Formaldehyde and Formaldehyde-Releasers

  • Anton C. de GrootEmail author
  • Mari-Ann Flyvholm
Reference work entry


This 31-page chapter in Kanerva’s Occupational Dermatology, 3rd edition (2018), discusses contact allergy to and allergic contact dermatitis from formaldehyde and formaldehyde-releasers. Formaldehyde has many applications, which are shown in tabular format in this publication. However, it is a ubiquitous and important allergen. Contact allergy to formaldehyde occurs frequently in women with hand dermatitis. Sensitization may also be caused by occupational exposure to formaldehyde, especially in metalworkers, nurses, other (para)medical professionals, and cosmetologists. Formaldehyde is widely distributed in the environment and is difficult to avoid completely. Thus, even in patients actively trying to avoid products containing it, the dermatitis will infrequently heal completely and permanently. In 2013, the concentration used for patch testing to detect formaldehyde sensitization was raised from 1% to 2% in water, as the latter reveals up to 80% more cases of sensitization.

Formaldehyde-releasers are chemicals, which release formaldehyde as a result of decomposition and/or chemicals synthesized from formaldehyde that may still contain residues of free formaldehyde. There are over 30 formaldehyde-releasers with a wide array of applications; most are used as preservatives in cosmetics, as antimicrobials in metalworking fluids, paint, lacquers, and varnishes or as durable press chemical finishes in textiles. These are shown in this chapter in tabular format with common names, IUPAC names, synonyms, trade names, CAS numbers, and applications.

Positive patch tests to formaldehyde-releasers are often accompanied by concomitant reactions to formaldehyde; in these cases, the patch test to the releaser may be the result of an allergic reaction to the formaldehyde which is present in or released by the donor test material.

With the exception of those used in cosmetics (e.g., quaternium-15, imidazolidinyl urea, diazolidinyl urea, DMDM hydantoin, and 2-bromo-2-nitropropane-1,3-diol), there is little published information on the relevance of observed positive patch test reactions to formaldehyde-releasers. Most reactions to releasers used in metalworking fluids appear not to be relevant with the exception of N,N′-methylenebis(5-methyloxazolidine). The presence of formaldehyde-releasers used as durable press chemical finishes in clothes appears to be safe for consumers. None of the formaldehyde-releasers are important causes of occupational allergic contact dermatitis.


Formaldehyde Formaldehyde-releaser Preservative Antimicrobial Cosmetics Metalworking fluids Durable press chemical finish Diazolidinyl urea Imidazolidinyl urea DMDM hydantoin Quaternium-15 2-Bromo-2-nitropropane-1,3-diol Bioban ® N,N′-Methylenebis(5-methyloxazolidine) tris(N-hydroxyethyl)hexahydrotriazine tris(Hydroxymethyl)nitromethane Urea-formaldehyde Melamine/formaldehyde Dimethylol dihydroxyethyleneurea Methenamine N-Methylolchloracetamide 


  1. Aalto-Korte K (2000) Simultaneous allergic reactions to quaternium-15 and methenamine. Contact Dermatitis 42:365PubMedGoogle Scholar
  2. Aalto-Korte K, Jolanki R, Estlander T (2003) Formaldehyde-negative allergic contact dermatitis from melamine-formaldehyde resin. Contact Dermatitis 49:194–196PubMedCrossRefGoogle Scholar
  3. Aalto-Korte K, Kuuliala O, Suuronen K et al (2008) Occupational contact allergy to formaldehyde and formaldehyde releasers. Contact Dermatitis 59:280–289PubMedCrossRefGoogle Scholar
  4. Agner T, Flyvholm M-A, Menné T (1999) Formaldehyde allergy : a follow-up study. Am J Contact Dermatitis 10:12–17PubMedGoogle Scholar
  5. Ågren S, Dahlquist I, Fregert S et al (1980) Allergic contact dermatitis from the preservative N-methylol-chloracetamide. Contact Dermatitis 6:202–203CrossRefGoogle Scholar
  6. Andersen KE, Boman A, Hamann K et al (1984) Guinea pig maximization tests with formaldehyde releasers. Results of two laboratories. Contact Dermatitis 10:257–266PubMedCrossRefGoogle Scholar
  7. Anderson BE, Tan TC, Marks JG Jr (2007) Patch-test reactions to formaldehyde, biobans, and other formaldehyde releasers. Dermatitis 18:92–95PubMedCrossRefGoogle Scholar
  8. Batta K, McVittie S, Foulds IS (1999) Occupational allergic contact dermatitis from N,N-methylene-bis-3-methyl-oxazolidine in a nylon spin finish. Contact Dermatitis 41:165PubMedCrossRefGoogle Scholar
  9. Berndt U, Hinnen U, Iliev D et al (2000) Hand eczema in metalworker trainees – an analysis of risk factors. Contact Dermatitis 43:327–332CrossRefGoogle Scholar
  10. Bracamonte BG, Ortiz de Frutos FJ, Iglesias Diez L (1995) Occupational allergic contact dermatitis due to formaldehyde and textile finish resins. Contact Dermatitis 33:139–140CrossRefGoogle Scholar
  11. Brinkmeier T, Geier J, Lepoittevin J-P et al (2002) Patch test reactions to biobans in metalworkers are often weak and not reproducible. Contact Dermatitis 47:27–31PubMedCrossRefGoogle Scholar
  12. Cahill JL, Nixon RL (2011) Allergic contact dermatitis in health care workers to diazolidinyl urea present in antimicrobial hand gel. Med J Aust 194:664–665PubMedCrossRefGoogle Scholar
  13. Carlson RM, Smith MC, Nedorost ST (2004) Diagnosis and treatment of dermatitis due to formaldehyde resins in clothing. Dermatitis 15:169–175PubMedGoogle Scholar
  14. Cockayne SE, McDonagh AJ, Gawdrodger DJ (2001) Occupational allergic contact dermatitis from formaldehyde resin in clothing. Contact Dermatitis 44:109–110PubMedCrossRefGoogle Scholar
  15. Cronin E (1991) Formaldehyde is a significant allergen in women with hand eczema. Contact Dermatitis 25:276–282PubMedCrossRefGoogle Scholar
  16. Davis MD, Scalf LA, Yiannias JA et al (2008) Changing trends and allergens in the patch test standard series. A Mayo Clinic 5-year retrospective review, January 1, 2001, through December 31, 2005. Arch Dermatol 144:67–72PubMedGoogle Scholar
  17. De Groot AC (2018) Monographs in contact allergy volume I. Non-fragrance allergens in cosmetics (part I and part 2). CRC Press Taylor and Francis Group, Boca Raton. ISBN 978-1-138-57325-3 and 978-1-138-57338-3Google Scholar
  18. De Groot AC, Coenraads PJ (2010) Twenty-five years quaternium-15 in the baseline series: does it deserve its place there? Contact Dermatitis 62:210–220PubMedCrossRefGoogle Scholar
  19. De Groot AC, Flyvholm M-A (2012) Formaldehyde and formaldehyde-releasers. In: Rustemeyer T, Elsner P, John SW, Maibach HI (eds) Kanerva’s occupational dermatology, 2nd edn. Springer, Berlin, pp 397–414CrossRefGoogle Scholar
  20. De Groot AC, Maibach HI (2010) Does allergic contact dermatitis from formaldehyde in clothes treated with durable-press chemical finishes exist in the USA? Contact Dermatitis 62:127–136PubMedCrossRefGoogle Scholar
  21. De Groot AC, Veenstra M (2010) Formaldehyde-releasers in cosmetics in the USA and in Europe. Contact Dermatitis 62:221–224PubMedCrossRefGoogle Scholar
  22. De Groot A, Flyvholm M-A, Lensen G et al (2009) Formaldehyde-releasers: relationship to formaldehyde contact allergy. Contact allergy to formaldehyde and inventory of formaldehyde-releasers. Contact Dermatitis 61:63–85PubMedCrossRefGoogle Scholar
  23. De Groot AC, White IR, Flyvholm M-A et al (2010a) Formaldehyde-releasers: relationship to formaldehyde contact allergy. Formaldehyde-releasers used in cosmetics. Part 1. Characterization, frequency and relevance of sensitization, and frequency of use in cosmetics. Contact Dermatitis 62:2–17PubMedCrossRefGoogle Scholar
  24. De Groot A, White IR, Flyvholm M-A et al (2010b) Formaldehyde-releasers: relationship to formaldehyde contact allergy. Formaldehyde-releasers used in cosmetics. Part 2. Patch test relationship to formaldehyde contact allergy, experimental provocation tests, amount of formaldehyde released and assessment of risk to consumers allergic to formaldehyde. Contact Dermatitis 62:18–31PubMedCrossRefGoogle Scholar
  25. De Groot A, Le Coz C, Lensen G et al (2010c) Formaldehyde-releasers: relationship to formaldehyde contact allergy. Formaldehyde-releasers in clothes: durable press chemical finishes. Part 1. Contact Dermatitis 62:259–271PubMedCrossRefGoogle Scholar
  26. De Groot A, Le Coz C, Lensen G et al (2010d) Formaldehyde-releasers: relationship to formaldehyde contact allergy. Formaldehyde-releasers in clothes: durable press chemical finishes. Part 2. Contact Dermatitis 63:1–9PubMedCrossRefGoogle Scholar
  27. De Groot A, Geier J, Flyvholm M-A et al (2010e) Formaldehyde-releasers: relationship to formaldehyde contact allergy. Metalworking fluids and remainder. Part 1. Contact Dermatitis 63:117–128PubMedGoogle Scholar
  28. De Groot A, Geier J, Flyvholm M-A et al (2010f) Formaldehyde-releasers: relationship to formaldehyde contact allergy. Metalworking fluids and remainder. Part 2. Contact Dermatitis 63:129–139PubMedGoogle Scholar
  29. DeKoven JG, Warshaw EM, Belsito DV et al (2017) North American contact dermatitis group patch test results: 2013–2014. Dermatitis 28:33–46PubMedCrossRefGoogle Scholar
  30. Donovan J, Skoynicki-Grant S (2006) Allergic contact dermatitis from formaldehyde textile resins in surgical uniforms and nonwoven textile masks. Dermatitis 18:40–44CrossRefGoogle Scholar
  31. Farli M, Ginanneschi M, Francalanci S et al (1987) Occupational contact dermatitis to N-methylol-chloroacetamide. Contact Dermatitis 17:182–184PubMedCrossRefGoogle Scholar
  32. Field S, O’Sullivan CRGN, Bourke JF (2010) Allergic contact dermatitis from N,N-methylenebismorpholine in a cutting oil. Dermatitis 21:292–293PubMedCrossRefGoogle Scholar
  33. Fisher AA, Kanof NB, Biondi EM (1962) Free formaldehyde in textiles and paper. Clinical significance. Arch Dermatol 86:753–756PubMedCrossRefGoogle Scholar
  34. Flyvholm M-A, Menné T (1992) Allergic contact dermatitis from formaldehyde. A case study focusing on sources of formaldehyde exposure. Contact Dermatitis 27:27–36PubMedCrossRefGoogle Scholar
  35. Fowler JF Jr, Skinner SM, Belsito DV (1992) Allergic contact dermatitis from formaldehyde resins in permanent press clothing: an underdiagnosed cause of generalized dermatitis. J Am Acad Dermatol 27:962–968PubMedCrossRefGoogle Scholar
  36. Fregert S (1981) Formaldehyde dermatitis from a gypsum-melamine resin mixture. Contact Dermatitis 7:56PubMedCrossRefGoogle Scholar
  37. Friis UF, Dahlin J, Bruze M et al (2014) Hidden exposure to formaldehyde in a swab caused allergic contact dermatitis. Contact Dermatitis 70:258–260PubMedCrossRefGoogle Scholar
  38. Gasperini M, Farli M, Lombardi P et al (1989) Contact dermatitis in the textile and garment industry. In: Frosch PJ et al (eds) Current topics in contact dermatitis. Springer, Berlin, pp 326–329CrossRefGoogle Scholar
  39. Gavin JG, Martinez ML, Fernandez-Redondo V et al (2008) Contact allergic dermatitis from melamine formaldehyde resins in a patient with a negative patch-test reaction to formaldehyde. Dermatitis 19:5–6Google Scholar
  40. Geier J, Lessmann H, Dickel H et al (2004a) Patch test results with the metalworking fluid series of the German Contact Dermatitis Research Group (DKG). Contact Dermatitis 51:118–130PubMedCrossRefGoogle Scholar
  41. Geier J, Lessmann H, Schnuch A et al (2004b) Contact sensitizations in metalworkers with occupational dermatitis exposed to water-based metalworking fluids: results of the research project “FaSt”. Int Arch Occup Environ Health 77:543–551CrossRefGoogle Scholar
  42. Giménez-Arnau AM, Deza G, Bauer A et al (2017) Contact allergy to preservatives: ESSCA* results with the baseline series, 2009–2012. J Eur Acad Dermatol Venereol 31:664–671PubMedCrossRefGoogle Scholar
  43. Hamann K (1980) Forcide 78 ® – another formaldehyde releaser in coolant oils. Contact Dermatitis 6:446PubMedGoogle Scholar
  44. Henricks-Eckerman M-L, Suuronen K, Jolanki R (2008) Analysis of allergens in metalworking fluids. Contact Dermatitis 59:261–267CrossRefGoogle Scholar
  45. Higgins CL, Palmer AM, Cahill JL, Nixon RL (2016) Occupational skin disease among Australian healthcare workers: a retrospective analysis from an occupational dermatology clinic, 1993–2014. Contact Dermatitis 75:213–222PubMedCrossRefGoogle Scholar
  46. Hjorth N (1979) N-methylol-chloracetamide, a sensitizer in coolant oils and cosmetics. Contact Dermatitis 5:330–331PubMedCrossRefGoogle Scholar
  47. Holness DL, Nethercott JR (1997) Results of patch testing with a specialized collection of plastic and glue allergens. Am J Contact Dermatitis 8:121–124PubMedGoogle Scholar
  48. Isaksson M, Zimerson E, Bruze M (1999) Occupational dermatoses in composite production. J Occup Environ Med 41:261–266CrossRefGoogle Scholar
  49. Isaksson M, Bråred-Christensson J, Engfeldt M et al (2014) Swedish Contact Dermatitis Research Group. Patch testing with formaldehyde 2.0% in parallel with 1.0% by the Swedish contact dermatitis research group. Acta Derm Venereol 94:408–410PubMedCrossRefGoogle Scholar
  50. Kadivar S, Belsito DV (2015) Occupational dermatitis in health care workers evaluated for suspected allergic contact dermatitis. Dermatitis 26:177–183PubMedCrossRefGoogle Scholar
  51. Kang KM, Corey G, Storrs FJ (1995) Follow-up study of patients allergic to formaldehyde and formaldehyde releasers: retention of information, compliance, course, and persistence of allergy. Am J Contact Dermatitis 6:209–215CrossRefGoogle Scholar
  52. Latorre N, Borrego L, Fernández-Redondo V et al (2011) Patch testing with formaldehyde and formaldehyde-releasers: multicentre study in Spain (2005–2009). Contact Dermatitis 65:286–292PubMedCrossRefGoogle Scholar
  53. Lazarov A (2004) Textile dermatitis in patients with contact sensitization in Israel: a 4-year prospective study. J Eur Acad Dermatol Venereol 18:531–537PubMedCrossRefGoogle Scholar
  54. Lazarov A, Trattner A, David M et al (2000) Textile dermatitis in Israel: a retrospective study. Am J Contact Dermatitis 11:26–29PubMedCrossRefGoogle Scholar
  55. Lazarov A, Trattner A, Abraham D et al (2002) Frequency of textile dye and resin sensitization in patients with contact dermatitis in Israel. Contact Dermatitis 46:119–120PubMedCrossRefGoogle Scholar
  56. Lisi P, Stingeni L, Cristaudo A et al (2014) Clinical and epidemiological features of textile contact dermatitis: an Italian multicentre study. Contact Dermatitis 70:344–350PubMedCrossRefGoogle Scholar
  57. Lundov MD, Johansen JD, Carlsen BC et al (2010) Formaldehyde exposure and patterns of concomitant contact allergy to formaldehyde and formaldehyde-releasers. Contact Dermatitis 63:31–36PubMedCrossRefGoogle Scholar
  58. Madan V, Beck MH (2006) Occupational allergic contact dermatitis from N,N-methylene-bis-5-methyl-oxazolidine in coolant oils. Contact Dermatitis 55:39–41PubMedCrossRefGoogle Scholar
  59. Meding B (2000) Differences between the sexes with regard to work-related skin disease. Contact Dermatitis 43:65–71CrossRefGoogle Scholar
  60. Merget R, Topcu M, Friese K et al (1999) A cross-sectional study of workers in the chemical industry with occupational exposure to hexamethylenetetramine. Int Arch Occup Environ Health 72:533–538PubMedCrossRefGoogle Scholar
  61. Metzler-Brenckle L, Rietschel RL (2002) Patch testing for permanent-press allergic contact dermatitis. Contact Dermatitis 46:33–37PubMedCrossRefGoogle Scholar
  62. Mirabelli MC, Zock J-P, Bircher AJ et al (2009) Metalworkers exposures and persistent skin symptoms in the ECRHS II and SAPALDIA 2 cohorts. Contact Dermatitis 60:256–263PubMedPubMedCentralCrossRefGoogle Scholar
  63. Parker LU, Taylor JS (1991) A 5-year study of contact allergy to quaternium-15. Am J Cont Derm 2:231–234CrossRefGoogle Scholar
  64. Pereira F, Rafael M, Pereira MA (1999) Occupational allergic contact dermatitis from a glue, containing isothiazolinones and N-methylol-chloroacetamide, in a carpenter. Contact Dermatitis 40:283PubMedCrossRefGoogle Scholar
  65. Pesonen M, Jolanki R, Larese Filon F, on behalf of the ESSCA network et al (2015) Patch test results of the European baseline series among patients with occupational contact dermatitis across Europe – analyses of the European Surveillance System on Contact Allergy network, 2002–2010. Contact Dermatitis 72:154–163CrossRefGoogle Scholar
  66. Pontén A, Goossens A, Bruze M (2013) Recommendation to include formaldehyde 2.0% aqua in the European baseline patch test series. Contact Dermatitis 69:372–374PubMedCrossRefGoogle Scholar
  67. Pontén A, Bruze M, Engfeldt M et al (2016) Concomitant contact allergies to formaldehyde, methylchloroisothiazolinone/methylisothiazolinone, methylisothiazolinone, and fragrance mixes I and II. Contact Dermatitis 75:285–289PubMedCrossRefGoogle Scholar
  68. Priha E (1995) Are textile formaldehyde regulations reasonable? Experiences from the Finnish textile and clothing industries. Regul Toxicol Pharm 22:243–249CrossRefGoogle Scholar
  69. Prodi A, Rui F, Belloni Fortina A et al (2016) Sensitization to formaldehyde in northeastern Italy, 1996 to 2012. Dermatitis 27:21–25PubMedCrossRefGoogle Scholar
  70. Reich HC, Warshaw Erin M (2010) Allergic contact dermatitis from formaldehyde textile resins. Dermatitis 21:65–76PubMedCrossRefGoogle Scholar
  71. Robertson M, Storrs FJ (1982) Allergic contact dermatitis in two machinists. Arch Dermatol 118:997–1002PubMedCrossRefGoogle Scholar
  72. Romaguera C, Grimalt F, Lecha M (1981) Occupational purpuric textile dermatitis from formaldehyde resins. Contact Dermatitis 7:152–153PubMedCrossRefGoogle Scholar
  73. Ross JS, Rycroft RJG, Cronin E (1992) Melamine-formaldehyde contact dermatitis in orthopaedic practice. Contact Dermatitis 26:203–204PubMedCrossRefGoogle Scholar
  74. Savage J (1978) Chloracetamide in nylon spin finish. Contact Dermatitis 4:179PubMedCrossRefGoogle Scholar
  75. Scheman AJ, Carroll PA, Brown KH et al (1998) Formaldehyde-related textile allergy: an update. Contact Dermatitis 38:332–336PubMedCrossRefGoogle Scholar
  76. Sherertz EF (1992) Clothing dermatitis: practical aspects for the clinician. Am J Contact Dermatitis 3:55–64CrossRefGoogle Scholar
  77. Soni BP, Sherertz EF (1996) Contact dermatitis in the textile industry: a review of 72 patients. Am J Contact Dermatitis 7:226–230PubMedGoogle Scholar
  78. Suuronen K, Aalto-Korte K, Piipari R et al (2007) Occupational dermatitis and allergic respiratory diseases in Finnish metal working machinists. Occup Med 57:277–287CrossRefGoogle Scholar
  79. Trattner A, Johansen JD, Menné T (1998) Formaldehyde concentration in diagnostic patch testing: comparison of 1% with 2%. Contact Dermatitis 38:9–13PubMedCrossRefGoogle Scholar
  80. Uter W, Frosch PJ (2002) Contact allergy from DMDM hydantoin, 1994–2000. Contact Dermatitis 47:57–58PubMedCrossRefGoogle Scholar
  81. Uter W, Aberer W, Armario-Hita JC et al (2012) Current patch test results with the European baseline series and extensions to it from the ‘European Surveillance System on Contact Allergy’ network, 2007–2008. Contact Dermatitis 67:9–19PubMedCrossRefGoogle Scholar
  82. Uter W, Amario-Hita JC, Balato A et al (2017) European Surveillance System on Contact Allergies (ESSCA): results with the European baseline series, 2013/14. J Eur Acad Dermatol Venereol 31:1516–1525PubMedCrossRefGoogle Scholar
  83. Warshaw EM, Ahmed RL, Belsito DV et al (2007) Contact dermatitis of the hands. Cross-sectional analyses of North American Contact Dermatitis Group Data, 1994–2004. J Am Acad Dermatol 57:301–315PubMedCrossRefGoogle Scholar
  84. Warshaw EM, Belsito DV, Taylor JS et al (2013) North American Contact Dermatitis Group patch test results: 2009 to 2010. Dermatitis 24:50–59PubMedCrossRefGoogle Scholar
  85. Warshaw EM, Maibach HI, Taylor JS et al (2015) North American Contact Dermatitis Group patch test results: 2011–2012. Dermatitis 26:49–59PubMedCrossRefGoogle Scholar
  86. Wentworth AB, Yiannias JA, Keeling JH et al (2014) Trends in patch-test results and allergen changes in the standard series: a Mayo Clinic 5-year retrospective review (January 1, 2006, to December 31, 2010). J Am Acad Dermatol 70:269–275PubMedCrossRefGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2020

Authors and Affiliations

  1. 1.Acdegroot publishingWapserveenThe Netherlands
  2. 2.National Research Centre for the Working EnvironmentCopenhagenDenmark

Personalised recommendations