Potential for Allergic Contact Dermatitis in Popular Hair Care Practices and Ingredients

The incidence of allergic contact dermatitis (ACD) due to personal care products is rising in parallel with increasing product availability and consumer interest. Hair products specifically represent a significant source of potential allergens, including preservatives, surfactants, emulsifiers, fragrances, adhesives, and dyes. ACD due to hair care products can present as dermatitis in the distinctive "rinse-off" distribution, involving the neck, eyelids, and lateral face in addition to the scalp. Herein, the authors review ingredients in hair care products that can cause ACD and practical tips for allergen identification.

Scalp involvement in patients referred for patch testing: Retrospective cross-sectional analysis of North American Contact Dermatitis Group data, 1996 to 2016

BACKGROUND

Scalp conditions are often multifactorial.

OBJECTIVE

To characterize patients with scalp involvement and patch-testing outcomes.

METHODS

Retrospective cross-sectional analysis of North American Contact Dermatitis Group data (1996-2016). Study groups included patients with scalp involvement (≤3 anatomic sites coded) with or without additional sites.

RESULTS

A total of 4.8% of patients (2331/48,753) had scalp identified as 1 of up to 3 affected anatomic sites. Approximately one-third of "scalp-only" individuals had a specific primary diagnosis of allergic contact dermatitis (38.6%), followed by seborrheic dermatitis (17.2%) and irritant contact dermatitis (9.3%). When adjacent anatomic sites were affected, allergic contact dermatitis was more frequently identified as the primary diagnosis (>50%). The top 5 currently clinically relevant allergens in scalp-only patients were p-phenylenediamine, fragrance mix I, nickel sulfate, balsam of Peru, and cinnamic aldehyde. Methylisothiazolinone sensitivity was notable when adjacent anatomic sites were involved. The top 3 specifically identified sources for scalp-only allergens were hair dyes, shampoo/conditioners, and consumer items (eg, hair appliances, glasses).

LIMITATIONS

Tertiary referral population.

CONCLUSION

Isolated scalp involvement was less likely to be associated with allergic contact dermatitis than when adjacent anatomic sites were involved. Overlap with multiple diagnoses was frequent, including seborrheic dermatitis, irritant dermatitis, other dermatoses, or all 3. p-Phenylenediamine was the most common allergen.

Nickel release from inexpensive jewelry and hair clasps purchased in an EU country - Are consumers sufficiently protected from nickel exposure?

BACKGROUND

Nickel allergic subjects are at risk factor of acquiring hand eczema. In 1990 and 1994, respectively, Denmark and member states in the EU regulated nickel release from selected consumer products. The intention was that the nickel epidemic could be controlled and prevented if the general population was protected from high cutaneous nickel concentrations. Despite a decrease, the prevalence of nickel allergy remains high as nearly 10% of young women are nickel allergic.

OBJECTIVE

This study aimed to perform dimethylglyoxime (DMG) testing of inexpensive jewelry and hair clasps purchased from random stores in Copenhagen, Denmark to detect the proportion of items that may result in nickel allergy.

METHODS

Inexpensive jewelry and hair clasps were purchased from 36 stores and street vendors in Copenhagen and were later tested for nickel release using the DMG test.

RESULTS

The study showed that 19.3% hair clasps, 14.8% earrings, and 12.9% necklaces intended for adult women released an excessive amount of nickel. Of 25 stores visited, 36.0% sold DMG positive jewelry. For items designed for children, excessive nickel release was identified in hair clasps (79.4%) and in finger rings (20%). Four (50.0%) of 8 children clothing stores sold jewelry that released too much nickel.

DISCUSSION

Excessive nickel release has been regulated since 1990 in Denmark. However, 1/5 of purchased items released nickel in concentrations that may lead to nickel allergy. Especially hair clasps intended for children released an excessive amount of nickel.