Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

Keynote webinar | Spotlight on medication adherence

LIVE: Thursday 27th June 2024, 18:00-19:30 (CEST)
Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.
ADVANCED SEARCH
Log in
Top
American Journal of Clinical Dermatology
Published in: American Journal of Clinical Dermatology 5/2004

01-10-2004 | Review Article

Cosmetic Allergy

Incidence, Diagnosis, and Management

Authors: Dr David I. Orton, John D. Wilkinson

Published in: American Journal of Clinical Dermatology | Issue 5/2004

Login to get access

Abstract

A recent epidemiologic survey in the UK revealed that 23% of women and 13.8% of men experience some sort of adverse reaction to a personal care product over the course of a year. Although most of these reactions may be due to subjective sensory irritation, various studies reveal that up to 10% of dermatologic patients who are patch tested are allergic to cosmetic products or their constituent ingredients. Causative products include deodorants and perfumes, skin care products, hair care products, and nail cosmetics.
Allergic contact dermatitis mainly results from fragrance chemicals and preservatives. Recent work has suggested that additional fragrance chemicals may need to be tested in order to identify those patients ‘missed’ by the current fragrance mix; in particular, hydroxy-isohexyl-3-cyclohexene carboxaldehyde (HMPPC Lyral®) has been singled out as an important sensitizing agent. The increased usage of natural fragrances and botanic extracts can also cause problems in their own right or through co-reactivity. The preservative methyldibromo glutaronitrile has also been recognized as an increasingly important sensitizer in Europe, which has led to the recent recommendation that it should be prohibited from ‘leave-on’ products until information on ‘safe’ consumer levels becomes available. Other emerging allergens include UV filters, tosylamide/formaldehyde resin, and nail acrylates.
The diagnosis of cosmetic allergy should be confirmed with patch testing, including testing of ‘whole’ products, when necessary, and repeat open application tests can be used to confirm the relevance of reactions in cases of doubt.
Footnotes
1
The use of trade names is for product identification purposes only and does not imply endorsement.
 
Literature
1.
De Groot AC, Beverdam E, Ayong C, et al. The role of contact allergy in the spectrum of adverse effects caused by cosmetics and toiletries. Contact Dermatitis 1988; 19: 195–201PubMedCrossRef
2.
De Groot AC, De Nater J, Van der Lende T, et al. Adverse effects of cosmetics and toiletries: a retrospective study in the general population. Int J Cosmet Sci 1987; 9: 255–9PubMedCrossRef
3.
Consumer Association Report on reactions on the skin to cosmetics and toiletries. London: Consumer Association 1979
4.
Willis CM, Shaw S, De Lacharrière O, et al. Sensitive skin: an epidemiological study. Br J Dermatol 2001; 145: 258–63PubMedCrossRef
5.
6.
De Groot AC. Contact allergy to cosmetics: causative ingredients. Contact Dermatitis 1987; 17: 26–34PubMedCrossRef
7.
Romaguera C, Carmarasa JMG, Alomar A, et al. Patch tests with allergens related to cosmetics. Contact Dermatitis 1983; 6: 167–8CrossRef
8.
Ngangu Z, Samsoen M, Foussereau J. Einige Aspekte Zur Kosmetika-Allergie in Strassburg. Derm Beruf Umwelt 1983; 31: 126–9PubMed
9.
10.
11.
Eiermann H, Larsen W, Maibach H, et al. Prospective study of cosmetic reactions: 1977–1980. North American Contact Dermatitis Group. J Am Acad Dermatol 1982; 6: 909–17PubMedCrossRef
12.
Nielsen NH, Linnberg A, Menne T, et al. Allergic contact sensitization in an adult Danish population: two cross-sectional surveys eight years apart (The Copenhagen Allergy Study). Acta Derm Venereol 2001; 81: 31–4PubMedCrossRef
13.
Grief M, Maibach H. United States cosmetic ingredient labelling. Contact Dermatitis 1977; 3: 1994–8
14.
Vigan M. Les Nourveaux allergens des cosmetiques: la cosmeto-vigilance. Ann Dermatol Venereol 1997; 124: 571–5PubMed
15.
Uter W, Geier J, Lessmann H, et al. Unvertäglichkeiten gegen Körperpflegeund Waschmittel: Was istzu tun?. Die Informations-und Dokumentationsstelle für kontaktallergien (IDOK) des Informationsverbundes Dermatologischer Kliniken (IVDK). Dt. Dermatol 1999; 47: 211–4
16.
17.
European Surveillance System of Contact Allergies - Data Centre [online]. Available from URL: http://​www.​ivdk.​gwdg.​de/​essca/​ [Accessed 2004 Aug 31].
18.
Wilkinson DS, Fregert S, Magnusson B, et al. Terminology of contact dermatitis. Acta Derm Venereol (Stockh) 1970; 50: 287–92
19.
Andersen KE, Johansen JD, Bruze M, et al. The time dose-response relationship for elicitation of contact dermatitis in Isoeugenol allergic individuals. Toxicol Appl Pharmacol 2001; 170: 166–71PubMedCrossRef
20.
Dooms-Goossens A. Cosmetics as causes of allergic contact dermatitis. Cutis 1993; 52: 316–20PubMed
21.
Rastogi SC. Analytical control of preservative labelling on skin creams. Contact Dermatitis 2000; 43: 339–43PubMedCrossRef
22.
Orton DI, Shaw S. Allergic contact dermatitis from pharmaceutical grade BHA in Timodine®, with negative results to analytical grade BHA. Contact Dermatitis 2001; 44: 191–2PubMedCrossRef
23.
De Groot AC. Patch testing: test concentrations and vehicles for 3700 chemicals. 2nd ed. Amsterdam: Elsevier, 1994
24.
Rycroft RJG, Menné T, Frosch PJ, Lepoittevin JP, editors. Textbook of contact dermatitis. 3rd ed. Heidelberg: Springer, 2001
25.
Rietschel RL, Fowler JF, editors. Fisher’s contact dermatitis. 4th ed. Baltimore: Williams & Wilkins, 1995
26.
De Groot AC, Bruynzeel DP, Bos JD, et al. The allergens in cosmetics. Arch Dermatol 1988; 124: 1525–9PubMedCrossRef
27.
Morren MA, Rodrigues R, Dooms-Goossens A, et al. Connubial contact dermatitis: a review. Eur J Dermatol 1992; 2: 219–23
28.
29.
Larsen WG, Maibach HI. Fragrance contact allergy. Semin Dermatol 1982; 1: 85–90
30.
de Groot AC, van der Kley AMJ, Bruynzeel DP, et al. Frequency of false-negative reactions to the fragrance mix. Contact Dermatitis 1993; 28: 139–40PubMedCrossRef
31.
32.
Rastogi SC, Johansen JD, Frosch PJ, et al. Deodorants on the European market: quantitative chemical analysis of 21 fragrances. Contact Dermatitis 1998; 39: 29–35CrossRef
33.
Rastogi SC. Analysis of fragrances in cosmetics by gas chromatography: mass spectrometry. J High Resolut Chromatogr 1995; 18: 653–8CrossRef
34.
Larsen WG, Nakayama H, Lindberg M, et al. Fragrance contact dermatitis: a world wide multicenter investigation. Am J Contact Dermat 1996; 7: 77–83PubMedCrossRef
35.
Frosch PJ, Johansen JD, Menne T, et al. Lyral® is an important sensitizer in patients sensitive to fragrances. Br J Dermatol 1999; 141: 1076–83PubMedCrossRef
36.
Volume 1 Cosmetics Legislation Products 1999 edition. European Commission Enterprise Directorate - General Pharmaceuticals and Cosmetics [online]. Available from URL: http://​www.​leffingwell.​com/​cosmetics/​vol_​1en.​pdf [Accessed 2004 August 31]
37.
Johansen JD. Fragrance contact allergy: a clinical review. Am J Clin Dermatol 2003; 4 (11): 789–98PubMedCrossRef
38.
Scheinman PL. The foul side of fragrance-free products: what every clinician should know about managing patients with fragrance allergy. J Am Acad Dermatol 1999; 41: 1020–4PubMedCrossRef
39.
Suskind RR. Hydroxycitronellal: the whole and final story. RIFM proceedings from the 6th International Information Exchange; 1992 Nov 19–20; Princetown. 75–83
40.
Goossens A, Beck MH, Haneke E, et al. Adverse cutaneous reactions to cosmetic allergens. Contact Dermatitis 1999; 40: 112–3PubMedCrossRef
41.
Decker Jr R. Frequency of preservative use in cosmetic formulas disclosed to the FDA-1984. Cosmetics Toiletries 1985; 100: 65–8
42.
Gruvberger B, Bruze M, Tammela M. Preservatives in moisturizers on the Swedish market. Acta Derm Venereol (Stockh) 1998; 78: 52–6CrossRef
43.
De Groot AC, Van Ginkel CJW, Weyland JW. Methyldibromo glutaronitrile (Euxyl K400): an important “new” allergen in cosmetics. J Am Acad Dermatol 1996; 35: 743–7PubMedCrossRef
44.
Wilkinson JD, Shaw S, Andersen KE, et al. Monitoring levels of preservative sensitivity in Europe: a 10-year overview (1991–2000). Contact Dermatitis 2002; 46: 207–10PubMedCrossRef
45.
Rastogi S, Schouten A, De Kruijf N, et al. Contents of methyl-, ethyl-, propyl-, and benzylparaben in cosmetic products. Contact Dermatitis 1995; 32: 28–30PubMedCrossRef
46.
Fisher A. The paraben paradoxes. Cutis 1973; 12: 177–81
47.
Cosmetic Ingredient Review. Final report on the safety assessment of formaldehyde [college report]. J Am Coll Toxicol 1984; 3: 157–84CrossRef
48.
Jordan WP, Sherman WT, King SE. Threshold responses in formaldehyde-sensitive subjects. J Am Acad Dermatol 1979; 1 (1): 44–8PubMedCrossRef
49.
Flyvholm MA, Hall BM, Agner T, et al. Threshold for occluded formaldehyde patch test in formaldehyde-sensitive patients. Contact Dermatitis 1997; 36: 26–33PubMedCrossRef
50.
Flyvholm MA, Tiedemann E, Menné T. Comparison of 2 tests for clinical assessment of formaldehyde exposure. Contact Dermatitis 1996; 34: 35–8PubMedCrossRef
51.
Agner T, Flyvholm MA, Menné T. Formaldehyde allergy: a follow-up study. Am J Contact Dermatitis 1999; 10: 12–7PubMedCrossRef
52.
Dooms-Goossens A, de Boulle K, Dooms S, et al. Imidazolidinyl urea dermatitis. Contact Dermatitis 1986; 14: 322–4PubMedCrossRef
53.
Marks Jr JG, Belsito DV, DeLeo VA, et al. North American Contact Dermatitis Group patch test results for the detection of delayed-type hypersensitivity to topical allergens. J Am Acad Dermatol 1998; 38: 911–8PubMedCrossRef
54.
Ziegler V, Ziegler B, Kipping D. Dose-response sensitization experiments with imidazolidinyl urea. Contact Dermatitis 1988; 19: 236–7PubMedCrossRef
55.
Jacobs MC, White IR, Rycroft RJG, et al. Patch testing with preservatives at St John’s from 1982 to 1993. Contact Dermatitis 1995; 33: 247–54PubMedCrossRef
56.
Kantor GR, Taylor JS, Ratz JL, et al. Acute allergic contact dermatitis from diazolidinyl urea (Germal II) in a hair gel. J Am Acad Dermatol 1985; 13: 116–9PubMedCrossRef
57.
Hectorne KJ, Fransway AF. Diazolidinyl urea: incidence of sensitivity, patterns of cross-reactivity and clinical relevance. Contact Dermatitis 1994; 30: 16–9PubMedCrossRef
58.
Ford GP, Beck MH. Reactions to quaternium-15, bronopol and Germal 115 in a standard series. Contact Dermatitis 1986; 14: 271–4PubMedCrossRef
59.
Frosch PJ, White IR, Rycroft RJG, et al. Contact allergy to Bronopol. Contact Dermatitis 1990; 22: 24–6PubMedCrossRef
60.
Menné T, Frosch PJ, Veien NK, et al. Contact sensitisation on 5-chloro-2-methyl-4-isothiazolin-3-one (MI/MCI): a European multicentre study. Contact Dermatitis 1991; 24: 334–41PubMedCrossRef
61.
Marks JG, Moss JN, Parno JR, et al. Methylchlorisothiazolinone/methylisothiazolinone (Kathon CG) Biocide: second United States multicenter study of human skin sensitization. Am J Contact Dermat 1993; 4: 87–9
62.
Cardin CW, Weaver JE, Bailey PT. Dose response assessment of Kathon® biocide. Contact Dermatitis 1986; 15: 10–6PubMedCrossRef
63.
Fewings J, Menen T. An update of the risk assessment for methylchloroisothiazolinone/methylisothiazolinone (MI/MCI) with focus on rinse-off products. Contact Dermatitis 1999; 41: 1–13PubMedCrossRef
64.
Van Ginkel C, Rundervoort G. Increasing incidence of contact allergy to the new preservative 1,2-dibromo-2,4-dicyanobutane (methyldibromoglutaronitrile). Br J Dermatol 1995; 132: 918–20PubMedCrossRef
65.
McFadden JP, Ross JS, Jones AB, et al. Increased rate of patch test reactivity to methyldibromo glutaronitrile. Contact Dermatitis 2000; 42: 54–5PubMedCrossRef
66.
Geir J, Schnuch A, Brasch J, et al. Patch testing with methyldibromoglutaronitrile. Am J Contact Dermat 2000; 11: 207–12CrossRef
67.
Bryld LE, Agner T, Menné T. Allergic contact dermatitis from 3-iodo-2-propynylbutylcarbamate (IPBC): an update. Contact Dermatitis 2001; 44: 276–8PubMedCrossRef
68.
De Groot AC, van der Walle HB, Weijland JW. Contact allergy to cocamidopropyl betaine. Contact Dermatitis 1995; 33: 419–22PubMedCrossRef
69.
Armstrong DK, Smith HR, Ross JS, et al. Sensitisation to coamidopropylbetaine: an 8-year review. Contact Dermatitis 1999; 40: 335–6
70.
McFadden JP, Ross JS, White IR, et al. Clinical allergy to cocamidopropyl betaine: reactivity to cocamidopropylamine and lack of reactivity to 3-dimethylaminopropylamine. Contact Dermatitis 2001; 45: 72–4PubMedCrossRef
71.
Krasteva M, Cristaudo A, Hall B, et al. Contact sensitivity to hair dyes can be detected by the consumer open test. Eur J Dermatol 2002 Jul-Aug; 12 (4): 322–6PubMed
72.
Wahlberg JE, Tammela M, Anderson C, et al. Contact allergy to p-Phenylenediamine in Sweden. Derm Beruf Umwelt 2002; 50 (2): 51–4
73.
Nikkels AF, Henry F, Pierard GE. Allergic reactions to decorative skin paintings. J Eur Acad Dermatol Venereol 2000; 15: 140–2CrossRef
74.
Le Coz CJ, Lefebvre C, Keller F, et al. Allergic contact dermatitis caused by skin painting (pseudotattooing) with black henna, a mixture of hemp-paraphenylenediamine and its derivatives. Arch Dermatol 2000; 136: 1515–7PubMedCrossRef
75.
Fisher AA. The persulfates: a triple threat. Cutis 1985; 35: 520–35PubMed
76.
Tosti A, Melino M, Bardazzi F. Contact dermatitis due to glyceryl monothioglycolate. Contact Dermatitis 1988; 19: 71–2PubMedCrossRef
77.
Liden C, Berg M, Farm G, et al. Nail varnish allergy with far-reaching consequences. Br J Dermatol 1993; 128: 57–62PubMedCrossRef
78.
Hausen BM, Milbrodt M, Koenig WA. The allergens of nail polish: allergenic constituents of common nail polish and toluene sulfonamide-formaldehyde resin (TS-F-R). Contact Dermatitis 1995; 33: 157–64PubMedCrossRef
79.
Sainio EL, Engstrom K, Henriks-Eckerman ML, et al. Allergenic ingredients in nail polishes. Contact Dermatitis 1997; 37: 155–62PubMedCrossRef
80.
Guin JD, Baas K, Nelson-Adesokan P. Contact sensitisation to cyanoacrylate adhesive as a cause of severe onychodystrophy. Int J Dermatol 1998; 37: 21–6CrossRef
81.
Freeman S, Lee MS, Gudmundsen K. Adverse contact reactions to sculptured acrylic nails: 4 case reports and a literature review. Contact Dermatitis 1995; 33: 381–5PubMedCrossRef
82.
Matthieu L, Dockx P. Discrepancy in patch test results with wool wax alcohols and Amerchol L101. Contact Dermatitis 1997; 36: 150–1PubMedCrossRef
83.
84.
85.
Sulzberger MB, Warshaw T, Herrmann F. Studies of skin-hypersensitivity to lanolin. J Invest Dermatol 1953 Jan; 20 (1): 33–43PubMed
86.
Wahlberg JE. Propylene Glycol: search for a proper and nonirritant patch test preparation. Am J Contact Dermat 1994; 5: 156–9
87.
88.
Serra-Baldrich E, Puig LL, Gimenez Arnau A, et al. Lipstick allergic contact dermatitis from gallates. Contact Dermatitis 1995; 32: 359–60PubMedCrossRef
89.
Perrenaud D, Homberger HP, Anderset PC, et al. An epidemic outbreak of papular and follicular contact dermatitis to tocopheryl linoleate in cosmetics. Dermatology 1994; 189: 225–33CrossRef
90.
Freeman S, Stephens R. Cheilitis: analysis of 75 cases referred to a contact dermatitis clinic. Am J Contact Dermat 1999; 10: 198–200PubMedCrossRef
91.
92.
Strauss RM, Orton DI. Allergic contact cheilitis in the UK: a retrospective analysis. Am J Contact Derm 2003; 14: 75–7
93.
Valsecchi R, Imberti G, Martino D, et al. Eyelid dermatitis: an evaluation of 150 patients. Contact Dermatitis 1992; 27: 143–7PubMedCrossRef
94.
Cooper SM, Shaw S. Eyelid dermatitis: an evaluation of 232 patch test patients over 5 years. Contact Dermatitis 2000; 42: 291–3PubMed
95.
Yan Ketel WG. Patch testing with eye cosmetics. Contact Dermatitis 1979; 5: 402CrossRef
96.
Ross JS, White H. Eyelid dermatitis due to cocamidopropyl betaine in an eye make-up remover. Contact Dermatitis 1991; 25: 64PubMedCrossRef
97.
Fisher AA. Allergic contact dermatitis due to rosin (colophony) in eyeshadow and mascara. Cutis 1988; 42: 507–8PubMed
98.
99.
100.
Raugi G, Storrs F, Larsen W. Photoallergic contact dermatitis to men’s perfumes. Contact Dermatitis 1979; 5: 251–60PubMedCrossRef
101.
Schauder S, Ippen H. Contact and photocontact sensitivity to sunscreens: review of a 15-year experience and of the literature. Contact Dermatitis 1997; 37: 221–32PubMedCrossRef
102.
Szczurko C, Dompmartin A, Michel M, et al. Photocontact allergy to benzophenone: ten years of experience. Photodermatol 1994; 10: 144–7
103.
English J, White I. Allergic contact dermatitis from isopropyl dibenzoylmethane. Contact Dermatitis 1986; 15: 94PubMedCrossRef
104.
Fisher A. Sunscreen dermatitis: Part II. The cinnamates. Cutis 1992; 50: 253–4PubMed
105.
106.
Thomson KF, Wilkinson SM. Allergic contact dermatitis to plant extracts in patients with cosmetic dermatitis. Br J Dermatol 2000; 142: 84–8PubMedCrossRef
107.
Coutts I, Shaw S, Orton DI. Patch testing with pure tea tree oil- 12 months experience [abstract]. Br J Dermatol 2002; 147 Suppl. 62: 70
108.
109.
Pasche-Koo F, French L, Pilett-Zanin PA. Contact urticaria and shock to hair dye. Allergy 1998; 53: 904–5PubMedCrossRef
110.
Schalock PC, Storrs FJ, Morrison L. Contact urticaria from Panthenol in a hair conditioner. Contact Dermatitis 2000; 43 (4): 223PubMedCrossRef
111.
Jagtman B. Urticaria and contact urticaria due to Basic Blue 99 in a hair dye. Contact Dermatitis 1996; 35: 52PubMedCrossRef
112.
113.
Niinimaki A, Niinimaki M, Makinen-Kiljunen S, et al. Contact Urticaria from protein hydrolysates in hair conditioners. Allergy 1998; 53: 1078–82PubMedCrossRef
114.
Laube S, Davies MG, Prais L, et al. Allergic contact dermatitis from medium-chain triglycerides in a moisturizing lotion. Contact Dermatitis 2002 Sep; 47 (3): 171PubMedCrossRef
Metadata
Title
Cosmetic Allergy
Incidence, Diagnosis, and Management
Authors
Dr David I. Orton
John D. Wilkinson
Publication date
01-10-2004
Publisher
Springer International Publishing
Published in
American Journal of Clinical Dermatology / Issue 5/2004
Print ISSN: 1175-0561
Electronic ISSN: 1179-1888
DOI
https://doi.org/10.2165/00128071-200405050-00006

Other articles of this Issue 5/2004

American Journal of Clinical Dermatology 5/2004 Go to the issue

Therapy in Practice

Effects of Airbag Deployment

Guest Commentary

Poly-L-Lactic Acid

Therapy in Practice

Folliculitis

Adis Drug Profile

Poly-L-Lactic Acid

Original Research Article

Sympathomimetic Drug Allergy

Leading Article

The Potential Role of Allergen-Specific Sublingual Immunotherapy in Atopic Dermatitis