Fragrance and Cosmetic Contact Allergy in Children

A review of the key ingredients in industrial formulations of baby wet wipes

The skin of newborns is classified as sensitive, with a higher risk of skin barrier disruption and irritation of a diapered area. Despite dermatologist recommendations to use only water and a cloth for cleaning, most of the population still relies on the comforts of modern parenting, which includes intensive daily usage of baby wet wipes. Novel baby formulations are designed following the concept of infant skin health, containing a gentle cleanser, suitable emollient, and buffer system enabling a slightly acidic pH value and they are free of ethyl alcohol. Thus, it is important to understand the chemical background of such a complex liquid formulation, with emphasis on its safety. In line with this, the present paper discusses the scientific background of various chemical compounds found in baby wipe formulations to improve the understanding of wet wipe designs and direct them toward more skin-friendly solutions.

Adverse Cosmetic Reactions in a Pediatric Population Reported to the Chongqing Drug Administration in China From 2017 to 2021

Background: Despite their ubiquitous use and several safety incidents involving cosmetics for children in China, there is little research on adverse reactions to cosmetics in children. Objectives: We assessed the cosmetic adverse reactions (CARs) reports submitted to the Chongqing Drug Administration in China for children, to understand the characteristics of CARs in a pediatric population and determine whether useful insights can be derived. Methods: We extracted the data file of the Chongqing Drug Administration's cosmetic adverse events reporting system from 2017 to 2021, and screened the information of people under the age of 18 years for analysis. Results: A total of 589 children were reported; of them, 475 female children and 114 male children, aged 1-17 years, and 89.6% were diagnosed with cosmetic contact Dermatitis. Itching and burning were the most prominent symptoms and accounted for 83.4% and 40.2%, respectively. The most frequently reported clinical sign was erythema (73.3%) followed by papule (37.9%). The face is the most vulnerable location to lesions, accounting for 80.8% of all areas, with girls having a significantly higher rate of facial and scalp damage than boys. The majority of the CARs were reported with cream, lotion, and toner for the skin (45.9%) and facial or body cleansing products (15.4%), and most of these products were purchased from authoritative shops. Conclusion: Although adults are the main group of people who use cosmetics, due to the special physiological structure of children, the safety of children's cosmetics should be given more attention. In addition, pediatricians and dermatologists should be active in submitting reports of adverse cosmetic events and encouraging consumers to do so likewise in situations in which a product adversely affects a child's health.

Usage of Children's Makeup and Body Products in the United States and Implications for Childhood Environmental Exposures

There is growing evidence of toxicity associated with ingredients found in cosmetics and personal care products. Children's makeup and body products (CMBPs) are widely marketed to children throughout the US; however, little is known about how and why children use them. We administered a survey to parents/guardians of children aged ≤12 years about the use of CMBPs. Among all the children (n = 312) of survey respondents (n = 207), 219 (70%) have used CMBPs in their lifetime. Older children used CMBPs at higher rates than younger children, and female children used CMBPs at higher rates than male children. Children of Hispanic/Latinx parents/guardians used CMBPs more often and for shorter durations and a greater proportion used lip, hair, and fragrance products than children of non-Hispanic parents/guardians. Approximately half the children that use CMBPs were reported to use them with play intentions. Compared to children of non-Hispanic parents/guardians, children of Hispanic/Latinx parents/guardians reported more play motivations for CMBP use. Using qualitative analysis approaches, responses suggest CMBPs are commonly used for fun or play activities. This mixed methods analysis serves as an introduction to understanding early life exposures to this unique and understudied class of products.

Pediatric allergic contact dermatitis. Part I: Clinical features and common contact allergens in children

Allergic contact dermatitis (ACD), a delayed hypersensitivity skin reaction to environmental allergens, has a prevalence that is similar in children and adults. However, diagnostic testing for ACD in pediatric populations accounts for less than one tenth of all patch tests. The relative infrequency of pediatric patch testing may be attributed to the difficulty in testing in this population, which includes a smaller surface area for patch test placement and maintaining cooperation during patch testing, especially in younger children. Diagnosis can be difficult in children because the appearance of ACD can mimic other common pediatric skin conditions, particularly atopic dermatitis and irritant contact dermatitis. Comprehensive history taking, guided by patient presentation, age group, and location of dermatitis, helps build clinical suspicion. Such clinical suspicion is one of the major reasons behind patch testing, with additional indications being recalcitrant dermatitis and dermatitis with atypical distribution. US pediatric data have shown the top allergens to be metals, fragrances, topical antibiotics, preservatives, and emollients. These trends are important to recognize to guide management and accurate diagnosis, because ACD tends to persist if the allergen is not identified and can affect patients' quality of life.

Patch testing in Israeli children with suspected allergic contact dermatitis: A retrospective study and literature review

BACKGROUND/OBJECTIVES

Childhood allergic contact dermatitis is recognized as a significant clinical problem. The objective was to evaluate the rate of positive patch tests in Israeli children with clinically suspected allergic contact dermatitis, identify possible sex and age differences, compare results with those in Israeli adults, and review pediatric studies in the literature.

METHODS

The study sample included 343 children and adolescents (197 female, 146 male; 1-18 years of age, mean age 11.8 years) with clinically suspected allergic contact dermatitis who underwent patch testing with a standard pediatric series of 23 allergens at a tertiary medical center from 1999 to 2012. Data on clinical characteristics and test results were collected retrospectively from the medical files.

RESULTS

Ninety-eight subjects (28.6%) (75 girls [38.1%], 23 boys [15.8%]) had at least one positive reaction. The most frequent reactions were to nickel sulfate, followed by potassium dichromate and cobalt chloride. Nickel sulfate sensitivity was more common in girls, especially those younger than 3 years and older than 12 years. The prevalence of contact sensitization was similar in subjects with and without atopic dermatitis (50% and 51%, respectively).

CONCLUSION

Nickel is the most common allergen in Israeli children, especially girls. Patch testing should be performed in children with clinically suspected allergic contact dermatitis regardless of atopic background.