Cosmetics and Skin Care Products

Allergic contact dermatitis to fragrances. Part 1

Fragrances are a large group of substances and the second most common cause of allergic contact dermatitis in Spain. These potential allergens are extremely common and the general population is subject to continuous exposure on a daily basis. While the fragrance markers included in the current Spanish standard patch test series are good, there is room for improvement. New markers that have emerged in recent years have proven to be of value in standard series used in other countries. Diagnosing fragrance allergy has taken on even greater importance since the European Union added 26 fragrances to its list of mandatory ingredients to be specified on product labels. The aim of this review is to provide an update on allergic contact dermatitis to fragrances. We examine the main sources of exposure and clinical manifestations of this condition and propose a diagnostic and treatment protocol.

[Skin sensitizers in cosmetics and skin care products]

Cosmetics are defined as "articles with mild action on the human body, which are intended to be applied to the human body through rubbing, sprinkling or other methods, aiming to clean, beautify and increase the attractiveness, alter the appearance or to keep the skin or hair in good condition (The Pharmaceutical Affairs Law: Article 2)." Consequently, they include personal hygiene products such as shampoos, soaps and toothpaste. In Europe, 1% of the population is estimated to be allergic to fragrances and 2-3% to ingredients of cosmetics; 10% of outpatients patch-tested for cosmetics allergy were found to be positive. Allergenic ingredients of cosmetics can be fragrances, hair dye, preservatives, antioxidants, emollients, surfactants, UV absorbers, pigments or resins used in nail cosmetics. Among standard allergen series, eight substances are related to cosmetics; in Japan in 2003, p-phenylenediamine (hair dyes) induced allergic reactions with the highest rate of 7.9% in outpatients patch-tested (n=805), followed by fragrance mix No. 1 (4.0%, mixture of eight fragrances frequently used), colophony (3.2%, main contents of pine resin), lanolin alcohol (2.7%,emollients), and formaldehyde, parabens, Kathon CG (2.7% ,1.9% and 1.0%, respectively; preservatives). Cosmetic allergy symptoms tend to be mild except those caused by hair dye. However, the population exposed to cosmetics is huge and the number of ingredients used in cosmetics increased up to more than 6000. Here, major cosmetic ingredient allergens, mainly reported in Japan, are reviewed and discussed.

Contact dermatitis: epidemiology and frequent sensitizers to cosmetics

Contact dermatitis is defined as a pattern of inflammatory response that may occur as a result of contact with external factors. The two most common causes are irritants and allergens. Very few reliable data on prevalence and incidence of contact dermatitis exist, and data from the few studies that have been carried out cannot be compared because of differences in methodology. Occupational contact dermatitis constitutes up to 30% of all occupational diseases for which compensation is payable and affects sufferers' home and social lives as well as their working lives. Patients can be advised about the use of personal protective equipment and creams and emollients to avoid or ameliorate their condition, but there is little epidemiological evidence for their efficacy. Patch testing, using the European Standard Series of Allergens, is necessary to determine which agent is responsible for the condition. Fragrances and preservatives used in cosmetics are among the most common allergens in contact allergic dermatitis, although the frequency of contact allergy in the general population is small. It is to be hoped that the European Dermato-Epidemiology Network Fragrance Study will go some way to addressing the need for a large population-based epidemiological study in order that public health organizations can give reliable advice about avoiding and treating contact dermatitis.