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Keywords:

  • allergic contact eczema;
  • dermatitis;
  • contact eczema;
  • dermatitis;
  • cosmetics;
  • irritant;
  • toxic contact eczema;
  • dermatitis

We carried out a descriptive study of 351 consecutive patients pertaining to the year 2000. Our incidence area is the northwest of Spain. These subjects were tested with the standard battery of GEIDC tests and with specific series of cosmetics and fragrances. Tests were read according to ICDRG.

A diagnostic suspicion of Allergic Contact Eczema/Dermatitis (ACED) (1) from cosmetic usage existed in 53 (15%) (45 female). The average age was 40.6 years (14–70 years) and personal or family atopy was not significant. The main occupational categories were housewives (32.5%), office workers (16%) and agricultural workers (8.3%).

Of the 53 patients, 34 (64.1%) were found to be positive for one or more allergens. The presentation was eczema/dermatitis (92.3%). The symptoms were referred with an evolution time of less than or equal to one year (82.9%).

The head was most commonly affected (79.4%) (the eyelids in 32.5%). The implicated cosmetics were facial creams (32.4%), haircare products – especially dyes, (26.4%), make-up products (23.5%), perfumes and, to a much lesser extent, sunscreen (2.1%). The causal allergenic groups were fragrances (44.1%), preservatives (32.3%), and para-phenylenediamine (23%). Fragrances were the allergen which most frequently justified the ACED to cosmetics in men (85.6%) and the most common sensitizers were oak moss absolute (14.7%), balsam of Peru, jasmine and isoeugenol (11.7%). The main preservatives causing allergy hypersensitivity in this group were formaldehyde (16.5%), Euxyl K 400 (14.6%), parabens (12.1%) and Kathon CG (11.75%).

In the last two decades there has been a significant increase in hypersensitivity reactions to cosmetic products, which is explained by the greater number of users and the increasing number of products offered (2,3).

Current reviews demonstrate that the most frequent allergenic groups are fragrances, preservatives, and para-phenylenediamine, showing effects in similar proportions to those found in our study (4,5).

Preservatives constitute the second most frequent allergenic group, and formaldehyde continues to be the most frequent allergen (6). A decrease can be observed in ACED caused by parabens, possibly due to replacement by preservatives with a more complex molecule, which in the not too distant future will also play a role as a cause of allergy. Although it has only recently been incorporated, Euxyl K 4000 is becoming more important within this group due to its extensive use (7).

Para-phenylenediamine is involved in the majority of hypersensitivity reactions due to contact hair dyes. It can present cross-reactions with other chemically related hair dyes such as p-toluendiamine, p-aminophenyldiamine, and even Henna (8).

It is recommended that similar studies be conducted periodically in order to observe the diverse variations in allergens responsible for hypersensitivity to cosmetic products.

References

  1. Top of page
  2. References
  • 1
    Johansson SGO, O'B Hourihane J, Bousquet J, Bruijnzeel-Koomen C, Dreborg S, Haahtela T, Kowalski ML, Mygind N, Ring J, Van Cauwenberge P, Van Hage-Hamsten M, Wüthrich B. A revised nomenclature for allergy. An EAACI position statement from the EAACI nomenclature task force. Allergy 2001;56:813824.
  • 2
    Robinson MK, Gerberick GF, Ryan CA, McNamee P, White IR, Basketter DA. The importance of exposure estimation in the assessment of skin sensitisation risk. Contact Dermatitis 2000;42:251259.
  • 3
    Liden C. Legislative and preventive measures related to contact dermatitis. Contact Dermatitis 2001;44:6569.
  • 4
    Goossens A, Beck MH, Haneke E, McFadden JP, Nolting S, Durupt G, Ries G. Adverse cutaneous reactions to cosmetic allergens. Contact Dermatitis 1999;40:112114.
  • 5
    De Groot AC. Contact Allergens. What's new? Cosmetic dermatitis. Clin Dermatol 1996;15:485492.
  • 6
    De Groot AC. Clinical relevance of positive patch test reactions to preservatives and fragrances. Contact Dermatitis 1999;41:224226.
  • 7
    De Groot AC, Van Ginkel CJW, Weyland JW. Methyldibromo glutaronitrile (Euxyl K 400): an important new allergen in cosmetics. J Am Acad Dermatol 1996;35:743747.
  • 8
    Conde Salazar L, Baz M, Guimaraens D, Cannavo A. Contact dermatitis in hairdressers: patch test results in 379 hairdressers. Am J Contact Dermatitis 1995;7:109115.

Accepted for publication 22 November 2001