Allergic Contact Dermatitis Induced by Cosmetics

There has been a twofold increase in the cases of allergic contact dermatitis due to cosmetic allergens in seven years with a majority of cases seen in women, according to a recent Danish research. A report from Dr. Tatyana Hamilton, MD, PhD from the Department of Dermatology and Skin Science, University of British Columbia, Canada, says that on an average, a woman usually uses over 12 cosmetic products per day with an estimate of over 168 specific constituents while a man uses over 6 personal care products comprising 85 similar components. Fragrances and preservatives used in skin care products have been implicated in the majority of cases of contact dermatitis followed by hair care and nail cosmetics.

Allergic contact dermatitis is an inflammatory response of the skin which when exposed to allergens or irritants results in an intensely itchy red rash seen over the exposed areas, swelling, and/or other inflammatory changes. Unlike the rash from urticaria, that disappears within minutes or after a few hours after exposure, contact dermatitis usually takes longer to heal, and can take few days to a few weeks after removal of the offending irritant.

In the review published in the Skin Therapy Letter, the authors suggest that Allergic Contact Dermatitis of the skin is caused by a hypersensitivity reaction to fragrances or preservatives used in certain cosmetic products.

There are innumerable cosmetic goods available today in the market which not only includes make-up products but also personal care products such as creams, lotions, perfumes, sunscreens, hair care and nail care products. Each of these products comprise a number of unique individual ingredients and these can range from fragrances, preservatives, antioxidants, humectants, emollients, vehicles, emulsifiers, hair dyes, ultraviolet absorbers, acrylates, nail polish components, and others.

The inclusion of these can proportionately increase our risk of our skin’s sensitivity leading to adverse reactions. Epidemiologically, there are more cases of contact dermatitis than listed as most people do not visit the doctor for mild adverse reactions.

Besides commonly known allergic substances such as nickel sulfate, neomycin, Balsam of Peru, fragrance mix, thimerosal, gold sodium thiosulfate, quaternium-15, formaldehyde, bacitracin, cobalt chloride and benzalkonium chloride, there are numerous incriminating preservatives including formaldehyde-releasing preservatives (FRP) that are capable of causing contact dermatitis.

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Seven different research studies which involved 30,207 patients patch tested with an impression for contact dermatitis showed that around 10 percent of definite reactions were due to cosmetic allergens.

Ascreening study by the North American Contact Dermatitis Group (NACDG) involving “patch testing” and the European analysis of 5911 cosmetic-allergic patients for allergic products indicate that most allergens are liable to be missed unless specifically screened for. This is becoming increasingly more challenging with the discovery of newly emerging allergens being used in multiple cosmetic products.

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Over 3000 fragrances are increasingly being used in the beauty industry representing the second most obvious group of cosmetic allergens. The tools used to evaluate for fragrance allergy include a blend of fragrances such as fragrance mix I (FMI) comprising amyl cinnamic and cinnamic alcohol, eugenol, cinnamic aldehyde, hydroxycitronellal, geraniol, isoeugenol, oak moss absolute and sorbitan sesquioleate, while fragrance mix II (FMII) incorporates hydroxyisohexyl 3-cyclohexene carboxaldehyde, citral, farnesol, coumarin, citronellol and hexyl cinnamal.

Balsam of Peru (BOP) is an aromatic fluid obtained from the bark of the tree Myroxylon balsamum native of El Salvador that is also used in the cosmetic industry and is a complex mixture of many unknown allergenic substances.

The “Fair Packaging and Labeling Act” prevents the listing of many unique fragrances as they are kept under wraps as trade secrets. It is prudent not to forget that many cosmetic preparations which are supposedly 'unscented' or free of fragrances besides being ‘hypoallergenic’ may contain concealed fragrances and as such, are not rendered completely safe for hypersensitive individuals. These include many of the herbal preparations available in the market.

The authors concluded that when assessing patients besides studying their individual case history, profession, hobbies and distribution of dermatitis the doctors should also check out their personal care products for potential allergens that can cause an allergic contact dermatitis. If found the recognized allergic substances should then be avoided by hypersensitive individuals. Adequate counseling and relevant information regarding safe personal care products is imperative to prevent allergic contact dermatitis.

Source: Allergic Contact Dermatitis to Preservatives and Fragrances in Cosmetics; Tatyana Hamilton, MD, PhD and Gillian C. de Gannes, MD, FRCPC; Skin Therapy Letter.Com.

Source-Medindia