Cosmetic allergy

Author: Vanessa Ngan, Staff Writer, 2012.


What is a cosmetic?

A cosmetic is defined as a topically applied product that is used to beautify, cleanse or protect the hair, skin, teeth or complexion. Countries around the world have in place regulatory standards that ensure these products are safe for the workers handling them, the environment, and for use by consumers.

 In essence, a cosmetic should not contain any active drug ingredient that may affect the structure or function of the skin. However, the division of cosmetics and drugs is not always clear as there are many products available that have two intended uses, for example, an antidandruff shampoo is a cosmetic because it is intended to cleanse the hair but it also contains a drug to treat the scalp and dandruff. Such products must comply with the requirements for both cosmetics and drugs.

Cosmetics can be broadly divided into the following groups.

  • Facial make-up: eye make-up, lipstick, blushes, foundation
  • Nail care: varnish, remover, artificial nails
  • Skin care: cleanser, moisturiser, toner
  • Hair care: shampoos, hair colour, dye, regrowth treatment
  • Oral care: toothpaste, mouthwash
  • Body cleansers: soap, bath additives, shower gel
  • Shaving: shaving foam/cream, aftershave
  • Fragrances: perfume, cologne
  • Deodorant: deodorant, antiperspirant
  • Sun protection: sunscreen 

What is a cosmetic allergy?

As you can see cosmetics play an important part in our daily life. It is estimated that on average women are using at least seven types of cosmetic each day, so it is not surprising that reactions to these products are quite common. Although the prevalence of cosmetic allergy in the general population is unknown, several studies suggest that up to 10% of the population will have some type of reaction to a cosmetic over the course of a lifetime. This figure may be much more as many mild reactions occurring at home are self-diagnosed and often self-treated.

An allergy to a cosmetic can produce a range of reactions.

Contact urticaria

  • Local burning sensation, tingling, itching may occur within minutes to about 1 hour after contact with the skin
  • Swelling and redness (wheal and flare) may be seen
  • Rash usually resolves by itself within 24 hours of onset

Anaphylaxis

  • Difficulty breathing, nausea, vomiting, rash with swelling
  • Rare, but can be fatal.
  • Reports of death due to the allergen in permanent hair dye

Irritant contact dermatitis

  • Accounts for 80% of all cases of contact dermatitis
  • Can occur in anyone but people with atopy are more prone to irritant dermatitis
  • Usually begins as patches of itchy, scaly skin or red rash, but can develop into blisters that ooze
  • For strong irritants, a reaction may occur within minutes or hours of exposure.
  • For weaker irritants, it may take days or weeks of continued exposure before symptoms appear.

Allergic contact dermatitis

  • The reaction only occurs when a person’s immune system is sensitised to the allergen (the person is allergic to a specific ingredient).
  • A rash usually develops more than 12 hours after contact with the allergen and usually peaks about 48 hours after exposure.
  • Symptoms include redness, swelling, intense itching and hive-like breakouts.
  • Face, lips, eyes, ears and neck are the most common sites for cosmetic allergy.

Photocontact dermatitis

  • The rash is caused by the interaction of sunlight with an ingredient in the cosmetic.

Some people may suffer from more than one type of reaction. In particular, atopic individuals are more prone to irritant contact dermatitis, which in turn increases their likelihood of allergic contact dermatitis, as their skin barrier function is weakened and sensitised to the allergen. It is possible for a cosmetic allergy to develop even after years of using a cosmetic without previous problems.

Contact allergic dermatitis to cosmetics

What are the allergens in cosmetics?

The range of cosmetics is vast so the pool of allergens is infinitely huge. The groups of allergens that appear to most frequently cause cosmetic allergy are fragrances, preservatives, and paraphenylenediamine (PPD) found in hair dyes.

Fragrances

  • More than 5000 different fragrances used in cosmetics and skin care products
  • Present in most types of cosmetics including perfumes, shampoos, conditioners, moisturisers, facial cosmetics, and deodorants
  • The most common cause of contact dermatitis from cosmetics
  • 70-80% of fragrance allergy can be picked up by patch testing with Fragrance Mix and Balsam of Peru
  • Cosmetic labelled “unscented” does not mean “fragrance-free” as some unscented products may contain a fragrance to mask another chemical odour. Products should be labelled “fragrance-free” or “without perfume” to indicate no fragrances have been used.

Preservatives

  • The second most common cause of contact dermatitis
  • Cosmetics that contain water have a preservative in them to prevent bacterial or fungal growth
  • Some of the preservatives most commonly found in cosmetics include:

Paraphenylenediamine hair dye

  • PPD is the third most common ingredient after fragrances and preservatives to cause contact dermatitis.
  • Used widely in permanent hair dyes because it gives a natural look.
  • Reactions may be mild and involve dermatitis to the upper eyelids or rims of the ears or may be more severe with swelling of the scalp and face.
  • New derivatives of PPD have a lower risk of causing allergy.

Other allergens used in cosmetics that can cause cosmetics allergy include:

Am I allergic to a cosmetic?

Cosmetic allergy is diagnosed by performing special allergy tests, called patch tests. Diagnosis may involve testing against a number of different chemicals due to the many potential allergens that cosmetics are made up of, as well as the person's own cosmetics as is. See individual contact allergens for patch testing recommendations.

An open application test may also be recommended.

Patch tests revealing multiple contact allergies to fragrances

What is the treatment for cosmetic allergy?

Contact dermatitis should clear rapidly once the cosmetic allergen is removed. Over-the-counter creams and ointments containing mild topical steroids, such as hydrocortisone 0.5–2.5%, may be used to help control itching, swelling, and redness. In more severe cases, a prescription steroid cream may be required, as well as antibiotic medication if the skin becomes blistered and infected. Bland emollients such as cetomacrogol cream can be used to soothe and relieve dryness.

What should I do to avoid cosmetic allergy?

If you have a cosmetic allergy the best way to prevent any problem is by avoiding all products that contain the allergen you are sensitive to. Some steps you can take to reducing cosmetic allergy reactions include:

  • Read the list of ingredients on all cosmetic products and know the names of the allergens you need to avoid
  • When trying out a new product, do a mini patch test by placing a small sample of the product on your inner wrist or elbow and wait for at least 24 hours to see if a reaction occurs
  • Choose products that don’t have a long list of ingredients to minimise the potential allergens
  • Apply perfume to your clothes rather than your skin, and allow the perfume to dry before putting on the clothes
  • Look for products that are hypoallergenic, fragrance-free and non-comedogenic. However, be aware that these may still cause reactions.

Your dermatologist may have further specific advice, particularly if you are highly sensitive to particular cosmetic allergens.

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References

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