Allergy to Cosmetics: A Literature Review

Occurrence of p-phenylenediamine antioxidants in human urine

General populations are widely exposed to various p-phenylenediamine antioxidants (PPDs). N-(1,3-dimethylbutyl)-N'-phenyl-p-phenylenediamine (6PPD), a typical p-phenylenediamine antioxidant, has been detected in human urine samples. However, the occurrence of other widely used PPDs in human urine is still unclear. This study comprehensively characterized the occurrence of 9 PPDs in human urine from 151 Chinese adults. Our results showed that all target PPDs were detected in human urine samples, with the total concentrations of PPDs ranging from 0.41 to 38 ng/mL. PPDs in human urine was dominated by 6PPD (mean 1.2 ng/mL, range < LOD - 3.8 ng/mL), followed by N-phenyl-N'-cyclohexyl-p-phenylenediamine (CPPD; 0.85 ng/mL, Collapse

Key Words

• 6PPD
• Human exposure
• Human urine
• PPDs
• Synthetic antioxidants

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MESH Headings

• Adult
• Humans
• Male
• Female
• Antioxidants
• Phenylenediamines
• Nitro Compounds

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Affiliation(s)

Weili Mao Department of Pharmacy, Quzhou Affiliated Hospital of Wenzhou Medical University, Quzhou People's Hospital, Quzhou, Zhejiang 324000, PR China
Hangbiao Jin Key Laboratory of Microbial Technology for Industrial Pollution Control of Zhejiang Province, College of Environment, Zhejiang University of Technology, Hangzhou, Zhejiang 310032, PR China; Innovation Research Center of Advanced Environmental Technology, Eco-Industrial Innovation Institute ZJUT, Quzhou, Zhejiang 324400, PR China
Ruyue Guo Key Laboratory of Microbial Technology for Industrial Pollution Control of Zhejiang Province, College of Environment, Zhejiang University of Technology, Hangzhou, Zhejiang 310032, PR China
Ping Chen Department of Pharmacy, Quzhou Affiliated Hospital of Wenzhou Medical University, Quzhou People's Hospital, Quzhou, Zhejiang 324000, PR China
Songyang Zhong Department of Pharmacy, Quzhou Affiliated Hospital of Wenzhou Medical University, Quzhou People's Hospital, Quzhou, Zhejiang 324000, PR China
Xilin Wu Department of Pharmacy, Quzhou Affiliated Hospital of Wenzhou Medical University, Quzhou People's Hospital, Quzhou, Zhejiang 324000, PR China.

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Analysis and Reporting of Adverse Drug Reactions of Cosmetics at a Tertiary Care Hospital

Background and objectives Cosmetovigilance is a term used for the activities related to the collection, evaluation, and monitoring of spontaneous reports of undesirable events observed during or after normal or reasonably foreseeable use of a cosmetic product. It is now considered a part of the public health system to determine the toxicity of cosmetic products. India has a pharmacovigilance system that monitors adverse drug reactions. Adverse effects due to the use of cosmetic products are undernumbered and a rigorous vigilant system is necessary to check the unmet needs of our country. Hence keeping the above in view, the study was conducted. Material and methods Patients of any gender, aged above 18 years, reporting adverse reactions to cosmetics at the study site were included in the study. The adverse reactions to cosmetics were noted. The causality of the observed adverse cosmetic reactions (ACRs) was done by the European Cosmetic, Toiletry and Perfumery Association (COLIPA) and Product Lifecycle Management (PLM) methods. Results A total of 120 patients were included in the study. The cosmetic products used by the patients were mainly face care products (n=144) followed by make-up care products (n=126). A total of 121 types of ACRs were reported. The majority of the ACRs were caused by products involved in facial care (62; 51.2%) followed by personal care products (20; 16.5%). In the causality assessment of the ACRs using the COLIPA method, 49.4% of patients were categorized as likely, and using the PLM method, 59% of the events were categorized as probable. Conclusion Most of the ACRs were caused by face care products and acne was reported as the most frequently occurring ACR. Awareness programs regarding the reporting of ACRs should be encouraged among cosmetic users and stakeholders.

Screening Allergenic Potencies of Skin-Contact Products Using the Human-Derived THP-1 Cell Activation Test

With the prevalence of allergic contact dermatitis (ACD) from the usage of skin-contact products, like wearable, skin care, and hair care products, screening their skin sensitizing potential is necessary, for the sake of alleviating the consequent public health impact. In the present study, a total of 77 skin-contact products classified by four categories, watch bands (WBs), skin care products (SCPs), hair care products (HCPs), and rubber gloves (RGs), were investigated, using an optimized in vitro assay of human cell line activation test (h-CLAT). Extracting the products using neutral artificial sweat simulated well the practical usage scenarios, and testing the extracts showed that 26 of them were allergy test positive, including nine WBs, six SCPs, two HCPs, and nine RGs. The allergenic response was mainly characterized by the induction of CD54 expression, and diverse paradigms of CD54 and CD86 levels were observed by analyzing dose-response curves, which could also be influenced by the compromised viability of the THP-1 cells. The data implicated the intricate regulation by different contributors to suspicious ingredients in the test samples. Altogether, a promising methodology for testing skin allergy potential was well established for commonly used commodities by neutral artificial sweat extraction coupled with h-CLAT screening. The findings would be of great help in tracing the potential allergens in practical products and improving their qualities.

Analysis of Adverse Reactions of Cosmetics in Chinese Han Population in Recent Five Years

Background

There are still some gaps in the summary and generalization of cosmetic-related adverse reaction reports.

Objective

The aim of this study is to summarize and analyze the occurrence of cosmetic adverse reactions in Shanghai Han population by using available survey data.

Materials and Methods

Collection, statistics and analysis of patients with cosmetic adverse reactions in Shanghai Huashan Hospital from 2017 to 2021.

Results

Among the 1004 patients, most of them (96.71%) were diagnosed as cosmetic contact dermatitis, which often occurred within 3 days of using cosmetics (51.79%). A total of 260 patients were tested with patch test, but the compliance rate was only 18.08%. Among them, 240 patients underwent additional European standard allergen tests, and positive allergens were detected in 210 cases (87.5%). Univariate analysis revealed that dosage form (emulsion and cream), age (≤25 years) and the allergic ingredients triethanolamine, rose oil, propylene glycol, thiomersal and musk ambrette are associated with the occurrence of cosmetic adverse reactions within seven days. A logit prediction model was also successfully constructed: Logit (P) = 1.710-0.796×1 + 1.185×2 -3.650X3-1.335X4.

Conclusion

This study complements the data reported on cosmetic adverse reactions in the Chinese Han population and suggests that in future clinical diagnosis and data collection, emphasis should be placed on patch testing, combining the patch test with cosmetic protoplast with the European standard allergen test to improve the detection rate.

The Role of Sex and Gender in Dermatology - From Pathogenesis to Clinical Implications

BACKGROUND

Sex and gender have increasingly been recognized as significant risk factors for many diseases, including dermatological conditions. Historically, sex and gender have often been grouped together as a single risk factor in the scientific literature. However, both may have a distinct impact on disease incidence, prevalence, clinical presentation, severity, therapeutic response, and associated psychological distress.

OBJECTIVES AND PROJECT DESCRIPTION

The mechanisms that underlie differences in skin diseases between males, females, men, and women remain largely unknown. The specific objectives of this review paper are:To highlight the biological differences between males and females (sex), as well as the sociocultural differences between men and women (gender) and how they impact the integumentary system.To perform a literature review to identify important sex- and gender-related epidemiological and clinical differences for various skin conditions belonging to a range of disease categories and to discuss possible biological and sociocultural factors that could explain the observed differences.To discuss dermatological skin conditions and gender-affirming treatments within the transgender community, a population of individuals who have a gender identity which is different than the gender identity they were assigned at birth.

FUTURE IMPACT

With the rising number of individuals that identify as non-binary or transgender within our increasingly diverse communities, it is imperative to recognize gender identity, gender, and sex as distinct entities. By doing so, clinicians will be able to better risk-stratify their patients and select treatments that are most aligned with their values. To our knowledge, very few studies have separated sex and gender as two distinct risk factors within the dermatology literature. Our article also has the potential to help guide future prevention strategies that are patient-tailored rather than using a universal approach.

Development of Sustainable Hydrophilic Azadirachta indica Loaded PVA Nanomembranes for Cosmetic Facemask Applications

Nanofiber-based facial masks have attracted the attention of modern cosmetic applications due to their controlled drug release, biocompatibility, and better efficiency. In this work, Azadirachta indica extract (AI) incorporated electrospun polyvinyl alcohol (PVA) nanofiber membrane was prepared to obtain a sustainable and hydrophilic facial mask. The electrospun AI incorporated PVA nanofiber membranes were characterized by scanning electron microscope, Ultraviolet-visible spectroscopy (UV-Vis) drug release, water absorption analysis, 2,2-diphenyl-1-picrylhydrazyl (DPPH) scavenging, and antibacterial activity (qualitative and quantitative) at different PVA and AI concentrations. The optimized nanofiber of 376 ± 75 nm diameter was obtained at 8 wt/wt% PVA concentration and 100% AI extract. The AI nanoparticles of size range 50~250 nm in the extract were examined through a zeta sizer. The water absorption rate of ~660% and 17.24° water contact angle shows good hydrophilic nature and water absorbency of the nanofiber membrane. The UV-Vis also analyzed fast drug release of >70% in 5 min. The prepared membrane also exhibits 99.9% antibacterial activity against Staphylococcus aureus and has 79% antioxidant activity. Moreover, the membrane also had good mechanical properties (tensile strength 1.67 N, elongation 48%) and breathability (air permeability 15.24 mm/s). AI-incorporated nanofiber membrane can effectively be used for facial mask application.

Development and Validation of an Instrument to Appraise the Tolerability, Safety of Use, and Pleasantness of a Cosmetic Product

Background: Acceptability tests are designed to demonstrate that there is no chance that cosmetics would irritate or distress users in day-to-day situations. Objectives: to develop and validate a tool or scale that dermatologists, general practitioners, and other healthcare professionals can employ to assess a cosmetic product’s tolerability, safety of usage, and pleasantness. Methods: A three-step modified Delphi technique was used in the consensus process. Two rounds of online surveys and a final face-to-face meeting were performed. Fifty experts for the Delphi panel were chosen to reflect a holistic array of expertise and perspectives in pharmacovigilance, dermatology, and cosmetic safety assessments. In round 1, 80 statements and 115 statements related to skin tolerance and cosmetic safety/efficacy, respectively, were distributed to all members of the expert panel. The expert panel was asked to rate the extent to which they agreed with each statement in the questionnaire using a 5-point Likert scale and given a chance to include a remark beside each item. A statement had to receive 80% of the panel’s approval to be accepted. Results: A total of 50 professional experts were recruited in the Delphi questionnaire rounds (response rate = 63%). The expert panel reached a consensus on 30 statements to evaluate skin tolerability and 34 statements to evaluate cosmetic safety and efficacy (agreement rate level ≥ 80%). The experts also proposed a generic, systematic approach that would allow patients to report both functional and physical symptoms in addition to those discovered during an examination (clinical signs). The confrontation of these symptoms determines whether the investigated cosmetic product is ultimately cutaneously acceptable. Conclusion: The tool that was proposed during this study offered good content validity. Future studies are recommended to test the developed tools in practice to evaluate the good skin compatibility and the safety and quality of cosmetics in the UAE and other nations.

Occurrence of Allergens in Cosmetics for Sensitive Skin

Sensitive skin is characterized by symptoms such as stinging and tingling in response to stimuli that usually do not cause unpleasant sensations. Epidemiological studies show that individuals with sensitive skin are more prone to developing skin allergies, although the link between both conditions is unknown. Aiming to evaluate the presence of allergens in facial-skin products for sensitive skin, a pool of 88 cosmetic products from international brands marketed in pharmacies and parapharmacies was analyzed. A list of allergens identified in product labels was compiled and grouped according to their function. Fragrances were the most common allergens, followed by skin-conditioning agents, surfactants, and preservatives. Fragrances presenting the highest use percentages were linalool, benzyl alcohol, geraniol, and citronellol. Overall, the majority of cosmetic formulations were absent of fragrance allergens, being present only in 7% of products. Other allergens were found in most products (95%). This finding should be interpreted with caution, since many of these compounds are rare sensitizers and studies demonstrating their risk for individuals with sensitive skin are lacking. With this study, useful information for health professionals is provided to support their advice and to help consumers choosing cosmetic products.

Facial contact dermatitis caused by cosmetic-relevant allergens

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.

Contact Dermatitis Associated With Hair Care Products: A Retrospective Analysis of the North American Contact Dermatitis Group Data, 2001-2016

BACKGROUND

Hair care products (HCPs) may cause both allergic contact dermatitis (ACD) and irritant contact dermatitis (ICD).

OBJECTIVES

The aims of the study were to determine the prevalence of HCP-associated ICD/ACD and to characterize relevant allergens.

METHODS

This study is a retrospective analysis of North American Contact Dermatitis Group (NACDG) patch test data, 2001-2016.

RESULTS

Of 38,775 patients tested, 3481 (9.0%) had positive patch test reactions associated with HCPs. The HCP-positive patients were significantly more likely to be female (79.9% vs 66.0%) and/or have primary sites of dermatitis on the face (32.0% vs 27.8%) or scalp (15.4% vs 2.2%) compared with the HCP-negative patients (P < 0.0001). Of 4908 HCP-associated positive patch test reactions, 86.9% (n = 4263) were due to allergens on the NACDG screening series; p-phenylenediamine (35.8%), methylisothiazolinone (9.7%), methylchloroisothiazolinone/methylisothiazolinone (8.7%), and cocamidopropyl betaine (5.9%) were the most frequent. Most reactions (87.7%, 3736/4263) were currently clinically relevant. The most common job associated with 366 occupationally related NACDG HCP-associated allergens was hairdresser/cosmetologist (71.9%). Two hundred eighty-two patients (0.7%) had ICD associated with HCPs. Shampoo/conditioners were the most frequent source of NACDG HCP-associated reactions (47.3%) and HCP-associated ICD (45.0%).

CONCLUSIONS

Of the HCP-positive patients, 18.5% had HCP reactions to allergens not on the NACDG screening series, underscoring the importance of patch testing to expanded series in patients suspected of HCP allergy.

Application of Newly Synthesized Sulfobetaine Based on Sweet Almond Oil in Bath Liquids for Sensitive Skin

Three formulations for bath liquids were developed, differing in the type of amphoteric surfactant applied. The formulations used Cocamidopropyl Betaine, Cocamidpropyl Hydroxide and newly synthesized sulfobetaine based on sweet almond oil (Oleicamidopropyl Sultaine). The molecular structure of the surfactant used in the manufactured formulations has a negatively charged sulfonate group and a positively charged quaternary nitrogen atom. Such molecular structures suggest that the functional properties of this substance are mild. Based on the research, it was found that the bath fluid containing the newly synthesized sulfobetaine based on sweet almond oil had the lowest zein number, the lowest pH increase of bovine albumin solution and the lowest ability to emulsify fatty dirt. This indicates a very low irritant effect of the tested bath liquid.

Allergic contact dermatitis to cosmetics: retrospective analysis of a population subjected to patch tests between 2004 and 2017

Background

Cosmetics are part of the daily life of the population, and their use can lead to allergic contact dermatitis.

Objectives

To assess the profile of patients diagnosed with allergic contact dermatitis to cosmetics treated at a referral center for 13 years, as well as the characteristics of the clinical picture and allergens involved.

Methods

This was a retrospective study, with analysis of medical records of patients attended at this service. The individuals included had a diagnostic hypothesis of allergic contact dermatitis to cosmetics and had previously been submitted to epicutaneous tests.

Results

A total of 1405 medical records were analyzed, 403 (28.7%) with suspected allergic contact dermatitis to cosmetics and 232 (16.5%) with confirmed diagnosis. Of these, 208 (89.7%) were women, and the age group most affected was 31 − 60 years. The most common locations were face in 195 cases (25.8%), cervical region in 116 (15.3%), and trunk in 96 (12.6%). The main allergens in the contact tests were toluene-sulfonamide-formaldehyde resin in 69 cases (29.7%), paraphenylenediamine in 54 (26.3%), Kathon CG® in 41 (20.7%), and fragrance-mix 1 in 29 (16.4%). In 154 (66.4%) of the 232 patients with a confirmed diagnosis of allergic contact dermatitis to cosmetics it was possible to specify the cosmetic product responsible for the lesions.

Study limitations

The absence of some allergens considered important in the world as causes of allergic contact dermatitis, which are not readily accessible among us.

Conclusions

The data of the analyzed population (predominance of young women), as well as the location of the lesions (face and cervical area) and the main allergens involved were consistent with those from the world literature.

Skin irritation potential of cosmetic preservatives: An exposure-relevant study

BACKGROUND

Preservatives represent one of the main causes of skin irritation and contact allergies.

AIMS

To comprehensively evaluate the skin irritation potential of phenoxyethanol, methylparaben, propylparaben, imidazolidinyl urea, and DMDM hydantoin under regulatory acceptable concentrations.

METHODS

A patch test and repeated open application test (ROAT) were applied to evaluate skin irritation in vivo. In vitro alternative methods consisting of the keratinocyte cytotoxicity assay, red blood cell (RBC) test, and hen's egg test-chorioallantoic membrane (HET-CAM) were performed to elucidate the mechanism of preservative-induced irritation responses.

RESULTS

The patch test showed that all test substances showed a weak erythema response. Propylparaben had the highest occlusive irritancy potential in the patch test, owing to damage to the cell membrane. The two formaldehyde releasers showed noticeable skin irritation potential in the ROAT through their cytotoxicity to keratinocytes, while a visible response was observed after applying phenoxyethanol and the two parabens. No filtration was noticed in the in vivo tests, which might be attributed to the failure of subcutaneous vessel alteration by the preservatives.

CONCLUSIONS

Commonly used cosmetic preservatives have minor skin irritation potential with mild erythema reaction under practical use, especially formaldehyde releasers and propylparaben.

An observational study on adverse reactions of cosmetics: The need of practice the Cosmetovigilance system

Introduction

Cosmetovigilance is public health surveillance on cosmetic products with a public health objective. Since the radical development in beautifying products in Saudi Arabia, the Saudi Food and Drug Authority takes the responsibility of regulating cosmetic products and issuing guidelines to ensure its safety. Despite this, there exists a lacuna of Re published reports on cosmetics-related adverse reactions in the Saudi population. We aimed to assess self-reported adverse reactions in the general public of the Eastern Province, Saudi Arabia.

Materials and Method

A cross-sectional study was conducted for three months. The questionnaire for data collection was adopted and modified from previous studies for the cosmetic utilization behaviors and adverse reactions.

Results

Among the 425 participants, 50.6% reported that they had at least one adverse reaction in the past two years. Redness of the skin (19%), pimples (15%), and itching (13%) were the commonly reported adverse reactions. The majority of the adverse reactions were reported with hair care (29%) and skincare products (25%). The majority [n = 181 (84.2%)] of the participants with managed the ARs by the cessation of the product use. The univariate analysis found that gender, age, allergic to medications and food, family history of allergy, mixing cosmetics, and frequent switching of cosmetic brands were associated with adverse events. However, the adjusted analysis found that allergic to medication (adjusted OR: 3.9), family history of allergy (adjusted OR: 1.91), and mixing cosmetics (adjusted OR: 1.70) were significantly associated with cosmetics-related adverse reactions.

Conclusion

Cosmetovigilance is a model of safety monitoring of cosmetics. It can be considered as a one of the element in public health activities. Pharmacists should be more vigil on this issue in the near future. To strengthen the findings further, a national wide prevalence study can be conducted prospectively and analyses causality and report to the pharmacovigilanvce system of the country.

An insight into toxicity and human-health-related adverse consequences of cosmeceuticals - A review

In recent years, the use of cosmeceutical-based personal care and beauty products has ever increased, around the world. Currently, an increasing number of compounds are being assimilated in the formulation of cosmetic products as preservatives, fragrances, surfactants, etc. to intensify the performance, quality, value, and lifespan of cosmetics. Nevertheless, many of these chemical additives pose toxic effects to the human body, exhibiting health risks from a mild hypersensitivity to life-threatening anaphylaxis or lethal intoxication. Therefore, the indiscriminate application of cosmeceuticals has recently become a mounting issue confronting public health. The present review focuses on exposure to a large variety of toxic substances used in cosmetic formulations such as 1,4-dioxane formaldehyde, paraformaldehyde, benzalkonium chloride, imidazolidinyl urea, diazolidinyl urea, trace heavy metals, parabens derivatives, phthalates, isothiazolinone derivatives (methylchloroiso-thiazolinone, and methylisothiazolinone), methyldibromo glutaronitrile, and phenoxy-ethanol. The biological risks related to these substances that they can pose to human health in terms of cytotoxicity, genotoxicity, mutagenicity, neurotoxicity oestrogenicity or others are also discussed. Researchers from academia, consultancy firms, governmental organizations, and cosmetic companies should carry out further progress to keep updating the consumers regarding the dark-sides, and health-related harmful apprehensions of cosmetics. In addition, the industry-motivated initiatives to abate environmental impact through green, sustainable and eco-friendly product development grasp significant perspective.

Clinical Profile and Allergens in Pigmented Cosmetic Dermatitis and Allergic Contact Dermatitis to Cosmetics in India

BACKGROUND

Pigmented cosmetic dermatitis (PCD) is frequently encountered in dark-skinned individuals as gradual hyperpigmentation on the face without preceding erythema or itching. Little is known about the allergen profile in PCD.

OBJECTIVES

The aim of the study was to describe the clinical profile and common allergens in PCD and allergic contact dermatitis (ACD) to cosmetics in Delhi.

METHODS

Records of patients suspected of PCD and ACD to cosmetics were analyzed. All patients were patch tested with the Indian standard series, Indian cosmetic and fragrance series, and personal cosmetics and, in relevant cases, hairdresser series.

RESULTS

One hundred six patients were analyzed. Patch test was positive in 77 cases (72.6%). Cetrimonium, gallate mix, thiomerosal, and skin lightening creams were more frequently positive in cases of PCD (P = 0.019-0.003), whereas p-phenylenediamine, toluene-2,5 diamine sulfate, p-aminophenol, m-aminophenol, and nitro-p-phenylenediamine were predominantly positive in ACD to cosmetics (P < 0.001).

CONCLUSIONS

Preservatives, antioxidants, and skin lightening creams seem to play a role in causation of PCD, whereas hair dye allergens cause ACD to cosmetics in India.

Skin hydration is significantly increased by a cream formulated to mimic the skin's own natural moisturizing systems

Background

Moisturizers are topical products designed to improve and maintain the skin barrier function and to help prevent dry skin.

Materials and methods

A new moisturizer (Ceramide cream) was formulated containing ingredients which mimic the skin's own natural moisturizing systems. Corneometry was performed at baseline, 2, 4, 6 and 24 hours following a single application of Ceramide cream to healthy skin, and compared to three reference moisturizers available over-the-counter, and placebo. Transepidermal water loss (TEWL) was also measured following a single application of Ceramide cream compared to baseline, and its safety was assessed by repeat insult patch test, ophthalmologist and pediatric testing.

Results

A single topical application of either the Ceramide cream or the three reference moisturizers resulted in a significant increase in skin hydration over time (P<0.001). The placebo cream did not significantly increase skin hydration at any time point. At 24 hours post-application, skin hydration measured for Ceramide cream was significantly greater (P<0.05) than that measured for all three of the reference moisturizers tested. Ceramide cream was also found to significantly decrease TEWL (P<0.001) over 24 hours, and was shown to be non-sensitizing to the skin of both adults and children and non-irritating to the skin, eyes and related eye area.

Conclusion

Ceramide cream increases skin hydration and improves barrier function which may make it suitable for use on dry skin.

Cinnamic acid derivatives in cosmetics: current use and future prospects

Cinnamic acid derivatives are widely used in cosmetics and possess various functions. This group of compounds includes both naturally occurring and synthetic substances. On the basis of the Cosmetic Ingredient Database (CosIng) and available literature, this review summarizes their functions in cosmetics, including their physicochemical and biological properties as well as reported adverse effects. A perfuming function is typical of many derivatives of cinnamaldehyde, cinnamyl alcohol, dihydrocinnamyl alcohol and cinnamic acid itself; these substances are commonly used in cosmetics all over the world. Some of them show allergic and photoallergic potential, resulting in restrictions in maximum concentrations and/or a requirement to indicate the presence of some substances in the list of ingredients when their concentrations exceed certain fixed values in a cosmetic product. Another important function of cinnamic acid derivatives in cosmetics is UV protection. Ester derivatives such as ethylhexyl methoxycinnamate (octinoxate), isoamyl p-methoxycinnamte (amiloxiate), octocrylene and cinoxate are used in cosmetics all over the world as UV filters. However, their maximum concentrations in cosmetic products are restricted due to their adverse effects, which include contact and a photocontact allergies, phototoxic contact dermatitis, contact dermatitis, estrogenic modulation and generation of reactive oxygen species. Other rarely utilized functions of cinnamic acid derivatives are as an antioxidant, in skin conditioning, hair conditioning, as a tonic and in antimicrobial activities. Moreover, some currently investigated natural and synthetic derivatives of cinnamic acid have shown skin lightening and anti-ageing properties. Some of them may become new cosmetic ingredients in the future. In particular, 4-hydroxycinnamic acid, which is currently indexed as a skin-conditioning cosmetics ingredient, has been widely tested in vitro and in vivo as a new drug candidate for the treatment of hyperpigmentation.

Contact dermatitis and patch testing for the allergist

OBJECTIVE

To review of contact dermatitis (CD) and its key allergens and provide updates and recommendations for the practicing allergist.

DATA SOURCES

Through the use of various scientific search engines (eg, PubMed and MEDLINE), we reviewed literature on CD, patch tests (PTs), key allergens, occupational dermatitis, and treatment.

STUDY SELECTIONS

Studies on CD, important allergens, and PTs were considered.

RESULTS

Contact-induced dermatitis may be due to allergic CD, irritant CD, systemic CD, contact urticaria, and protein CD. Key allergens include metals (nickel, gold), topical medicaments (topical corticosteroids), and cosmetics and personal care products (fragrances and preservatives such as methyl- and methylchloro-isothiazolinone). Present relevance of a positive PT result is the combination of definite, probable, and possible relevance and should be correlated with the patient's history and physical examination. Treatment of allergic CD includes identification of relevant allergens, patient education, avoidance, and provision of alternative products the patient can use.

CONCLUSION

CD is a common inflammatory skin disease and should be suspected in patients presenting with acute, subacute, or chronic dermatitis. The gold standard for diagnosing allergic CD is a PT. This article provides practical recommendations for the diagnosis and management of CD commonly seen by the allergist in their practice.

Safety and Efficacy of Nail Products

Over the past several decades, the commercialization of nail cosmetics has increased. From nail polishes to artificial nails, different methods of nail beautification have become popularized. However, the impact of these products remains largely unknown. Governments have passed legislation in attempts to regulate nail cosmetics, but these regulations may not be adequate and are difficult to enforce. Knowledge of the safety and efficacy of nail products remains limited due to the relative dearth of literature published on the topic. This review serves to summarize and interpret the data available regarding common nail products and their safety and efficacy. Nail products such as nail polish, nail polish removers, and artificial nails have shown to have some adverse effects through case reports and studies. Harmful substances such as toluenesulfonamide-formaldehyde resin and methacrylates have been identified in commercial nail products, leading to several adverse effects, but in particular, allergic contact dermatitis. Exposure to substances such as acetonitrile found in removers may have more toxic and caustic effects, especially if ingested. In addition, for nail technicians there are negative effects linked with occupational exposure. Compounds used in nail products may become aerosolized and lead to asthma, eye and throat irritation, and even neurocognitive changes.

Program for Contact Allergen Research (PPAC) - a new tool for dermatologists

In Brazil there is no classification of dermatological products by the presence of vehicles with sensitizing potential. The objective of this study is to create a database to classify such products based on the absence of the selected allergens, aiming at making it available for medical consultation. We conducted an observational study, from the content of labels and/or inserts on the composition of 966 dermatological products in the Brazilian market. No chemical analysis was performed. The database called Programa para Pesquisa de Alérgenos de Contato (www.ppac.com.br) was created, in which safe products for patients allergic to dermatological vehicles are provided.

Patch testing in suspected allergic contact dermatitis to cosmetics

Background. Increasing use of cosmetics has contributed to a rise in the incidence of allergic contact dermatitis (ACD) to cosmetics. It is estimated that 1–5.4% of the population is sensitized to a cosmetic ingredient. Patch testing helps to confirm the presence of an allergy and to identify the actual allergens which are chemical mixtures of various ingredients. Objectives. The aims of this study are to perform patch testing in suspected ACD to cosmetics and to identify the most common allergen and cosmetic product causing dermatitis. Methods. Fifty patients with suspected ACD to cosmetics were patch-tested with 38 antigens of the Indian Cosmetic Series and 12 antigens of the Indian Standard Series. Results. The majority (58%) of patients belonged to the 21–40 years age group. The presence of ACD to cosmetics was confirmed in 38 (76%) patients. Face creams (20%), hair dyes (14%), and soaps (12%) were the most commonly implicated. The most common allergens identified were gallate mix (40%), cetrimide (28%), and thiomersal (20%). Out of a total of 2531 patches applied, positive reactions were obtained in 3.75%. Conclusion. Incidence of ACD to cosmetics was greater in females. Face creams and hair dyes were the most common cosmetic products implicated. The principal allergens were gallate mix, cetrimide, and thiomersal.