77%, 95% confidence interval [CI], 2.58–3.97%) showed positive results. Most of these patients were tested for shellac due to a suspicion of cosmetic contact dermatitis. Seven patients with present relevance were found, five with relation to cosmetics, and the other two with an occupational background of food handling. The reaction index for shellac was 0.51 and the positivity ratio was 67.56% (95% CI, 52.48–82.65%). ConclusionsShellac appears to be a prevalent allergen in patients with suspected contact dermatitis related with cosmetics or foodstuff. However, further studies are needed to validate its use in other patients.

Contact Allergy to Shellac. Retrospective Cross-Sectional Study With Data From the Spanish Registry of Research in Contact Dermatitis and Cutaneous Allergy (REIDAC)

IntroductionShellac is a known allergen present mainly in cosmetics used on the eyelids and lips, although new sources of exposure have recently been described. Our objective was to assess the use of shellac as a contact allergen in Spain and the clinical profile of patients allergic to shellac. MethodsThis retrospective cross-sectional study included patients patch tested for shellac between 2018 and 2021 from the Spanish Registry of Contact Dermatitis and Cutaneous Allergy (REIDAC). ResultsA total of 980 patients were patch tested for shellac (20% in ethanol), and 37 (3.77%, 95% confidence interval [CI], 2.58–3.97%) showed positive results. Most of these patients were tested for shellac due to a suspicion of cosmetic contact dermatitis. Seven patients with present relevance were found, five with relation to cosmetics, and the other two with an occupational background of food handling. The reaction index for shellac was 0.51 and the positivity ratio was 67.56% (95% CI, 52.48–82.65%). ConclusionsShellac appears to be a prevalent allergen in patients with suspected contact dermatitis related with cosmetics or foodstuff. However, further studies are needed to validate its use in other patients.

Cellulose Nanocrystals for Skin Barrier Protection by Preparing a Versatile Foundation Liquid.

Most of the foundation liquids in the market need makeup removers for cleaning, while the excessive use of makeup removers might lead to skin barrier damage, which would further lead to many kinds of dermatosis, such as skin sensitivity, facial telangiectasia, rosacea, acne, as well as various cosmetic contact dermatitis. Inspired by the protective effect of fiber-rich diet on the intestinal mucosal mechanical barrier, a novel hemp/cellulose nanocrystals (CNCs)-based foundation liquid featuring easy-wiping property has been constructed, which will effectively solve the post-makeup skin cleaning problems. In this experiment, the formula of the foundation liquid can be obtained through hemp/CNCs instead of mineral oil and titanium oxide, which are considered to have undesirable local tolerance, sensitizing potential, and are environmental pollutants, to create a moisture barrier. Industrial hemp is a hot issue in cosmetic research, and a great quantity of discarded industrial hemp stalk is available to be used to produce hemp/CNCs through grinding and acidification. The graft technique is adapted to obtain hemp/CNCs-g-polylactic acid (PLA). By replacing the hydroxyl group on the side of hemp/CNCs, hemp/CNCs-g-PLA reduces the intermolecular hydrogen bonding, resulting in a higher dispersion in the oil phase. The hemp/CNCs-g-PLA has excellent performance in terms of biological compatibility, water resistance, and non-penetration into the skin. With basic features of a foundation liquid to alleviate discoloration, age spots, and skin roughness, the foundation liquid based on hemp/CNCs-g-PLA provides a novel characteristic of easy-wiping, which helps to avoid the damage to the skin barrier caused by excessive cleansing.

Patch test in Chinese in Shanghai with cosmetic allergy to cosmetic series and products.

There are increasing cosmetic adverse reactions in China, mostly cosmetic contact dermatitis, with the development of its cosmetics industry. To identify the allergens and cosmetics products responsible for cosmetic allergic contact dermatitis (CACD) in Shanghai. Five hundred and sixty patients, including 342 suspected CACD patients from dermatological clinic and 218 cosmetics consumers with an allergic history, were patch tested with a cosmetic series (C-1000 series). And 154 patients patched with possible culprit cosmetics. Two hundred and forty-six subjects showed positive reaction to C-1000 series. Clinic patients had much higher positive rate than that of cosmetics consumers. Leading allergens were methylisothiazolinone (MI), methylisothiazolinone+methylchloro-isothiazolinone (MCI/MI), thimerosal, and the positive rates were significantly higher in patients than in cosmetic consumers (P<.001 for all). MCI/MI elicited positive patch test reactions in 73.5% of MI-positive patients. Of those patched with cosmetic products, 19 patients had 31 positive reactions, including 22 skin care products and 5 color decorating. Preservatives, especially MI, MCI/MI, and thimerosal, were the most common cosmetic allergens, and skin care products occupied the most allergic reaction of CACD. Patch testing is highly recommended for suspected CACD patients. Future comparative investigation with large sample size should benefit cosmetovigilance surveillance.

Contact Dermatitis to Cosmetics.

Allergic contact dermatitis (ACD) to cosmetics is extremely common-probably the most common reason patients present for patch testing. The diagnosis should initially be suspected based on the patient history and the distribution of the dermatitis. Once the diagnosis is suspected, empiric recommendations for low allergenicity products should be implemented until patch testing is performed. The face is exposed to greatest number of cosmetics, and as a result, facial dermatitis is the prototypical presentation of cosmetic contact dermatitis. In particular, the eyelids are frequently involved, with common sources including shampoo, conditioner, facial cleansers, makeup remover, mascara, nail polish, acrylic nails, makeup sponges, eyelash curlers, and allergens transferred from the hands. Other typical facial distributions include lateral facial dermatitis, central facial dermatitis, and generalized facial dermatitis, each with its own unique set of most likely causes. Lateral facial and/or neck dermatitis is often a "rinse-off" pattern, with shampoo and/or conditioner rinsing down over these areas. Central facial dermatitis, when due to ACD, can be due to gold being released from gold rings and contaminating makeup foundation or to ingredients in moisturizers, wrinkle creams, topical medications, or makeup. Sparing of the lateral face is largely due to the fact that patients are more assiduous about applying the aforementioned substances to the central face than to the lateral face. Generalized facial dermatitis should trigger consideration of airborne contactants, facial cleansers, makeup foundation, and moisturizers and medications that are being applied confluently. Once adequate patch testing has been performed, there are a number of extremely helpful resources to help patients find products that are safe for use, such as the American Contact Dermatitis Society's "Contact Allergen Management Program" app.

Clinical profile of 300 men with facial hypermelanosis.

Facial hypermelanosis is a significant cause of cosmetic disfigurement, social embarrassment and psychological morbidity affecting quality of life. To study clinicoepidemlogic patterns of facial hypermelanoses among men. Medical records of all adult males presenting with facial hypermelanoses were analyzed for this retrospective cross sectional study for demographic details, duration, cosmetic usage, sun exposure, drug intake, infections, systemic or cutaneous diseases, and family history of hypermelanotic dermatosis. Laboratory investigations and skin biopsy were performed when deemed necessary. These were 300 Indian men aged 18 to 74 (mean 37.35) years with 121 (40.3%) individuals aged 31-50 years. Various patterns of melasma in 230 (76.7%) patients were the major cause of facial hypermelanosis. Periorbital hypermelanosis was observed in 32 (10.7%), freckles and lentigens in 26 (8.7%), acanthosis nigricans in 12 (4%) and lichen planus pigmentosus in 10 (3.3%), pigmented cosmetic contact dermatitis in 7, and nevus of Ota in 6 persons. The 71 (30.8%) patients with melasma had a history of frequent sun exposure, 9 (3.9%) patients had systemic comorbidities. Family history of periorbital melanosis was present in 7 (21.8%), personal or family history of atopy in 5 (15.6%) patients. Acanthosis nigricans was associated with obesity in 9 (75%) of patients and with diabetes mellitus in 4 (33.3%) cases. Melasma, periorbital hypermelanosis, acanthosis nigricans and lichen planus pigmentosus remain the predominant causes for facial hypermelanosis in men.

Cosmetic Habits and Cosmetic Contact Dermatitis in Children

Allergic contact dermatitis from cosmetics in children and adolescents has recently become more frequently observed and recognized. Fragrances, hair dyes, sunscreen agents, and preservative agents, particularly methylisothiazolinone, are the most frequently reported contact allergens.

Pigmented Contact Dermatitis

Pigmented Contact dermatitis is a non-eczematous variant of contact dermatitis clinically characterised by reddish-brown to slate grey pigmentation in a reticulate pattern, usually without any active or preceding clinical dermatitis. A detailed history is essential to establish the temporal correlation of exposure to a possible sensitizer, which further helps in differentiating PCD from its close mimickers such as melasma, lichen planus pigmentosus erythema dychromicum perstans, etc. Clinical variants of PCD include Riehl’s melanosis, pigmented cosmetic contact dermatitis, pigmented contact cheilitis and purpuric dermatitis. Histopathology shows pigment incontinence. Patch testing should be performed to identify the causative allergen and besides a papule or vesicle, a brown pigment may develop at the patch test site. Patients should be counselled regarding complete avoidance of the causative allergen and also the resistance of this condition to various treatment modalities.

Investigation of Allergenicity of Some Cosmetic Mixtures by Using ex vivo Local Lymph Node Assay-BrdU Endpoints

Background: Balsam of Peru and fragrance mix are commonly used in cosmetic products. Allergy to fragrance is the most common cause of cosmetic contact dermatitis. Methods: In the present study, ex vivo local lymph node assay-5-bromo-2′-deoxyuridine (LLNA-BrdU) was used to evaluate the dermal sensitization potential of these cosmetic mixtures. The stimulation index values and estimated concentration (EC3) values were calculated and the potency classification was found for each mixture. At the same time, in order to measure the irritant effect without having to use additional animals, a combination of ex vivo LLNA-BrdU and the irritancy assay was conducted. Results: Th1 [interleukin (IL)-2, interferon-γ] and Th2 cytokine (IL-4, IL-5) releases from lymph node cell culture were investigated as non-radioactive endpoints. According to the results of ex vivo LLNA-BrdU assays, EC3 values were found to be 3.09% (moderate) for balsam of Peru and 4.44% (moderate) for fragrance mix. Cytokine analysis results indicate that both Th1 and Th2 cytokines are involved in the regulation of murine contact allergy and can be considered as useful endpoints. Conclusion: In conclusion, according to our results, fragrance mix and balsam of Peru can be considered as moderate sensitizers; however, in high concentrations, both of them have irritation properties. The cytokines investigated can be considered as the endpoints of the ex vivo LLNA-BrdU assay.

Allergic Contact Dermatitis to Plant Extracts in Cosmetics

Topically applied cosmetics and medicaments containing botanical extracts are commonly used. Despite popular beliefs of their benignancy, some botanicals have been implicated in causing allergic contact dermatitis in susceptible patients. The offending allergen may be the botanical extract itself or another ingredient such as a fragrance, preservative, dye, or sunscreen found in the product. Specific botanicals implicated in causing cosmetic contact dermatitis include Compositae family plants, tea tree oil, peppermint, lavender, lichens, henna, and others.

Multicenter study of preservative sensitivity in patients with suspected cosmetic contact dermatitis in Korea

As many new cosmetic products are introduced into the market, attention must be given to contact dermatitis, which is commonly caused by cosmetics. We investigate the prevalence of preservative allergy in 584 patients with suspected cosmetic contact dermatitis at 11 different hospitals. From January 2010 to March 2011, 584 patients at 11 hospital dermatology departments presented with cosmetic contact dermatitis symptoms. These patients were patch-tested for preservative allergens. An irritancy patch test performed on 30 control subjects using allergens of various concentrations showed high irritancy rates. Preservative hypersensitivity was detected in 41.1% of patients. Allergens with the highest positive test rates were benzalkonium chloride (12.1%), thimerosal (9.9%) and methylchloroisothiazolinone/methylisothiazolinone (MCI/MI) (5.5%). Benzalkonium chloride and chlorphenesin had the highest irritancy rate based on an irritancy patch test performed using various concentrations. Seven of 30 normal subjects had a positive irritant patch reading with 0.1% benzalkonium chloride and eight of 30 normal subjects had a positive irritant patch reading at 4 days with 0.5% chlorphenesin in petrolatum. Although benzalkonium chloride was highly positive for skin reactions in our study, most reactions were probably irritation. MCI/MI and thimerosal showed highly positive allergy reactions in our study. The optimum concentration of chlorphenesin to avoid skin reactions is less than 0.5%.

Trend of contact allergy to cosmetic ingredients in Thais over a period of 10 years*

Contact allergy to cosmetic ingredients is common. However, there are no recent comprehensive studies on contact allergy to cosmetic ingredients in Asia. To identify positive patch test reactions in patients tested at Siriraj Hospital, Bangkok, Thailand to allergens present in cosmetics. A retrospective review of medical records from the outpatient contact dermatitis clinic was conducted from January 1999 to December 2008. Patients with at least one positive patch test reaction to allergens associated with cosmetic ingredients were studied. The results were evaluated using Pearson's χ(2) -test with Yates' continuity correction or Fisher's exact test where appropriate,and a p-value <0.002 was considered to be statistically significant by Bonferroni correction. There were 1247 cases (239 males and 1008 females; mean age 38.5 years). Fragrance chemicals and preservatives were the most commonly recognized cosmetic allergens. Ammoniated mercury was the only allergen that showed a significantly increased frequency over the 10-year period (p = 0.0008). Our study showed that ammoniated mercury is an emerging cosmetic allergen, showing an increased prevalence in recent years in Thailand. A focus is required on emerging cosmetic allergens and what may account for the upward trend of cosmetic contact dermatitis.

The Validated Hypoallergenic Cosmetics Rating System: Its 30-Year Evolution and Effect on the Prevalence of Cosmetic Reactions

The validated hypoallergenic (vh) rating system was initiated in 1988 to try to objectively validate the "hypoallergenic" claim in cosmetics. To show how the system rates cosmetic hypoallergenicity and to compare the prevalence of cosmetic contact dermatitis (CCD) among users of regular cosmetics versus cosmetics with high VH numbers. (1) Made a VH list based on top allergens from patch-test results published by the North American Contact Dermatitis Group (NACDG) and the European Surveillance System on Contact Allergies (ESSCA); (2) reviewed global regulatory, cosmetic, drug, packaging, and manufacturing practices to show how allergens may contaminate products; (3) compared cosmetic ingredients lists against the VH list to obtain the VH rating (the more allergens absent, the higher the VH rating); and (4) obtained CCD prevalence among users of regular cosmetics versus users of cosmetics with high VH ratings. (1) Two VH lists (1988, 2003) included only cosmetic allergens in the NACDG surveys, the third (2007) included cosmetic and potential contaminant noncosmetic allergens, and the fourth (2010) adds ESSCA patch-test surveys. (2) CCD prevalence is 0.05 to 0.12% (average, 0.08%) among users of cosmetics with high VH ratings versus 2.4 to 36.3% among users of regular cosmetics. The VH rating system is shown to objectively validate the hypoallergenic cosmetics claim.

Fragrance contact dermatitis in Korea: a joint study

The purpose of this study is to determine the frequency of responses to selected fragrances in patients with suspected fragrance allergy and to evaluate the risk factors. 9 dermatology departments of university hospitals have participated in this study for the past 1 year. To determine allergic response to fragrances, 18 additional fragrances in addition to the Korean standard and a commercial fragrance series were patch-tested in patients with suspecting cosmetic contact dermatitis. Over 80% of the patients were women, and the most common site was the face. Cinnamic alcohol and sandalwood oil (Santalum album L.) showed high frequencies of positive responses. Of the specific fragrances, ebanol, alpha-isomethyl-ionone (methyl ionone-gamma) and Lyral (hydroxyisohexyl 3-cyclohexane carboxdaldehyde) showed high positive responses. We compared the results obtained during this study with those of other studies and concluded that including additional fragrance allergens may be useful for the detection of fragrance allergy.

Results of patch testing with lavender oil in Japan.

We report the annual results of patch testing with lavender oil for a 9-year period from 1990 to 1998 in Japan. Using Finn Chambers and Scanpor tape, we performed 2-day closed patch testing with lavender oil 20% pet. on the upper back of each patient suspected of having cosmetic contact dermatitis. We compared the frequency of positive patch tests to lavender oil each year with those to other fragrances. We diagnosed contact allergy when patch test reactions were + or <+ at 1 day after removal. The positivity rate of lavender oil was 3.7% (0-13.9%) during the 9-year period from 1990 to 1998. The positivity rate of lavender oil increased suddenly in 1997. Recently, in Japan, there has been a trend for aromatherapy using lavender oil. With this trend, placing dried lavender flowers in pillows, drawers, cabinets, or rooms has become a new fashion. We asked patients who showed a positive reaction to lavender oil about their use of dried lavender flowers. We confirmed the use of dried lavender flowers in 5 cases out of 11 positive cases in 1997 and 8 out of 15 positive cases in 1998. We concluded that the increase in patch test positivity rates to lavender oil in 1997 and 1998 was due to the above fashion, rather than due to fragrances in cosmetic products.

A Study of As is Patch Test in Cosmetic Contact Dermatitis

A Study of As is Patch Test in Cosmetic Contact Dermatitis

Is it really fragrance-free?

Background : Fragrance allergy is the most common cause of cosmetic contact dermatitis. Many occult sources of fragrance exist. Those which cause the most concern are some “fragrance-free” products that contain fragrance raw ingredients. Thus, the very patients requiring fragrance-free items may be exposed to potential perfume allergens or cross-reactors in seemingly safe products. Additionally, medications dermatologists recommend, both prescription and over-the-counter, sometimes contain fragrance. Objective : This report describes a patient with chronic hand dermatitis sensitized to multiple fragrance ingredients including rose oil, present in the “fragrance-free” soap she used. Additionally, the tar soaks recommended to her also contained fragrance. Conclusion : It is no longer sufficient to recommend the use of products labeled fragrance-free to fragrance-sensitive patients. These patients must be educated to read labels and look for plant extracts that are potential perfume sensitizers and cross-reactors. Rose oil, which has been felt to be a rare sensitizer, may be a more common allergen than previously recognized, perhaps because of its existence in a popular “fragrance-free” soap and, conceivably, in many “all-natural” products. Further testing with rose oil should be conducted in the future. Finally, manufacturers need to be more forthright in the labeling of their products.

An Analysis of Patch Test Results in Patients with Cosmetic and Noncosmetic Contact Dermatitis

An Analysis of Patch Test Results in Patients with Cosmetic and Noncosmetic Contact Dermatitis