The role of contact allergy in the spectrum of adverse effects caused by cosmetics and toiletries

Of 982 female clients of beauticians interviewed, 254 (25.9%) claimed to have experienced adverse reactions to cosmetics and toiletries in the preceding 5 years. Most reactions were caused by skin-care products (36.6%), followed by personal cleanliness products (29.5%), eye cosmetics (24.0%), deodorants and antiperspirants (12.6%), and facial make-up products (8.3%). 150 women were patch tested. In the European standard series, only a few positive reactions were seen to possible cosmetic allergens: fragrance mix (n = 3), wool alcohols (n = 3), formaldehyde (n = 2), balsam of Peru (n = 1), and colophony (n = 1). In the cosmetic series, only Kathon CG elicited positive patch test reactions (n = 3). Cosmetic allergy was considered to be "proven" in 3 patients (2.0%), and "possible" in 7 (4.7%). It is concluded that contact allergy is responsible for a minority (less than 10%) of all reactions to cosmetics and toiletries. The majority of reactions are due to irritation from personal cleanliness products such as soaps, shampoos, bath foams and from deodorants, or worsening of pre-existing dermatoses such as seborrhoeic dermatitis and acne.