Benzophenone 4: an emerging allergen in cosmetics and toiletries?

Patch Testing With Benzophenone-3 and -4: The North American Contact Dermatitis Group Experience, 2013-2020

Background: Benzophenone (BZP)-3 and BZP-4 are ultraviolet (UV) absorbers used in sunscreens and personal care products (PCPs) and may cause allergic contact dermatitis. Objective: To characterize positive patch test reactions to BZP-3 (10% in petrolatum [pet]) and BZP-4 (2% pet) in a screening allergen series. Methods: Retrospective analysis of patients tested to BZP-3 and BZP-4 was conducted by the North American Contact Dermatitis Group from 2013 to 2020. Results: Of 19,618 patients patch tested to BZP-3 and BZP-4, 103 (0.5%) and 323 (1.6%) had positive reactions, respectively: 413 (2.1%) reacted to at least 1 BZP (BZP-positive patient). As compared with BZP-negative patients, BZP-positive patients were significantly more likely to have a history of hay fever (39.3% vs 33.4%, P = 0.0134), history of atopic dermatitis (39.8% vs 30.7%, P = 0.0001), and facial involvement (37.4% vs 32.2%, P = 0.0272). Most reactions were currently clinically relevant (BZP-3: 90.4%; BZP-4: 65.8%). Common identified sources included PCPs and sunscreens. Coreactivity between BZP-3 and BZP-4 was low: 13.5% (14/104) of BZP-3-positive patients were allergic to BZP-4 and 4.3% (14/322) of BZP-4-positive patients were allergic to BZP-3. Conclusions: Eight-year prevalence of BZP positivity was 2.1%. Reactions were frequently clinically relevant and linked to PCPs and sunscreens.

Patch test results in a Dutch paediatric population with suspected contact allergy: A retrospective cohort study

BACKGROUND

Allergic contact dermatitis (ACD) in paediatric patients is on the rise. Continuous identification of emerging allergens is of great importance to ensure accurate patch testing.

OBJECTIVES

To assess the frequency and relevance of contact sensitivity in children and adolescents and evaluate changes in sensitization rates in the last decade.

METHODS

All patients with suspected ACD who underwent patch testing at the Amsterdam University Medical Centers between 2015 and 2021 were included.

RESULTS

Of 439 patients tested with the European Baseline Series (EBS) and additional series, 334 (76%) patients had at least 1 positive reaction and 172 patients (39%) had 1 or more relevant positive reactions. If additional series would have been omitted, 20% of patients would have been underdiagnosed. Compared to patients tested between 1996 and 2013, reactions to metal allergens, isothiazolinones, methyldibromo glutaronitrile, carba mix, amerchol L-101, and benzophenone-4 were more frequently observed.

CONCLUSIONS

This study confirms the need for patch testing in paediatric patients suspected of having ACD. For accurate patch testing, it is advised to include additional series.

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.

Allergic contact dermatitis: a significant environmental and occupational skin disease

This review article seeks to provide an overview of allergic contact dermatitis (ACD) as a significant environmental and occupational skin disease, the phases of ACD, its causes from the occupational and environmental perspectives, its detection, the effects of ACD with respect to the social, psychological, occupational, and financial perspectives, and its cure and/or prevention. Human skin is very sensitive and as the largest organ in the body, it is highly prone to direct and indirect contact with the substances from its environment. The skin reacts to these substances (xenobiotics) differently depending on the individual's tolerance level or threshold. Allergic contact dermatitis is a significant environmental and occupational skin disease that should not be ignored in our society because it can affect the quality of life of an affected individual. There are multiple causes of ACD, and these causes of ACD have been discussed from two perspectives: environmental and occupational. The effects of ACD can be psychological, social, financial, and occupational. There is need for more public enlightenment on the effects of ACD as well as a precise understanding that it is not a contagious disease so as to significantly reduce the psychological and social effects of ACD on these patients.

Ultraviolet filters in sunscreens and cosmetic products-A market survey

BACKGROUND

As several reports have raised a variety of environmental, health, and safety issues related to ultraviolet (UV) filters, it is crucial to understand the trends in the exposure of the population to UV filters.

OBJECTIVE

To determine the frequency of UV filter usage in sunscreens and other cosmetic products in Thai market.

METHODS

We surveyed the UV filter labelling on sunscreens and cosmetic products sold in the Thai market. In all, 312 sunscreens and 1350 other cosmetic products were investigated.

RESULTS

Titanium dioxide was the most frequently used UV filter in both sunscreens (66.7%) and other cosmetic products (68.4%). Ethylhexyl methoxycinnamate was the most common organic UVB filter, whereas butyl methoxydibenzoylmethane was the most common organic UVA filter. In sunscreens aimed at children, bis-ethylhexyloxyphenol methoxyphenyl triazine was the most commonly used UV filter. The most frequent co-occurrence of UV filters was titanium dioxide and ethylhexyl methoxycinnamate.

CONCLUSIONS

Titanium dioxide was the most commonly used UV filter, which differs from the findings of previous surveys. Knowing the availability and frequency of each UV filter provides valuable information about consumer exposure levels, facilitates refinements of the allergen series in patch testing, and enhances the monitoring of adverse effects of UV filters.

Can natural products improve skin photoprotection?

Abstract Due to increased UV radiation on the Earth’s surface, caused by depletion of the stratospheric ozone, people have become more susceptible to different types of skin damage, such as erythema, sunburns, and cancer; this is especially of concern in tropical countries. Thus, efforts to improve awareness as well as the use of sunscreen are increasing worldwide. However, synthetic UV filters have been associated with deleterious effects such as photosensitization. Natural products have been used by ancient cultures for several purposes, including protecting the skin from the sun. However, there is still doubt today whether photoprotection is a real phenomenom or whether it is simply tanning of the skin. Plants have self-protective mechanisms and produce secondary metabolites that can protect themselves from UV radiation. Yet, can phytochemical compounds protect human skin? This review discusses the paradoxical effect of chemical UV filters and the influence of phytochemicals in in vitro and in vivo tests of photoprotection.

[When sunscreens do not help: allergic contact dermatitis to UV filters]

Ultraviolet (UV) filters may cause allergic and more frequently photoallergic contact dermatitis. Therefore, a photopach test should always be performed in case of a suspected contact sensitivity to UV filters. We report a case of a 65-year-old woman with a recurrent erythema of the face and décolleté after sun exposure despite application of a sunscreen. The (photo)patch test revealed a contact sensitivity to the UV filter butyl-methoxybenzoylmethane. Treatment with a topical glucocorticoid and avoidance of the particular UV filter led to a rapid improvement.

Transformation of benzophenone-type UV filters by chlorine: Kinetics, products identification and toxicity assessments

The present study focused on the kinetics, transformation pathways and toxicity of several benzophenone-type ultraviolet filters (BPs) during the water chlorination disinfection process. The transformation kinetics of the studied three BPs was found to be second-order reaction, which was dependent on the concentration of BPs and chlorine. The second-order rate constants increased from 86.7 to 975 M(-1) s(-1) for oxybenzone, 49.6-261.7 M(-1) s(-1) for 4-hydroxybenzophenone and 51.7-540 M(-1) s(-1) for 2-hydroxy-4-methoxybenzophenone-5-sulfonic acid with the increasing pH value from 6 to 8 of the chlorination disinfection condition. Then the transformation products (TPs) of these BPs were identified by HPLC-QTof analysis. Several transformation pathways, including electrophilic substitution, methoxyl substitution, ketone groups oxidation, hydrolysis, decarboxylation and ring cleavage reaction, were speculated to participate in the chlorination transformation process. Finally, according to the toxicity experiment on luminescent bacteria, Photobacterium phosphoreum, enhanced toxicity was observed for almost all the TPs of the studied BPs except for 2,2'-dihydroxy-4,4'-dimethoxybenzophenone; it suggested the formation of TPs with more toxic than the parent compounds during the chlorination process. The present study provided a foundation to understand the transformation of BPs during chlorination disinfection process, and was of great significance to the drinking water safety.

Occurrence, distribution and ecological risk assessment of multiple classes of UV filters in surface waters from different countries

Organic UV filters are common ingredients of personal care products (PCPs), but little is known about their distribution in and potential impacts to the marine environment. This study reports the occurrence and risk assessment of twelve widely used organic UV filters in surface water collected in eight cities in four countries (China, the United States, Japan, and Thailand) and the North American Arctic. The number of compounds detected, Hong Kong (12), Tokyo (9), Bangkok (9), New York (8), Los Angeles (8), Arctic (6), Shantou (5) and Chaozhou (5), generally increased with population density. Median concentrations of all detectable UV filters were <250 ng/L. The presence of these compounds in the Arctic is likely due to a combination of inadequate wastewater treatment and long-range oceanic transport. Principal component analysis (PCA) and two-way analysis of variance (ANOVA) were conducted to explore spatiotemporal patterns and difference in organic UV filter levels in Hong Kong. In general, spatial patterns varied with sampling month and all compounds showed higher concentrations in the wet season except benzophenone-4 (BP-4). Probabilistic risk assessment showed that 4-methylbenzylidene camphor (4-MBC) posed greater risk to algae, while benzophenone-3 (BP-3) and ethylhexyl methoxycinnamate (EHMC) were more likely to pose a risk to fishes and also posed high risk of bleaching in hard corals in aquatic recreational areas in Hong Kong. This study is the first to report the occurrence of organic UV filters in the Arctic and provides a wider assessment of their potential negative impacts in the marine environment.

New insights about infant and toddler skin: implications for sun protection

The skin is increasingly recognized as a component of the innate immune response, in addition to its role as a physical barrier. Although the deleterious effects of solar ultraviolet radiation (UVR), including immunosuppression and cutaneous tumorigenesis, are widely acknowledged, most studies to date have concentrated on adult skin. Despite the more sensitive nature of infant and toddler skin, little is known about its responses to UVR exposure, whether acute or long-term. Accumulating evidence suggests not only that the skin's barrier protection remains immature throughout at least the first 2 years of life but also that accumulation of UVR-induced changes in the skin may begin as early as the first summer of life. Such evidence not only affirms the importance of sun protection during the infant and toddler years but underscores the need for more research to establish evidence-based standards of care in this area. In this article we review recent studies in which differences between the skin properties of infants and young children and those of adults were compared, and we discuss the implications of these differences for sun-protection practices.

A reversed-phase ion-interaction chromatographic method for in-vitro estimation of the percutaneous absorption of water-soluble UV filters

An analytical method based on ion-interaction chromatography with UV detection for simultaneous in-vitro estimation of the percutaneous absorption of the most used water-soluble UV filters in sunscreen cosmetics is proposed. These UV filters were phenylbenzimidazole sulfonic acid, disodium phenyl dibenzimidazole tetrasulfonate, benzophenone-4, and terephthalylidene dicamphor sulfonic acid. The methodology is based on applying the sunscreen containing the target UV filters to human epidermis in a diffusion cell. Analytes are determined in the receptor solution. To ensure skin integrity, screening of the cells was carried out by analytical determination of a marker. Analytical variables such as percentage ethanol, concentration of ion-pairing agent, pH of the mobile phase, and temperature were studied in order to achieve high resolution of the chromatographic peaks in the lowest possible time of analysis. The conditions selected consisted of a mobile phase composed of 35:65 (v/v) ethanol-ammonium acetate buffer solution (pH 4, containing 50 mmol L(-1) tetra-n-butylammonium bromide). The chromatographic determination was carried out with the analytical column at 50 degrees C. UV detection was carried out at the maximum absorption wavelength for each analyte. The limit of detection (3s(y/x)/b) ranged from 16 to 65 ng mL(-1), depending on the analyte.

‘New’ contact allergens

PURPOSE OF REVIEW

Due to the continuously changing environmental conditions, it is necessary to regularly monitor and update the spectrum of contact allergens that elicit contact dermatitis. New contact allergens and known contact allergens with currently increasing importance need to be identified for diagnostic and preventive purposes.

RECENT FINDINGS

Within the last few years, allergic contact allergy to a number of substances derived from plants and other materials was reported for the first time. Furthermore, it has become obvious that dyes, especially paraphenylenediamine-related dyes, and fragrances are sources of contact allergens with increasing frequency. It is likely that within these groups of substances some as yet unidentified agents are relevant allergens.

SUMMARY

It is an ongoing challenge for clinicians to meticulously explore the exposure of eczema patients to possible new allergens. Dyes and fragrances, in particular, are of increasing significance not only because of their known ingredients but also because of new allergenic compounds.