Trend of contact allergy to cosmetic ingredients in Thais over a period of 10 years*

Systematic review on skin adverse effects of important hazardous hair cosmetic ingredients with a focus on hairdressers

BACKGROUND

The burden of occupational hand eczema in hairdressers is high, and (partly strong) allergens abound in the hair cosmetic products they use.

OBJECTIVES

To systematically review published evidence concerning contact allergy to an indicative list of active ingredients of hair cosmetics, namely, p-phenylenediamine (PPD), toluene-2,5-diamine (PTD), persulfates, mostly ammonium persulfate (APS), glyceryl thioglycolate (GMTG), and ammonium thioglycolate (ATG), concerning the prevalence of sensitization, particularly in terms of a comparison (relative risk; RR) between hairdressers and non-hairdressers.

METHODS

Following a PROSPERO-registered and published protocol, eligible literature published from 2000 to February 2021 was identified, yielding 322 publications, and extracted in standardized publication record forms, also considering risk of bias.

RESULTS

Based on 141 publications, the contact allergy prevalence to PPD was 4.3% (95% CI: 3.8-4.9%) in consecutively patch tested patients. Other ingredients were mostly tested in an aimed fashion, yielding variable, and partly high contact allergy prevalences. Where possible, the RR was calculated, yielding an average increased sensitization risk in hairdressers of between 5.4 (PPD) and 3.4 (ATG). Additional evidence related to immediate-type hypersensitivity, experimental results, exposures, and information from case reports was qualitatively synthesized.

CONCLUSIONS

An excess risk of contact allergy is clearly evident from the pooled published evidence from the last 20 years. This should prompt an improvement in working conditions and product safety.

Green synthesis of silver nanoparticles using Coffea canephora fruit skin extract and its application for mercury detection in face cream samples

Mercury is one of the most toxic heavy metals causing harmful effects on the human body; meanwhile, mercury is found in some face cream products to give a whitening effect. The upper limit concentration of mercury in skin-lightening products defined by the Food and Drug Administration (FDA) is under one mg/L as Hg²⁺. A new green analytical spectrophotometric method for mercury analysis has been developed by employing a biological reagent from fruit skin extract of robusta coffee (Coffea canephora) as a bioreductor for silver ions as well as a stabilizer for the AgNPs product. The detection principle of this method is based on the decrease of the color intensity of silver nanoparticles (AgNPs) after the addition of Hg²⁺ ions due to the re-oxidization of the AgNPs by Hg²⁺ ions to colorless Ag⁺ ions. To achieve the most significant sensitivity, linearity of measurement, and validity, the method was optimized toward the volume of AgNPs and reaction time. In this research, the synthesized AgNPs were also characterized by UV-Vis Spectrometry as well as a particle size analyzer (PSA) to determine the size of nanoparticles. The result showed that the optimum conditions were attained at 4 mL AgNPs solution and 3-min reaction resulting in a linear measurement of Hg²⁺ in the range of 0-15 mg/L with LOD and LOQ of 0.039 and 0.130 mg/L, respectively. This method is quite selective and has been validated by applying it to real face cream samples with satisfactory results supported by average recoveries of close to 100%.

Skin Toxicity of Selected Hair Cosmetic Ingredients: A Review Focusing on Hairdressers

The safety assessment of cosmetics considers the exposure of a ‘common consumer’, not the occupational exposure of hairdressers. This review aims to compile and appraise evidence regarding the skin toxicity of cysteamine hydrochloride (cysteamine HCl; CAS no. 156-57-0), polyvinylpyrrolidone (PVP; CAS no. 9003-39-8), PVP copolymers (CAS no. 28211-18-9), sodium laureth sulfate (SLES; CAS no. 9004-82-4), cocamide diethanolamine (cocamide DEA; CAS no. 68603-42-9), and cocamidopropyl betaine (CAPB; CAS no. 61789-40-0). A total of 298 articles were identified, of which 70 were included. Meta-analysis revealed that hairdressers have a 1.7-fold increased risk of developing a contact allergy to CAPB compared to controls who are not hairdressers. Hairdressers might have a higher risk of acquiring quantum sensitization against cysteamine HCl compared to a consumer because of their job responsibilities. Regarding cocamide DEA, the irritant potential of this surfactant should not be overlooked. Original articles for PVP, PVP copolymers, and SLES are lacking. This systematic review indicates that the current standards do not effectively address the occupational risks associated with hairdressers’ usage of hair cosmetics. The considerable irritant and/or allergenic potential of substances used in hair cosmetics should prompt a reassessment of current risk assessment practices.

Analysis of factors influencing skin reactions to sunscreens, skin whitening products, and deodorants: Results from a large-scale patch test dataset in China

BACKGROUND

Cosmetic products are widely used in daily life and can cause skin reactions. However, to date, few studies have investigated the prevalence and associated factors of skin reactions to different types of cosmetic products using patch test results.

OBJECTIVES

To investigate the frequency and associated factors of skin reactions to sunscreens, skin whitening products, and deodorants using patch test results in China.

METHODS

This cross-sectional analysis used data collected during 2004-2017 at the Shanghai Skin Disease Hospital, China. Skin reactions were measured using patch tests following internationally standardized protocols.

RESULTS

In total, 151 280 patch tests comprising 16 477 cosmetic products conducted in 4029 healthy volunteers were analyzed. The frequencies of skin reactions to different cosmetic products were 1.07%, 1.28%, and 4.41% for sunscreens, skin whitening products, and deodorants, respectively. With increasing age, a higher frequency of reactions to sunscreens in women (p < 0.001) and a lower frequency of reactions to skin whitening products in men (p < 0.05) were observed. In addition, men were more likely to develop skin reactions to deodorants compared to women (p < 0.05). Skin reactions were more frequent in winter (p < 0.05), which was true for different types of cosmetic products.

CONCLUSIONS

The frequency of patch testing for different cosmetic products was 1.07-4.41%. The effects of age, sex, and season vary among the different types of cosmetic products. We hope that these findings can offer guidance for a healthy skincare concept.

Analysis of factors influencing patch test reactions: Results from a large- population-based study in Chinese

BACKGROUND

Patch test, as a helpful tool in clinic diagnosis and safety assessment of cosmetics, is affected by many factors.

OBJECTIVES

To investigate the influencing factors of patch test reactions in a highly standardized large-scale dataset of Chinese.

METHODS

Patch test data (n = 151,280) from safety assessments of cosmetic products were obtained following internationally standardized patch testing protocols during 2004-2017 in China.

RESULTS

The frequency of patch test reactions was 1.45% (2,191/151,280), with majority of the reactions being "score 1" reactions (also known as doubtful reactions, n = 2,075) and a small number being "score 2" reactions (weak reactions, n = 116). Patch test reactions were 67% more frequent in winter (p < 0.001), associated with temperatures (p < 0.001), rather than relative humidity (P:0.29). The frequency of reactions was higher in men than in women (p:0.001), especially in winter. The risk to develop reactions clearly increased with age in women (p < 0.001), but not in men (p:0.14). In women, the frequency of reactions in the old group (≥50 years old) was 30% more than the young group (<30 years old).

CONCLUSIONS

The frequency of patch test reactions to cosmetic products was 1.45% in our large-scale study. The influencing factors of patch test include season, sex, and age, which should be considered when conducting and interpreting patch testing.

Ultraviolet filters in sunscreen products labeled for use in children and for sensitive skin

BACKGROUND

The active ingredients in sunscreen products are ultraviolet (UV) filters, many of which are known potential allergens. The use of sunscreen in younger children and individuals with sensitive skin requires special attention, since absorption and allergen sensitization are of concern.

OBJECTIVE

This study aims to evaluate the ultraviolet filters in sunscreen products labeled specifically for "kids" or as "sensitive/hypoallergenic" and compare these to general sunscreen products.

METHODS

From December 2017 to March 2018, the ingredient labels on commercially available sunscreen products in Bangkok, Thailand, were analyzed.

RESULTS

Two hundred and forty-six sunscreen products were examined. Of these, twenty products (8.1%) were marketed for "kids." Forty-one products (16.6%) were labeled as "sensitive" or "hypoallergenic." Ethylhexyl methoxycinnamate (EHMC) and benzophenone-3 (BP3) were less prevalent in products for children [(P = .004) and (P = .029), respectively]. Eighty-five percent of sunscreen products labeled for kids contained at least one chemical UV filter. There was no significant difference between BP3, butyl methoxydibenzoylmethane (BMDM), and octocrylene (OCR) in products labeled for sensitive skin compared to products with no specific labels. Moreover, methylene bis-benzotriazolyl tetramethylbutylphenol (MBBT) was more commonly found in products for sensitive skin than in nonsensitive products (P = .001).

CONCLUSIONS

Common allergenic UV filters were found in sunscreens labeled as sensitive and for children. Regulations for displaying these specific labels should be established for improved benefits and safety to allergy-prone skin.

Associated factors of widespread pattern of dermatitis among patch test population: 12-Year retrospective study

BACKGROUND/OBJECTIVE

Widespread dermatitis is often associated with diagnostic and therapeutic challenges. Multiple factors influence this widespread pattern of dermatitis. We aim to study the associated factors in patch-tested patients who presented with widespread pattern of dermatitis.

METHOD

This retrospective, case-control study was conducted on patients with dermatitis who were patch tested during January 2005 to December 2016. The demographic data, patient and family histories, diagnoses, and patch test findings were recorded and analyzed.

RESULTS

Of the 3201 included patients, 645 (20.2%) had widespread pattern of dermatitis. Being male, age >60, and history of either atopic dermatitis (AD) or metal allergy were significantly associated with the widespread dermatitis pattern. A multivariate analysis demonstrated that preservatives were the significant offending allergens, especially methylchloroisothiazolinone/methylisothiazolinone (MCI/MI), and methylisothiazolinone (MI) alone.

CONCLUSION

Widespread pattern of dermatitis is associated with gender, age, underlying atopic dermatitis and a history of metal allergy. Preservatives are the significant offending allergens of widespread dermatitis, especially MCI/MI, and MI alone. A thorough history taking and patch testing, including preservatives, are necessary to determine the cause of widespread pattern of dermatitis.

Facial Microfiber Tissue with plant extracts: A new cosmetic concept shows whitening efficacy in Asian volunteers

BACKGROUND

The Asian population presents a high incidence of Fitzpatrick skin types III and IV. The management of skin tone is a very important cosmetic issue in these groups. Efficacy check of a new cosmetic concept to achieve skin color lightening arouses great interest.

OBJECTIVE

To estimate the clinical efficacy of a new facial microfiber tissue (FMT) which combines a surface micropeeling technology (due to the structure of the microfibers) with skin whitening cosmetic actives in Asian skin. The FMT is a new concept featuring a dry microfiber tissue loaded with cosmetic actives, which is just wetted with little tap water before use.

METHODS

A total of 34 females aged 21-58 years old with Fitzpatrick skin types III and IV were enrolled in this randomized, blank-controlled trial for 12 weeks. Participants applied FMT on the left or right forearm according to random assignment. At the same time, FMT was used on the face. Skin whitening effects on the forearm and face were evaluated using Mexameter MX18 and Minolta Spectrophotometer CM-2600d. In addition, assessment by subjects via a self-evaluation questionnaire was conducted at study end.

RESULTS

The FMT treatment showed a significant whitening effect mainly on the forearm compared with blank control forearm. Facial whitening was also noted. No adverse reactions were reported during the study.

CONCLUSION

The new cosmetic concept of FMT can be used as an effective and safe whitening cosmetic agent.

Contact sensitizers in commercial hair dye products sold in Thailand

BACKGROUND

Hair dyes are known to contain potent contact allergens for which sensitization rates have increased over the last decade.

OBJECTIVE

To examine the type and frequency of potent contact sensitizers labelled on hair dyes sold in metropolitan Bangkok, Thailand.

METHODS

During the 2013-2014 study period, labelled ingredient information from home use and professional hair dye products was collected.

RESULTS

Two hundred and fifty-two hair dye products were evaluated. One hundred and forty-nine products from 48 brands were domestically produced in Thailand, and 103 products were from 23 multinational brands produced in countries other than Thailand. Two hundred and fourteen of 252 (84.9%) hair dye products were found to contain strong skin sensitizers, with 118 (46.8%) being found in domestically produced products, and 96 (38.1%) being found in multinational brand products. Thirty-eight hair dye products (15.1%) were free of potent skin sensitizers. The number of domestically produced products (31, 20.8%) that were free of potent skin sensitizers was significantly higher (p = 0.002) than the number of multinational brand products (7, 6.8%).

CONCLUSIONS

p-Phenylenediamine was the most prevalent potent sensitizer found among domestically produced hair dyes available on the market. Our findings indicate regional differences in hair dye allergen exposure.

Cosmetic preservative labelling on the Thai market

BACKGROUND

Preservatives are added to cosmetics and other consumer products to prevent microbial growth and product degradation. Many cosmetic preservatives are skin sensitizers and frequent causes of contact dermatitis. The use of preservatives may vary by country and/or region, according to legislation, and may be reflected in differences in the prevalence rates of preservative allergy worldwide.

OBJECTIVE

To examine the type and frequency of preservative use in cosmetics sold in Thai markets in metropolitan Bangkok, Thailand.

METHODS

Preservatives contained in 1000 different cosmetics sold in Thai markets were documented and analysed, based on the labelling of ingredients.

RESULTS

Most of the cosmetic and skincare products sold in Thai markets were international brands, with only a small proportion of cosmetic products being produced in Thailand. International brand cosmetics were more likely to contain non-formaldehyde-releasing preservatives than domestically produced brands. Isothiazolinone-based preservatives, which are responsible for the current increase in the prevalence of contact allergy, were found at a significant frequency in domestically produced, leave-on cosmetic products.

CONCLUSION

Preservatives in cosmetics were significantly different according to source of production and type of cosmetics.

Childhood Physical and Sexual Abuse in Caribbean Young Adults and Its Association with Depression, Post-Traumatic Stress, and Skin Bleaching

BACKGROUND

The global prevalence of skin depigmentation/skin bleaching among blacks, estimated at 35%, is on the rise and is associated with a host of negative health and medical consequences. Current etiological approaches do not fully capture the emotional and psychological underpinnings of skin bleaching. The current study investigated the potential mediating role of depression, or post-traumatic stress symptoms (avoidance and hyperarousal) on the relationship between childhood physical and sexual abuse (CPSA) and skin bleaching.

METHODS

A total of 1226 university participants (ages 18-30 years and 63.4% female) from three Caribbean countries (Jamaica, Barbados, and Grenada) provided data for the current analysis. They all completed self-reported measures of general demographic information along with the short screening scale for posttraumatic stress disorder (DSM-IV), childhood trauma, and skin bleaching questions.

RESULTS

The prevalence of skin bleaching in our study was 25.4%. Our findings showed that individuals who bleached their skin were more likely to have been abused as children (21.6% versus 13.5%, p<0.001), were more likely to have significant symptoms of trauma (34.1% versus 24.0%, p=0.005), and were more likely to have significant depression (43.7% versus 35.1%, p=0.032). We found that trauma-related hyperarousal symptoms positively mediated the relationship between childhood physical and sexual abuse and skin bleaching (Indirect Effect=0.03, p<0.05), while avoidance (Indirect Effect=0.000, p>0.05) and depressive (Indirect Effect=0.005, p>0.05) symptoms did not.

CONCLUSION

The presence of trauma symptoms and childhood physical and sexual abuse (CPSA) may increase the likelihood of skin bleaching. Findings suggest that further exploration is needed to ascertain if the presence of skin bleaching warrants being also screened for trauma.

The globalization of whitening: prevalence of skin lighteners (or bleachers) use and its social correlates among university students in 26 countries

BACKGROUND

The aim of this study was to investigate the use of skin lighteners and its social correlates in university students from 26 low, middle income, and emerging economy countries.

METHODS

Using anonymous questionnaires, data were collected from 19,624 undergraduate university students (mean age 20.8, SD 2.8) from 27 universities in 26 countries across Asia, Africa, and the Americas. Multivariate logistic regression analysis was used to identify associations between sociodemographic, social, health risk, mental health and abuse, and the use of skin lighteners.

RESULTS

Overall, the prevalence of previous 12-month skin lightener use was 24.5, and 16.7% in male and 30.0% in female students. The use of skin lighteners varied by country, ranging from 0% in Turkey to 83.8% in Thailand. In multivariate logistic regression analysis among both men and women, social variables (highly-organized religious activity and lack of personal mastery) and health variables (inconsistent condom use) were associated with skin lightening use. In addition, male students from a lower income country, having a lack of social support, and a history of childhood sexual abuse were more likely to use skin lighteners, and women aged 20-21 years old, residing on the university campus, being a student of health and welfare, and having a lack of personal control, inadequate physical activity, and depressive symptoms were more likely users of skin-lightening products.

CONCLUSION

A high prevalence of skin lightener use was found in this large sample of university students, and social and health-related risk factors were identified.

Cosmetic contact sensitivity in patients with melasma: results of a pilot study

Background. Some of the patients with melasma perhaps have pigmented cosmetic dermatitis. However, cosmetic contact sensitivity in melasma remains poorly studied particularly in the Indian context. Objectives. To study cosmetic contact sensitivity in patients with melasma. Materials and Methods. 67 (F : M = 55 : 12) consecutive patients with melasma between 19 and 49 years of age were patch tested sequentially during January-December, 2012, with Indian Cosmetic and Fragrance Series, Indian Sunscreen Series, p-phenylenediamine, and patient's own cosmetic products. Results. 52 (78%) patients were in the age group of 20-40 years. The duration of melasma varied from 1 month to 20 years. Centrofacial, malar, and mandibular patterns were observed in 48 (72%), 18 (27%), and 1 (1%) patients, respectively. Indian Cosmetics and Fragrance Series elicited positive reactions in 29 (43.3%) patients. Cetrimide was the most common contact sensitizers eliciting positivity in 15 (52%) patients, followed by gallate mix in 9 (31%) patients and thiomersal in 7 (24%) patients. Only 2 of the 42 patients showed positive reaction from their own cosmetics while the other 5 patients had irritant reaction. Indian Sunscreen Series did not elicit any positive reaction. Conclusion. Cosmetics contact sensitivity appears as an important cause of melasma not associated with pregnancy, lactation, or hormone therapy.

Direct determination of mercury in cosmetic samples by isotope dilution inductively coupled plasma mass spectrometry after dissolution with formic acid

A new method was proposed for the accurate determination of mercury in cosmetic samples based on isotopic dilution (ID)-photochemical vapor generation (PVG)-inductively coupled plasma mass spectrometry (ICP MS) measurement. Cosmetic samples were directly dissolved in formic acid solution and subsequently subjected to PVG for the reduction of mercury into vapor species following by ICP MS detection. Therefore, the risks of analyte contamination and loss were avoided. Highly enriched (201)Hg isotopic spike is added to cosmetics and the isotope ratios of (201)Hg/(202)Hg were measured for the quantitation of mercury. With ID calibration, the influences originating from sample matrixes for the determination of mercury in cosmetic samples have been efficiently eliminated. The effects of several experimental parameters, such as the concentration of the formic acid, and the flow rates of carrier gas and sample were investigated. The method provided good reproducibility and the detection limits were found to be 0.6 pg mL(-1). Finally, the developed method was successfully applied for the determination of mercury in six cosmetic samples and a spike test was performed to verify the accuracy of the method.