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Current cosmetic regulations primarily focus on protecting consumers, not the professional user who is subjected to a partly different, and certainly more intense exposure to hazardous substances. Against this background, this systematic review aims to compile and appraise evidence regarding skin toxicity of 2-hydroxyethyl methacrylate (HEMA; CAS no. 212-782-2) and ethyl cyanoacrylate (ECA; CAS no. 7085-85-0) contained in cosmetic glues used among hairdressers and beauticians who perform nail treatments and eyelash extension as well as hair extension applications. This systematic review followed the Preferred Reporting Items for Systematic review and Meta-Analysis (PRISMA) 2020 recommendations for reporting systematic reviews and meta-analysis. In total, six publications from six countries were eligible for this systematic review. A meta-analysis revealed that hairdressers and beauticians have a ninefold increased risk of developing contact allergy to HEMA compared with controls who are not hairdressers and beauticians. Results for ECA are lacking. The results of this systematic review clearly show that-regarding contact allergy to acrylates-it is not appropriate to apply risk assessment for consumers to hairdressers and beauticians who occupationally handle cosmetic glues. The regulations in existence do not adequately address occupational risks for hairdressers and beauticians connected with the use of acrylate-containing cosmetic substances and need reconsideration., (© 2022 The Authors. Contact Dermatitis published by John Wiley & Sons Ltd.)

Hairdressers are at high risk of developing occupational hand eczema. Opinions on the health and safety concerns of nonfood consumer products, such as cosmetics and their ingredients, consider the exposure of a "common consumer," which may not account for occupational exposure of hairdressers. As a result, there is a parlous scenario in which serious safety concerns about occupational exposures are present. The purpose of this review is to compare the frequency of exposure to various types of hair cosmetic products among hairdressers and consumers. Database searches for this review yielded a total of 229 articles; 7 publications were ultimately included. The analysis showed that-dependent on the task-hairdressers were exposed 4 to 78 times more than consumers to a wide spectrum of hair cosmetic products used in their daily working life, ranging from shampoos, conditioners, oxidative and nonoxidative hair colors, to bleaching agents. The highest frequency was found for coloring hair with oxidative hair color. Consumer use frequency does not appear to be appropriate for representing hairdresser exposure. The current standards do not effectively address the occupational risks associated with hairdressers' use of cosmetics. The findings of this study should cause current risk-assessment procedures to be reconsidered., (© 2022 The Authors. Contact Dermatitis published by John Wiley & Sons Ltd.)

Background: Facial allergic contact dermatitis caused by cosmetic products is common. New allergens in cosmetics continuously emerge., Objectives: To investigate characteristics of patients with facial dermatitis (FD) between 2010 and 2019 including patch test results from cosmetic-related allergens and a new test series with cosmetic-relevant natural ingredients (CRNIs)., Methods: This is a retrospective study analysing demographics, clinical characteristics according to MOAHLFA index (male; occupation; atopic dermatitis; hand; leg; face; age ≥ 40 years), and patch test results to 27 cosmetic-relevant allergens in FD patients. A prospective study evaluating a screening test series with CRNIs in consecutive FD patients for 1 year was also conducted. These patients received a questionnaire for collecting extra characteristics (eg, concerning quality of life)., Results: Of 8740 tested patients, 2292 (26.2%) had FD. Of these, 30.6% had cosmetic-induced FD. The most common cosmetic-related allergens were fragrances and preservatives. The most common patch test-positive CRNIs were hydroperoxides of limonene and linalool, and propolis. Potato and peanut were rare, but the most common prick test-positive CRNIs, however, without any relation to the use of cosmetic products. FD affected nearly all patients' quality of life and caused limitations to their daily life., Conclusions: Updated management and quick diagnosis of FD is important to avoid negative impact on patients' quality of life., (© 2021 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

Background: Naturally derived cosmetic product ingredients of both plant and animal origin are being included increasingly in product formulations in order to cater to consumer preferences. They may be an overlooked cause of reactions to cosmetic products in some patients with dermatitis., Objectives: To identify naturally derived cosmetic product ingredients with allergenic potential (type I and type IV) and propose a cosmetic screening test series., Methods: The study was conducted in two steps. The first step was a market survey using a nonprofit application helping consumers avoid problematic substances in cosmetic products. The application contained 10 067 cosmetic products that were label checked for naturally derived cosmetic product ingredients. The second step was a literature search to examine how frequently the naturally derived ingredients were described and related to allergic reactions in cosmetics or other topically administered products., Results: We identified 121 different naturally derived cosmetic product ingredients that were included in at least 30 cosmetic products. In total, 22 ingredients were selected for a screening test series., Conclusions: We propose a supplemental patch test and a prick test screening series with naturally derived cosmetic product ingredients for patients with skin reactions to cosmetic products, aiming to identify a cause in more patients than is currently possible., (© 2020 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

Background: There is currently no agreed cosmetic series for use across Europe., Objectives: To establish allergens currently tested in local and national cosmetic series., Method: Members of the European Surveillance System on Contact Allergy and the European Cooperation in Science and Technology project TD1206 ("StanDerm") were surveyed to establish their current practice., Results: A wide range of allergens was tested but there was significant variation between centres on the allergens considered to be important in screening for allergy to cosmetics. The number of allergens tested in addition to the baseline series varied between 2 and 50., Conclusions: There is a need for further investigation to establish the frequency and relevance of reactions to cosmetic allergens to enable an agreed evidence-based cosmetic series to be produced. Criteria for inclusion need to be established., (© 2019 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

Background: In view of the current and unprecedented increase in contact allergy to methylisothiazolinone (MI), we characterized and evaluated two recent epidemics of contact allergy to preservatives used in cosmetic products to address failures in risk assessment and risk management., Objective: To evaluate temporal trends of preservative contact allergy., Methods: The study population included consecutive patch tested eczema patients seen at a university hospital between 1985 and 2013. A total of 23 138 patients were investigated for a contact allergy., Results: The overall prevalence of contact allergy to at least one preservative increased significantly over the study period, from 6.7% in 1985 to 11.8% in 2013 (p < 0.001). Importantly, the preservatives methyldibromo glutaronitrile and MI rapidly resulted in high sensitization prevalence rates, which reached epidemic proportions. Although the proportion of patients with current clinical disease attributable to methyldibromo glutaronitrile contact allergy decreased significantly following the ban on its use in cosmetic products (p < 0.001), the sudden and high proportion of current sensitization to MI requires immediate attention (p < 0.001)., Conclusions: The introduction of new preservatives in Europe with inadequate pre-market risk assessment has rapidly increased the overall burden of cutaneous disease caused by preservatives. We suggest that the cosmetic industry has a responsibility to react faster and replace troublesome preservatives when a preservative contact allergy epidemic is recognized, but the European Commission has the ultimate responsibility for failures in risk management after new, major sensitizing preservatives are introduced onto the market., (© 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

Background: Chlorhexidine may cause type I and type IV allergy. Some chlorhexidine-allergic individuals have been exposed in the healthcare setting as patients or healthcare workers, but for others the source of sensitization is unknown. Chlorhexidine may be used as a preservative or an antimicrobial agent in cosmetic products at a concentration up to 0.3%, as set by the European Cosmetics Directive (now Regulations)., Objectives: To identify cosmetic product types containing chlorhexidine, and to measure the concentration of chlorhexidine in selected products., Methods: Between February 2013 and April 2013, we checked for chlorhexidine in cosmetic products in 14 supermarkets, one hairdressing salon and one beauty and retail store in Copenhagen, Denmark by reading the ingredient labels. The chlorhexidine concentration was measured in 10 selected products by high-performance liquid chromatography (HPLC) with an ultraviolet (UV) detector., Results: Chlorhexidine was found in 80 of 2251 checked products (3.6%) in the following categories: hair products (57/760), creams (9/324), face washes (4/24), wet wipes (4/63), skin tonics (3/22), make-up removers (2/25), and mouth washes (1/17). Chlorhexidine concentrations were 0.01-0.15%., Conclusions: We found chlorhexidine in various cosmetic product types, predominantly aimed at females, and in hair products. The measured chlorhexidine concentrations were all within the permitted limit. The relevance for allergic sensitization should be further explored., (© 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

Background: Fragrance ingredients are a frequent cause of allergic contact dermatitis. The EU Cosmetics Directive states that 26 specific fragrance ingredients, known to cause allergic contact dermatitis, must be declared on the ingredient lists of cosmetic products., Objectives: To investigate frequencies of sensitization to the 26 individual fragrances and evaluate their importance as screening markers of fragrance allergy., Method: This was a retrospective study based on data from the Department of Dermato-Allergology, Copenhagen University Hospital Gentofte. Eczema patients (n = 1508) were patch tested (January 2008 to July 2010) with the 26 fragrance ingredients., Results: Sensitization to the 26 fragrances was identified in 115 (7.6%) subjects. The most frequent allergens were Evernia furfuracea (n = 50), Evernia prunastri (n = 31), and hydroxyisohexyl 3-cyclohexene carboxaldehyde (n = 24). Including fragrance mix I, fragrance mix II and Myroxylon pereirae, 196 (13.0%) had a fragrance allergy. Testing with the 26 fragrances additionally identified 23 subjects who would otherwise have gone undetected. The majority (75.7%) of positive reactions to the 26 fragrances were of clinical relevance., Conclusions: Sensitization to the 26 individual fragrance ingredients was identified in 7.6% of the subjects patch tested. Most reactions were of clinical relevance. Fragrance-allergic subjects would be missed if testing with the individual fragrance ingredients was not performed., (© 2011 John Wiley & Sons A/S.)

Background: Methylisothiazolinone (MI) used alone is a new preservative causing a high prevalence of contact allergy. The eliciting threshold of MI is unknown. The combination of MI and phenoxyethanol enhances the antimicrobial efficacy of MI., Objectives: The eliciting doses of MI contact allergy in a patch test and a repeated open application test (ROAT) were investigated. In the patch test, it was determined whether phenoxyethanol influenced the reactivity to MI., Methods: Eleven MI-allergic individuals were patch tested with two dilution series of 12 doses of MI and the same 12 doses with phenoxyethanol. The ROAT mimicked the use of a cream preserved with 100, 50 and 5 ppm MI (corresponding to 0.21, 0.105 and 0.0105 µg MI/cm(2))., Results: Phenoxyethanol had no influence on the reactions to MI. The lowest eliciting dose in the patch test was 1.47 µg MI/cm(2). In the ROAT, 7 patients (64%) reacted to 0.21 and 0.105 µg MI/cm(2) and 2 patients (18%) reacted to 0.0105 µg MI/cm(2), corresponding to a cream preserved with 5 ppm MI., Conclusions: A maximum of 100 ppm MI is permitted in cosmetic products. Eighteen per cent of MI-allergic patients reacted to a concentration 20 times lower in a ROAT. The amounts used in cosmetics should be reduced, and the development of MI contact allergy should be monitored closely., (© 2011 John Wiley & Sons A/S.)

Background: Fragrance mix II (FM II) is a relatively new screening marker for fragrance contact allergy. It was introduced in the patch test baseline series in Denmark in 2005 and contains six different fragrance chemicals commonly present in cosmetic products and which are known allergens., Aim: To investigate the diagnostic contribution of including FM II in the baseline series by comparing it with other screening markers of fragrance allergy: fragrance mix I (FM I), Myroxylon pereirae and hydroxyisohexyl 3-cyclohexene carboxaldehyde (HICC)., Method: Retrospective study of 12 302 patients consecutively patch tested with FM II by members of the Danish Contact Dermatitis Group 2005-2008., Results: FM II gave a positive patch test in 553 patients (4.5%), and in 72.2% of these patients the reaction was judged to be clinically relevant. FM II ranked second in detecting fragrance allergy, after FM I. If FM II had not been included as a screening marker in the baseline series, 15.6% (n = 202) of individuals with fragrance allergy would not have been identified by the other fragrance screening markers (FM I, M. pereirae or HICC)., Conclusion: FM II contributes substantially to detecting fragrance allergy. It ranked second among the fragrance screening markers tested in the baseline series and detects individuals with an allergy who otherwise would not have been identified., (© 2010 John Wiley & Sons A/S.)

Background: Most cosmetics and industrial products contain preservatives. Preservative allergy is common and, historically, changing contact allergy epidemics caused by preservatives have been observed. In 1997, Alan Dillarstone predicted a stable development of preservative allergy following mandatory ingredient labelling on cosmetic products., Objectives: To investigate the development in the prevalence of preservative allergy in Denmark over a 24-year period (1985-2008) and to challenge the prediction made by Dillarstone., Patients/methods: A retrospective analysis of patch test data was performed (n = 18179). Comparisons were made using a chi(2) test. Logistic regression analyses were used to test for associations., Results: The development of preservative allergy mirrored those of other European patch test centres. The development was not dependent on sex or age group. The prevalence was higher among women and those aged 41-60 years. Formaldehyde allergy was persistently prevalent over the study years. The overall prevalence of preservative allergy increased significantly (P(trend) = 0.001), mainly because of patch testing with additional preservatives in recent years., Conclusions: Dillarstone's prediction was confirmed as the prevalence of contact allergy to individual preservatives remained relatively stable. However, the overall burden of preservative allergy seemed to increase. Introduction of new preservatives may add to the burden of contact allergy.

Background: The preservative methyldibromo glutaronitrile (MDBGN) has been banned, first from stay-on, and later from rinse-off cosmetics, in the EU countries because of increasing rates of contact allergy., Objectives: To evaluate the frequency of contact allergy to MDBGN among patients patch tested by the Danish Contact Dermatitis Group just before and following regulatory decisions., Patients/methods: The data set comprised 19 279 consecutive eczema patients patch tested from 2003-2007 with MDBGN 0.3% in petrolatum (pet.) or, in a minority of patients, with Euxyl K 400 1.5% in pet., Results: A significantly decreasing trend in the frequency of positive patch tests to MDBGN was found from 4.6% in 2003 to 2.6% in 2007 (P < 0.001). The decreasing trend was seen for both men and women. A significantly decreasing proportion of cases with a current relevance of contact allergy to MDBGN was also seen from 51.3% in 2003 to 29% in 2007 (P < 0.001)., Conclusions: Regulatory interventions have already had a major effect on allergic disease due to MDBGN in Denmark. The same trends are likely to be seen in other EU countries.

The preservative methyldibromo glutaronitrile (MDBGN) has caused an epidemic of contact allergy in Europe. However, most data concerning contact allergy comes from hospital departments of dermatology. As a part of the primary health care sector, Danish dermatologists in private practice provide the front line of care for patients with skin diseases. Data from this source may therefore better reflect trends in the general population than material from hospital departments of dermatology. In this study, the frequency of MDBGN allergy and the characteristics of patients seen by dermatologists in private practice were studied. In 1 year, 2146 patients were patch tested by the participating dermatologists from 4 clinics in various parts of Denmark. 5% (110) had positive patch tests to MDBGN, with no difference between the sexes. After adjustment was made for other background variables, multivariate analysis using logistic regression showed a significant association between hand eczema and MDBGN allergy (OR 2.5, P < 0.001). In 53 cases (52.4%), the patch test reaction to MDBGN was judged to be of current relevance. Creams and lotions accounted for 31% of the identified causative products and liquid soaps for 23%. It is concluded that contact allergy to MDBGN is frequent among patients seen by dermatologists in private practice. This is consistent with results from hospital departments of dermatology in Europe and indicates a general trend and ongoing epidemic in the general population. The significant relationship between hand eczema and MDBGN allergy is of concern, and the finding that wash-off products, especially liquid soaps, play a significant role in MDBGN allergy calls for a revision of the safety assessment of MDBGN in wash-off products.

An increased frequency of contact allergy to methyldibromoglutaronitrile (MDBGN), a commonly used preservative in cosmetics and other consumer products, has been reported in recent years. A high-performance liquid chromatography (HPLC) method for the determination of MDBGN in cosmetic products has been validated in the present study. The identification is performed by reductive electrochemical detection of the bromine present in the molecule. The method is suitable for compliance testing of cosmetic products as well as for the research to support clinical and epidemiological studies.

Most people in modern society are exposed daily to fragrance ingredients from one or more sources. Fragrance ingredients are also one of the most frequent causes of contact allergic reactions. The diagnosis is made by patch testing with a mixture of fragrance ingredients, the fragrance mix. This gives a positive patch-test reaction in about 10% of tested patients with eczema, and the most recent estimates show that 1.7-4.1% of the general population are sensitized to ingredients of the fragrance mix. Fragrance allergy occurs predominantly in women with facial or hand eczema. These women typically have a history of rash to a fine fragrance or scented deodorants. Chemical analysis has revealed that well known allergens from the fragrance mix are present in 15-100% of cosmetic products, including deodorants and fine fragrances, and most often in combinations of three to four allergens in the same products. This means that it is difficult to avoid exposure, as products labelled as 'fragrance free' have also been shown to contain fragrance ingredients, either because of the use of fragrance ingredients as preservatives or masking perfumes, or the use of botanicals. About 2500 different fragrance ingredients are currently used in the composition of perfumes and at least 100 of these are known contact allergens. Therefore, it is advisable to supplement standard patch testing with the patient's own stay-on cosmetic products, as well as the fragrance chemical hydroxyisohexyl-3-cyclohexane carboxaldehyde, which on its own gives responses in 1-3% of tested patients. The focus in recent years on the ingredients of the fragrance mix will probably result in the fragrance industry changing the composition of perfumes, and thus make the current diagnostic test less useful. New diagnostic tests are under development to identify contact allergy to new allergens, reflecting the continuous developments and trends in exposure.

Introduction: Hairdressers are exposed to wet work and manifold allergens at work, rendering exposure complex and the aetiology of occupational hand eczema (OHE) often multifactorial in this occupational group. Objectives: To identify exposure patterns associated with increased risk of hand eczema in hairdressers. Methods: All hairdressers graduating from 2004 to 2007 and 2015 to 2018 received a questionnaire in 2009 and 2020, respectively. Current exposures (with or without regular glove use) and OHE were self‐reported, and their association examined. Patterns of exposure were identified by latent class analysis (LCA). Results: A total response of 39.9% (668/1675) was obtained. Six exposure profiles (#1–6) were identified by LCA across 11 tasks performed with or without gloves as well as deep conditioning, that is, 23 task items. Compared to profile #1 with the lowest OHE risk (reference) an increased risk of current OHE were seen in profile #4 [adjusted odds ratio [aOR] 6.5, 95% confidence interval [CI] 1.5–44.8 and #6 (aOR 39.4, 95%CI 6.1–362.8)] in logistic regression analysis. Profile #1 and #6 had performed the same tasks, but in profile #6 regular glove use was performed in 9.1% (1/ 11) of tasks compared to 72.7% (8/11) of tasks in profile #1 (p = 0.002). Conclusion: Although occupational exposures in hairdressing are complex, meaningful patterns associated with a wide range of OHE risk can be identified by LCA. The increase of OHE risk seems predominantly to be due to poor compliance with protective gloves. LCA could be applied to further fields of complex (skin) exposures. [ABSTRACT FROM AUTHOR]

Artificial nail modelling systems (ANMS), encompassing artificial nails and long-lasting nail polish, are sources of acrylate exposure in beauticians and users of ANMS. Hairdressers' exposure to ANMS from self-use and occupational exposure is currently unknown. In 2020 a questionnaire was sent to all hairdressers graduating during 2008 to 2018 in Denmark (n = 4,830). Selfuse of ANMS was reported by 87.6% of respondents (1,251/1,428), and application of ANMS to others was reported by 22.1% (316/1,428). Of these, application to others was performed in a salon by 37.1% (109/294), privately by 51.0% (150/294) and in both settings by 11.9% (35/294). Compliance with glove use was seen in 23.0% (67/291) among those applying ANMS to others. Among hairdressers exposed to ANMS, 4.3% (52/1,218) reported ANMS-related hand eczema. Being a trained beautician (adjusted odds ratio 3.26, 95% confidence interval 1.06-9.99) and having had a positive patch-test to acrylates (adjusted odds ratio 7.70, 95% confidence interval 1.44-41.13) were associated with ANMS-related hand dermatitis. In conclusion, hairdressers have a high prevalence of exposure to ANMS and ANMS-related hand dermatitis. Compliance with glove use when applying ANMS to others is poor. Patch-testing with acrylates is valuable in the diagnostic work-up of hand eczema in hairdressers. [ABSTRACT FROM AUTHOR]

Background: Preservatives such as formaldehyde and formaldehyde‐releasers are common causes of contact allergy. Objectives: To examine trends in contact allergy to formaldehyde and formaldehyde‐releasers in patch tested patients in Denmark over a 10‐year period (2007‐2016), and to investigate relevant sources of formaldehyde among the patients. Methods: A cross‐sectional registry study on patch test data from patients tested with formaldehyde and formaldehyde‐releasers (N = 8463) was performed. The presence of released formaldehyde in products from formaldehyde‐allergic patients was identified with chemical analyses (chromotropic acid or acetylacetone test). Results: The prevalence of contact allergy to formaldehyde 1% was 1.5%, and ranged between 0.97% and 2.3%, with a decreasing trend in this 10‐year period. Contact allergy to formaldehyde 2% was found in 2.4%, and no significant trend was observed. Quaternium‐15 was the formaldehyde‐releaser most often positive (0.86%). Patients allergic to formaldehyde often had simultaneous positive patch test reactions to formaldehyde‐releasers (36%). Almost 63% of the patients with formaldehyde allergy used products that released formaldehyde; cosmetics were the most common sources. Conclusions: Although contact allergy to formaldehyde 1% decreased in this 10‐year time period, contact allergies to formaldehyde and formaldehyde‐releasers overall remain frequent in patients. In most cases, formaldehyde‐allergic patients are exposed to ≥1 products containing formaldehyde. Improved regulation on permitted amounts of free formaldehyde in cosmetics is still warranted, including direct labelling of formaldehyde when it is present in small but relevant amounts. [ABSTRACT FROM AUTHOR]

Summary: Background: In 2011, a multicentre study was conducted in order to determine how hair dye manufacturers instructed consumers to perform a self‐test prior to dyeing their hair, in order to identify individuals who are likely to react upon subsequent hair dyeing. A number of concerns were raised concerning the variability in instructions between products and producers, and the safety and validity of this tool. Objectives: To perform a 5‐year follow‐up study in order to determine whether manufacturers still recommend a self‐test, and if so, whether the procedures have been changed. Methods: During March 2016, a total of 40 oxidative hair dye products from 21 different manufacturers were bought in retail stores in 8 European countries. Results: The consumers were instructed to perform a self‐test prior to hair dyeing for 39 of the products; however, the procedures varied greatly regarding the method of application, the amount of hair dye applied, the location and size of the application area, the number of applications, whether or not rinsing was performed after application, the reading times, and how a positive reaction was defined. Conclusions: Self‐testing is still recommended by almost all manufacturers of permanent hair dyes. There are major variations in the instructions, even in products from the same manufacturer. The previously raised concerns regarding safety and validity still remain. [ABSTRACT FROM AUTHOR]

Background The use of methylisothiazolinone ( MI) in cosmetic products has caused an unprecedented epidemic of MI contact allergy. Current data concerning exposures at a European level are required. Objectives To describe demographics and MI exposures for European patients with MI contact allergy. Methods Eleven European dermatology departments from eight European countries prospectively collected data between 1 May and 31 October 2015 among consecutive patients who had positive patch test reactions to MI (2000 ppm aq.). Results A total of 6.0% (205/3434; range 2.6-13.0%) of patients had positive patch test reactions to MI. Dermatitis most frequently affected the hands (43.4%), face (32.7%), arms (14.6%), and eyelids (11.7%); 12.7% had widespread dermatitis. For 72.7% (149/205), MI contact allergy was currently relevant mainly because of exposure to cosmetic products (83.2%; 124/149). Of these 124 patients, 19.5% were exposed to leave-on and rinse-off cosmetic products, 24.8% only to leave-on cosmetic products and 38.9% only to rinse-off cosmetic products containing MI or methylchloroisothiazolinone/ MI. The majority of these (79%) noted onset of their dermatitis between 2013 and 2015. Fifteen patients (7.3%) had previously experienced allergic reactions when they were in newly painted rooms. Conclusion Clinically relevant MI contact allergy remains prevalent across European countries, mainly because of exposure to rinse-off and leave-on cosmetic products. [ABSTRACT FROM AUTHOR]

The article presents a case study of 55-year-old White non-atopic metalworker with the medical history of work-related hand eczema. It notes the allergic contact dermatitis caused by the emulsifying agent 2-Amino-2-methyl-1-propanol (AMP), which is used in metalworking fluids (MWF), and AMP used in cosmetics like hair dyes.

Background The prevalence of contact allergy to the isothiazolinone preservative methylchloroisothiazolinone ( MCI) in combination with methylisothiazolinone ( MI) and MI alone has increased in the last couple of years. Objectives To investigate the prevalence of contact allergy to MI, MCI/ MI and benzisothiazolinone ( BIT) among patch tested patients at Gentofte Hospital, as well as the use of MI in cosmetic products. Methods Patients patch tested with either MI, MCI/ MI or BIT from 2010 to 2012 were included in the study. The MOAHLFA index was registered in all patch tested patients, and relevant exposures were determined in patients with an isothiazolinone allergy. In a market survey, the ingredient labels of cosmetic products were investigated for MI content. Results The prevalence of MI and MCI/ MI contact allergy increased significantly from 2010 to 2012: from 2.0% to 3.7% for MI (n = 2766), and from 1.0% to 2.4% for MCI/ MI (n = 2802). MI-allergic patients had occupational, hand and face dermatitis significantly more often, and were aged > 40 years. Cosmetics were the most common substances causing relevant exposure found in both MCI/ MI-allergic and MI-allergic patients. MI was found in 3.3% of cosmetics on the Danish retail market. Conclusions The increase in MI contact allergy is alarming, and urgent action is needed. [ABSTRACT FROM AUTHOR]

Fragrances frequently cause contact allergy, and cosmetic products are the main causes of fragrance contact allergy. As the various products have distinctive forms of application and composition of ingredients, some product groups are potentially more likely to play a part in allergic reactions than others. To determine which cosmetic product groups cause fragrance allergy among Danish eczema patients. This was a retrospective study based on data collected by members of the Danish Contact Dermatitis Group. Participants ( N = 17716) were consecutively patch tested with fragrance markers from the European baseline series (2005-2009). Of the participants, 10.1% had fragrance allergy, of which 42.1% was caused by a cosmetic product: deodorants accounted for 25%, and scented lotions 24.4%. A sex difference was apparent, as deodorants were significantly more likely to be listed as the cause of fragrance allergy in men (odds ratio 2.2) than in women. Correlation was observed between deodorants listed as the cause of allergy and allergy detected with fragrance mix II (FM II) and hydroxyisohexyl 3-cyclohexene carboxaldehyde. Deodorants were the leading causes of fragrance allergy, especially among men. Seemingly, deodorants have an 'unhealthy' composition of the fragrance chemicals present in FM II. [ABSTRACT FROM AUTHOR]

Background: Methylchloroisothiazolinone/methylisothiazolinone (MCI/MI) has been one of the most frequent sensitizers since the 1980s. In 2005, the use of MI alone was approved for the preservation of cosmetic and household products in the EU. Before that, MI was used in industrial products, and the first cases of isolated MI contact allergy were published. Objectives: To present the prevalence and causes of MI contact allergy. Materials and methods: Patch test results from 2536 dermatitis patients tested with MI at Gentofte University Hospital between May 2006 and February 2010 were analysed. A retrospective investigation of medical records from MI-allergic patients was performed to reveal the causes of their MI contact allergy. Results: Of patch-tested patients, 1.5% had MI contact allergy. It was associated with occupational dermatitis, hand eczema and age above 40 years. Exposure to MI in cosmetic products was found in 12 (32%) cases, and exposure to MI in occupational products was found in 11 (30%) cases; 5 of the 11 were painters. Conclusions: The prevalence of MI contact allergy is already at the same level as that of other sensitizing preservatives, which have been on the market for several years, but no rising trend was identified. MI contact allergy was associated with both occupational and consumer products. [ABSTRACT FROM AUTHOR]

Background: Formaldehyde and formaldehyde-releasers are widely used in consumer products and may often cause contact allergy. Objective: To investigate the prevalence of concomitant contact allergy to formaldehyde and formaldehyde-releasers in dermatitis patients, and to determine the sources of formaldehyde exposure based on personal and occupational products obtained from dermatitis patients. Methods: Patch test data from referred dermatitis patients with a positive patch test reaction to formaldehyde or formaldehyde-releasers were analysed. For the period 2000–2008, the formaldehyde content in products obtained from formaldehyde-allergic patients was analysed by chromotropic acid test and/or acetylacetone test. Results: Patients allergic to a formaldehyde-releaser often had simultaneous contact allergy to formaldehyde. Other combinations were also prevalent. In patients who reacted to more than two formaldehyde-releasers, nearly all reacted simultaneously to formaldehyde. Seventy-five percent of the formaldehyde-allergic patients used a product that contained formaldehyde. The main source of formaldehyde exposure was cosmetics (78%). Conclusions: Concomitant contact allergy to formaldehyde and formaldehyde-releaser remains common. Furthermore, contact allergy to a formaldehyde-releaser was nearly always concomitant with another formaldehyde-releaser. Formaldehyde was commonly found in personal products used by formaldehyde-allergic patients. [ABSTRACT FROM AUTHOR]

Axillary dermatitis is common and overrepresented in people with contact allergy to fragrances. Many people suspect their deodorants to be the incriminating products. In order to investigate the significance of isoeugenol in deodorants for the development of axillary dermatitis when used by people with and without contact allergy to isoeugenol, patch tests with deodorants and ethanol solutions with isoeugenol, as well as repeated open application tests (ROAT) with roll-on deodorants with and without isoeugenol at various concentrations, were performed in 35 dermatitis patients, 10 without and 25 with contact allergy to isoeugenol. A positive ROAT was observed only in patients hypersensitive to isoeugenol (P < 0.001) and only in the axilla to which the deodorants containing isoeugenol had been applied (P < 0.001). Deodorants containing isoeugenol in the concentration range of 0.0063–0.2% used 2 times daily on healthy skin can thus elicit axillary dermatitis within a few weeks in people with contact allergy to isoeugenol. [ABSTRACT FROM AUTHOR]

The preservative methyldibromo glutaronitrile (MDBGN) has caused an epidemic of contact allergy in Europe. However, most data concerning contact allergy comes from hospital departments of dermatology. As a part of the primary health care sector, Danish dermatologists in private practice provide the front line of care for patients with skin diseases. Data from this source may therefore better reflect trends in the general population than material from hospital departments of dermatology. In this study, the frequency of MDBGN allergy and the characteristics of patients seen by dermatologists in private practice were studied. In 1 year, 2146 patients were patch tested by the participating dermatologists from 4 clinics in various parts of Denmark. 5% (110) had positive patch tests to MDBGN, with no difference between the sexes. After adjustment was made for other background variables, multivariate analysis using logistic regression showed a significant association between hand eczema and MDBGN allergy (OR 2.5,P < 0.001). In 53 cases (52.4%), the patch test reaction to MDBGN was judged to be of current relevance. Creams and lotions accounted for 31% of the identified causative products and liquid soaps for 23%. It is concluded that contact allergy to MDBGN is frequent among patients seen by dermatologists in private practice. This is consistent with results from hospital departments of dermatology in Europe and indicates a general trend and ongoing epidemic in the general population. The significant relationship between hand eczema and MDBGN allergy is of concern, and the finding that wash-off products, especially liquid soaps, play a significant role in MDBGN allergy calls for a revision of the safety assessment of MDBGN in wash-off products. [ABSTRACT FROM AUTHOR]

Chloroatranol and atranol have been identified as the main allergens in the fragrance material of botanical origin, oak moss absolute. A previous study has shown that nearly all individuals sensitized to chloroatranol will elicit to 5 jig/mi. in a repeated open application test and that 50% will get a reaction to 0.15 µg/ml under patch test conditions. Thus, chloroatranol is known as a potent allergen. The aim of the current investigation was to quantify exposure to chloroatranol and the chemically related substance atranol in some popular perfumes, eaux de parfum and eaux de toilette available on the European market. In total, 31 products were analysed by liquid chromatography-electrospray ionization-tandem mass spectrometry (LC-ESI-MS-MS) for their contents of atranol and chloroatranol. The 2 substances were found in 87% (n = 27) of the products. The median concentration of atranol in perfumes was 0.502 µg/ml and 0.012 µg/ml in eaux de toilette, and 0.235 µg/ml and 0.006 µg/ml for chloroatranol, respectively, in perfumes and eaux de toilette. Chloroatranol was found at a maximum concentration of 53 µg/ml and atranol at one of 190 µg/ml. The wide exposure to oak moss allergens, together with significant amounts of these potent allergens in at least half of perfumes and some eaux de toilettes explains the high frequencies of oak moss absolute allergy. It is suggested that regulations should be introduced aimed directly at these substances, and not just at oak moss absolute. [ABSTRACT FROM AUTHOR]

In the present study, we have investigated 42 cosmetic products based on natural ingredients for content of 11 fragrance substances; geraniol, hydroxycitronellal, eugenol, isoeugenol, cinnamic aldehyde, cinnamic alcohol, α-amylcinnamic aldehyde, citral, coumarin, dihydrocoumarin and α-hexylcinnamic aldehyde. The study revealed that the 91% (20/22) of the natural ingredients based perfumes contained 0.027%-7.706% of 1 to 7 of the target fragrances. Between 1 and 5 of the chemically defined synthetic constituents of fragrance mix were found in 82% (18/22) of the perfumes, 35% (7/20) of the other cosmetic products (shampoos, creams, tonics, etc.) were found to contain 0.003-0.0820% of 1 to 3 of the target fragrances. Relatively high concentrations of hydroxycitronellal, coumarin, cinnamic alcohol and αamyl cinnamic aldehyde were found in some of the investigated products. The detection of hydroxycitronellal and α-hexylconnamic aldehyde in some of the products demonstrates that artificial fragrances, i.e. compounds not yet regarded as natural substances, may be present in products claimed to be based on natural ingredients. [ABSTRACT FROM AUTHOR]

The article discusses five cases of isothiazolinones-induced chronic dermatitis. The patients include a 47-year-old male who does not have a previous skin disease's history, a 35-year-old male whose patch test reaction to benzisothiazolinone (BIT) was positive, and a 42-year-old healthy female. It suggests that the cases reveal the increasing problem with isothiazolinones-induced contact allergy.

The article presents a study which focuses on the investigation of the occurrence of contact allergy to hydroxyisohexyl 3-cyclohexene carboxaldehyde (HICC) among eczema patients. It says that the evaluation and recording of the clinical relevance were according to the standardized guidelines set by the Danish Contact Dermatitis Group (DCDG). Results show that the positive patch test reaction to HICC is more significant in women than in men.

The article presents two case studies of allergic contact dermatitis caused by exposure to methyldibromo glutaronitrile (MDBGN) in a cleaning detergent and sunscreen agent. The first case was that of a 62-year-old woman, who was presented with chronic hand eczema and periodic flares during the past 3 years. Another case involved a 41-year-old woman who complained of a generalized eczematous rash starting during a 1-month vacation in Guatemala.

A case study of 9-year-old non-atopic boy developed eczema on his face, chest, arms and legs, after his bedroom had been painted with Flügger Flutex. is presented. It discusses importance of a complete declaration of isothiazolinones in products beyond cosmetics. It further discusses risk of sensitization for contact allergens.

The article presents a case study of a 9-year-old boy who developed severe vesicular and bullous dermatitis on his arms and trunks caused by a temporary henna tattoo. He was diagnosed with acute allergic contact dermatitis and was treated with topical corticosteroids and clobetasone under occlusion by his general physician.

The article presents a case study of a three-year-old boy who was referred to the hospital with a recurrent itching rash in August 2012. It says that episodes of itching rash appeared when wipe preserved with isothiazolinone was used in the patient. It adds that erythematous eczema in the popliteal fossa and on the dorsal surfaces of the hands were revealed by his physical examination. Moreover, the eczema has improved during the short-term treatment using topical steroid.