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
some 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 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
methyldibromoglutaronitrile 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.
Fragrance ingredients are the most frequent cause of cosmetic
allergy, accounting for up to 30–45% of allergic reactions to
cosmetics in eczema patients. As well as being found in products
marketed to provide a scent they are also incorporated into the
majority of other skin care products. Fragrance ingredients can
cause dermatitis at the sites of application and also volatile or
photosensitive patterns of contact dermatitis, but may involve
other sites by direct transfer or even connubial contact.
Managing patients with proven fragrance allergy often proves
extremely difficult. Advising patients to use products labeled as
‘fragrance free’ will not necessary avoid all contact with
fragrance materials due to a discrepancy in the accepted
definition of the term. Fragrance is defined as any substance,
natural or synthetic, used solely to impart an odor to a cosmetic
product. However, if a fragrance material has more than one
function (e.g. preservative or emollient) it could legally still
be included in a fragrance-free product. Although these masking
fragrances are uncommon sensitizers, fragrance-allergic patients
should avoid them wherever possible. These substances include
benzyl alcohol, benzaldehyde, and cyclopentadecanolamide.
Consumers may also be unaware that rose oil, sandalwood oil, and
cedarwood oil are all fragrances and that other essential oils,
flower plant extracts, and flavorings are also usually
fragrances. Therefore, it is important to acknowledge that
natural fragrances and botanical extracts may also cause problems
for the fragrance-allergic individual.
Though further research is needed, a recent study has found that
a common group of chemicals used to preserve deodorants have been
detected in breast-cancer tissue. Researchers at the University
of Reading in England found traces of these chemicals, called
parabens, in 18 out of 20 samples, suggesting that they may be
absorbed by the body after they are applied to the skin. By
reading the ingredients of the products you purchase you can
become educated on what they contain and be able to reduce
unwanted substances.
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