Skip to main content

Contact Dermatitis to Cosmetics

Abstract

Allergic contact dermatitis (ACD) to cosmetics is extremely common—probably the most common reason patients present for patch testing. The diagnosis should initially be suspected based on the patient history and the distribution of the dermatitis. Once the diagnosis is suspected, empiric recommendations for low allergenicity products should be implemented until patch testing is performed. The face is exposed to greatest number of cosmetics, and as a result, facial dermatitis is the prototypical presentation of cosmetic contact dermatitis. In particular, the eyelids are frequently involved, with common sources including shampoo, conditioner, facial cleansers, makeup remover, mascara, nail polish, acrylic nails, makeup sponges, eyelash curlers, and allergens transferred from the hands. Other typical facial distributions include lateral facial dermatitis, central facial dermatitis, and generalized facial dermatitis, each with its own unique set of most likely causes. Lateral facial and/or neck dermatitis is often a “rinse-off” pattern, with shampoo and/or conditioner rinsing down over these areas. Central facial dermatitis, when due to ACD, can be due to gold being released from gold rings and contaminating makeup foundation or to ingredients in moisturizers, wrinkle creams, topical medications, or makeup. Sparing of the lateral face is largely due to the fact that patients are more assiduous about applying the aforementioned substances to the central face than to the lateral face. Generalized facial dermatitis should trigger consideration of airborne contactants, facial cleansers, makeup foundation, and moisturizers and medications that are being applied confluently. Once adequate patch testing has been performed, there are a number of extremely helpful resources to help patients find products that are safe for use, such as the American Contact Dermatitis Society’s “Contact Allergen Management Program” app.

This is a preview of subscription content, access via your institution.

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6
Fig. 7
Fig. 8
Fig. 9

References

  1. Amin KA, Belsito DV (2006) The aetiology of eyelid dermatitis: a 10-year retrospective analysis. Contact Dermatitis 55(5):280–285

    Article  PubMed  Google Scholar 

  2. Pascher F (1982) Adverse reactions to eye area cosmetics and their management. J Soc Cosmet Chem 33:249

    CAS  Google Scholar 

  3. Mohajerin AH (1972) Common cutaneous disorders of the eyelids. Cutis 10:279

    Google Scholar 

  4. Rietschel RL, Warshaw EM, Sasseville D, Fowler JF, DeLeo V, Belsito DV, Taylor JS, Storrs FJ, Mathias CG, Maibach HI, Marks JG, Zug KA, Pratt M, North American Contact Dermatitis Group (2007) Common contact allergens associated with eyelid dermatitis: data from the North American Contact Dermatitis Group 2003-2004 study period. Dermatitis 18(2):78–81

    Article  PubMed  Google Scholar 

  5. Dejobert Y, Delaporte E, Piette F, Thomas P (2005) Eyelid dermatitis with positive patch test to coconut diethanolamide. Contact Dermatitis 52(3):173

    Article  PubMed  Google Scholar 

  6. Gallo R, Marro I, Pavesi A (2005) Allergic contact dermatitis from shellac in mascara. Contact Dermatitis 53(4):238

    Article  CAS  PubMed  Google Scholar 

  7. Le Coz CJ et al (2002) Allergic contact dermatitis from shellac in mascara. Contact Dermatitis 46(3):149–152

    Article  PubMed  Google Scholar 

  8. Saxena M, Warshaw E, Ahmed DD (2001) Eyelid allergic contact dermatitis to black iron oxide. Am J Contact Dermat 12(1):38–39

    CAS  PubMed  Google Scholar 

  9. Fisher AA (1977) Allergen replacements in allergic dermatitis. Int J Dermatol 16(5):319–328

    Article  CAS  PubMed  Google Scholar 

  10. Guin JD (2000) Eyelid dermatitis from benzophenone used in nail enhancement. Contact Dermatitis 43(5):308–309

    CAS  PubMed  Google Scholar 

  11. Moffitt DL, Sansom JE (2002) Allergic contact dermatitis from phthalic anhydride/trimellitic anhydride/glycols copolymer in nail varnish. Contact Dermatitis 46(4):236

    Article  CAS  PubMed  Google Scholar 

  12. Frosch PJ, Kligman AM (1977) A method for appraising the stinging capacity of topically applied substances. J Soc Cosmet Chem 28:197

    Google Scholar 

  13. Lahti A (1978) Skin reactions to some antimicrobial agents. Contact Dermatitis 4(5):302–303

    Article  CAS  PubMed  Google Scholar 

  14. Lahti A, Oikarinen A, Viinikka L, Ylikorkala O, Hannuksela M (1983) Prostaglandins in contact urticaria induced by benzoic acid. Acta Derm Venereol 63(5):425–427

    CAS  PubMed  Google Scholar 

  15. Lahti A, Väänänen A, Kokkonen EL, Hannuksela M (1987) Acetylsalicylic acid inhibits non-immunologic contact urticaria. Contact Dermatitis 16(3):133–135

    Article  CAS  PubMed  Google Scholar 

  16. Maibach HI, Engasser P (1988) Management of cosmetic intolerance syndrome. Clin Dermatol 6(3):102–107

    Article  CAS  PubMed  Google Scholar 

  17. Sugai T, Takahashi Y, Takagi T (1977) Pigmented cosmetic dermatitis and coal tar dyes. Contact Dermatitis 3(5):249–256

    Article  CAS  PubMed  Google Scholar 

  18. Nakavama H, Hanaoka H, Ohshiro A (1974) Allergen controlled system (ACS). Kanehara Shuppan Co, Tokyo

    Google Scholar 

  19. Jacob SE, Castanedo-Tardan MP (2008) A diagnostic pearl in allergic contact dermatitis to fragrances: the atomizer sign. Cutis 82(5):317–318

    PubMed  Google Scholar 

  20. Britz MB, Maibach HI (1979) Human cutaneous vulvar reactivity to irritants. Contact Dermatitis 5(6):375–377

    Article  CAS  PubMed  Google Scholar 

  21. Lewis FM, Harrington CI, Gawkrodger DJ (1994) Contact sensitivity in pruritus vulvae: a common and manageable problem. Contact Dermatitis 31(4):264–265

    Article  CAS  PubMed  Google Scholar 

  22. Lewis FM, Shah M, Gawkrodger DJ (1997) Contact sensitivity in pruritus vulvae: patch test results and clinical outcome. Am J Contact Dermat 8(3):137–140

    CAS  PubMed  Google Scholar 

  23. Petersen CS (1997) Lack of contact allergy in consecutive women with vulvodynia. Contact Dermatitis 37(1):46–47

    Article  CAS  PubMed  Google Scholar 

  24. Nunns D, Ferguson J, Beck M, Mandal D (1997) Is patch testing necessary in vulval vestibulitis? Contact Dermatitis 37(2):87–89

    Article  CAS  PubMed  Google Scholar 

  25. Fisher AA (1973) Allergic reaction to feminine hygiene sprays. Arch Dermatol 108(6):801–802

    Article  CAS  PubMed  Google Scholar 

  26. Gowdy JM (1972) Feminine deodorant sprays. N Engl J Med 287(4):203

    CAS  PubMed  Google Scholar 

  27. Paley K, English JC 3rd, Zirwas MJ (2008) Pterygium inversum unguis secondary to acrylate allergy. J Am Acad Dermatol 58(2 Suppl):S53–S54

    Article  PubMed  Google Scholar 

  28. Ramos L, Cabral R, Goncalo M (2014) Allergic contact dermatitis caused by acrylates and methacrylates—a 7-year study. Contact Dermatitis 71(2):102–107

    Article  CAS  PubMed  Google Scholar 

  29. Drucker AM, Pratt MD (2011) Acrylate contact allergy: patient characteristics and evaluation of screening allergens. Dermatitis 22(2):98–101

    PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Matthew J. Zirwas.

Ethics declarations

Conflict of Interest

The author has served as a consultant for numerous personal care product and pharmaceutical companies which are listed in the following table.

Ethical Approval

This article does not contain any studies with human participants or animals performed by any of the authors.

Matthew J Zirwas commercial relationships, updated Jan 2018.

Company Product Condition Role Recipient
Regeneron/Sanofi Dupixent Atopic dermatitis Speaker, consultant, investigator Self
Fit Bit Fitbit Fitness/activity tracker Consultant Self
Genench/Novartis Xolair Chronic urticaria Speaker Self
L’Oreal CeraVe Xerosis, dermatitis Consultant Self
Menlo Serlopitant Pruritus Consultant Self
AsepticMD AsepticMD Acne, keratosis pilaris Part owner Self
Leo Tralokinumab Atopic Dermatitis Investigator Employer
Janssen Guselkumab Psoriasis Investigator Employer
Incyte Baricitinib Atopic Dermatitis Investigator Employer
Foamix Minocycline Rosacea, Acne Investigator Employer
DS Biopharma DS107 Atopic Dermatitis Investigator Employer
UCB Bimekizumab Psoriasis Investigator Employer

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Zirwas, M.J. Contact Dermatitis to Cosmetics. Clinic Rev Allerg Immunol 56, 119–128 (2019). https://doi.org/10.1007/s12016-018-8717-9

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12016-018-8717-9

Keywords

  • Contact dermatitis
  • Cosmetic dermatitis
  • Allergic contact dermatitis
  • Eczema