Methylisothiazolinone (MIT) is a heterocyclic organic compound used as a preservative in cosmetics and personal care products in concentrations up to 0.01%. MIT is a colorless, clear liquid with a mild odor that is completely soluble in water; mostly soluble in acetonitrile, methanol, and hexane; and slightly soluble in xylene. Consistent with its solubility, dermal penetration is low. The Cosmetic Ingredient Review Expert Panel noted the in vitro evidence of neurotoxicity but concluded that the absence of any neurotoxicity findings in the many in vivo studies, including subchronic, chronic, and reproductive and developmental animal studies, suggests that MIT would not be neurotoxic as used in cosmetics. Although recognizing that MIT was a sensitizer in both animal and human studies, the panel concluded that there is a threshold dose response and that cosmetic products formulated to contain concentrations of MIT at 100 ppm (0.01%) or less would not be expected to pose a sensitization risk. Accordingly, MIT may be safely used as a preservative in cosmetics up to that concentration.

SummaryBackground Adherence to topical psoriasis treatments is low, which leads to unsatisfactory treatment results. Smartphone applications (apps) for patient support exist but their potential to improve adherence has not been systematically evaluated.Objectives To evaluate whether a study-specific app improves adherence and reduces psoriasis symptoms compared with standard treatment. Methods We conducted a randomized controlled trial (RCT, clinicaltrials.gov registration: NCT02858713). Patients received once-daily medication [calcipotriol/ betamethasone dipropionate (Cal/BD) cutaneous foam] and were randomized to no app (n = 66) or app intervention (n = 68) groups. In total, 122 patients (91%) completed the 22-week follow-up. The primary outcome was adherence, which was defined as medication applied ≥ 80% of days during the treatment period and assessed by a chip integrated into the medication dispenser. Secondary outcomes were psoriasis severity measured by the Lattice System Physician's Global Assessment (LS-PGA) and quality of life, measured using the Dermatology Life Quality Index (DLQI) at all visits. Results Intention-to-treat analyses using regression was performed. More patients in the intervention group were adherent to Cal/BD cutaneous foam than those in the nonintervention group at week 4 (65% vs. 38%, P = 0Á004). The intervention group showed a greater LS-PGA reduction than the nonintervention group at week 4 (mean 1Á86 vs. 1Á46, P = 0Á047). A similar effect was seen at weeks 8 and 26, although it did not reach statistical significance. Conclusions This RCT demonstrates that the app improved short-term adherence to Cal/BD cutaneous foam treatment and psoriasis severity.

Kojic acid functions as an antioxidant in cosmetic products. Kojic acid was not a toxicant in acute, chronic, reproductive, and genotoxicity studies. While some animal data suggested tumor promotion and weak carcinogenicity, kojic acid is slowly absorbed into the circulation from human skin and likely would not reach the threshold at which these effects were seen. The available human sensitization data supported the safety of kojic acid at a use concentration of 2% in leave-on cosmetics. Kojic acid depigmented black guinea pig skin at a concentration of 4%, but this effect was not seen at 1%. The Cosmetic Ingredient Review (CIR) Expert Panel concluded that the 2 end points of concern, dermal sensitization and skin lightening, would not be seen at use concentrations below 1%; therefore, this ingredient is safe for use in cosmetic products up to that level.

Propylene glycol is an aliphatic alcohol that functions as a skin conditioning agent, viscosity decreasing agent, solvent, and fragrance ingredient in cosmetics. Tripropylene glycol functions as a humectant, antioxidant, and emulsion stabilizer. Polypropylene glycols (PPGs), including PPG-3, PPG-7, PPG-9, PPG-12, PPG-13, PPG-15, PPG-16, PPG-17, PPG-20, PPG-26, PPG-30, PPG-33, PPG-34, PPG-51, PPG-52, and PPG-69, function primarily as skin conditioning agents, with some solvent use. The majority of the safety and toxicity information presented is for propylene glycol (PG). Propylene glycol is generally nontoxic and is noncarcinogenic. Clinical studies demonstrated an absence of dermal sensitization at use concentrations, although concerns about irritation remained. The CIR Expert Panel determined that the available information support the safety of tripropylene glycol as well as all the PPGs. The Expert Panel concluded that PG, tripropylene glycol, and PPGs ≥3 are safe as used in cosmetic formulations when formulated to be nonirritating.

Hyaluronic acid, sodium hyaluronate, and potassium hyaluronate function in cosmetics as skin conditioning agents at concentrations up to 2%. Hyaluronic acid, primarily obtained from bacterial fermentation and rooster combs, does penetrate to the dermis. Hyaluronic acid was not toxic in a wide range of acute animal toxicity studies, over several species and with different exposure routes. Hyaluronic acid was not immunogenic, nor was it a sensitizer in animal studies. Hyaluronic acid was not a reproductive or developmental toxicant. Hyaluronic acid was not genotoxic. Hyaluronic acid likely does not play a causal role in cancer metastasis; rather, increased expression of hyaluronic acid genes may be a consequence of metastatic growth. Widespread clinical use of hyaluronic acid, primarily by injection, has been free of significant adverse reactions. Hyaluronic acid and its sodium and potassium salts are considered safe for use in cosmetics as described in the safety assessment.

This report provides a review of the safety of Glycolic Acid, Ammonium, Calcium, Potassium, and Sodium Glycolates, Methyl, Ethyl, Propyl, and Butyl Glycolates, Lactic Acid, Ammonium, Calcium, Potassium, Sodium, and TEA-Lactates, and Lauryl, Myristyl, and Cetyl Lactates. These ingredients belong to a group known as alpha-hydroxy acids (AHAs). Products containing these ingredients may be for consumer use, salon use, or medical use. This report does not address the medical use. In consumer and salon use, AHAs can function as mild exfoliants, but are also used as pH adjusters and skin-conditioning agents. AHAs are absorbed by the skin; the lower the pH, the greater the absorption. Metabolism and distribution studies show expected pathways and distribution. Consistent with these data, acute oral animal studies show oxalate-induced renal calculi, an increase in renal oxalate, and nephrotoxic effects. No systemic effects in animals were seen with dermal application, but irritation at the sight of application was produced. While many animal studies were performed to evaluate AHA-induced skin irritation, it was common for either the AHA concentration or the pH of the formulation to be omitted, limiting the usefulness of the data. Clinical testing using AHA formulations of known concentration and pH was done to address the issue of skin irritation as a function of concentration and pH. Skin irritation increased with AHA concentration at a given pH. Skin irritation increased when the pH of a given AHA concentration was lowered. Repeat insult patch tests using lotions and creams containing up to 10% Glycolic or Lactic Acid were negative. Glycolic Acid at concentrations up to 10% was not comedogenic and Lactic Acid at the same concentrations did not cause immediate urticarial reactions. Glycolic Acid was found to be nonirritating to minimally irritating in animal ocular tests, while Lactic Acid was found to be nonirritating to moderately irritating. In vitro testing to predict ocular irritation suggested Glycolic Acid would be a minimal to moderate-severe ocular irritant, and that Lactic Acid would be a minimal to moderate ocular irritant. Developmental and maternal toxicity were reported in rats dosed by gavage at the highest dose level used in a study that exposed the animals on days 7-21 of gestation. No developmental toxicity was reported at levels that were not maternally toxic. AHAs were almost uniformly negative in genotoxicity tests and were not carcinogenic in rabbits or rats. Clinical reports suggested that AHAs would enhance the penetration of hydroquinone and lidocaine. Animal and clinical tests were done to further evaluate the potential ofAHAs to enhance the skin penetration of other chemical agents. Pretreatment of guinea pig skin with Glycolic Acid did not affect the absorption of hydroquinone or musk xylol. Clinical tests results indicated no increase in penetration of hydrocortisone or glycerin with Glycolic Acid pretreatment. Because AHAs can act to remove a portion of the stratum corneum, concern was expressed about the potential that pretreatment with AHAs could increase skin damage produced by UV radiation. Clinical testing was done to determine the number of sunburn cells (cells damaged by UV radiation that show distinct morphologic changes) produced by 1 MED of UV radiation in skin pretreated with AHAs. A statistically significant increase in the number of sunburn cells was seen in skin pretreated with AHAs compared to controls. These increases, however, were less than those seen when the UV dose was increased from 1 MED to 1.56 MED. The increase in UV radiation damage associated with AHA pretreatment, therefore, was of such a magnitude that it is easily conceivable that aspects of product formulation could eliminate the effect. Based on the available information included in this report, the CIR Expert Panel concluded that Glycolic and Lactic Acid, their common salts and their simple esters, are safe for use in cosmetic products at concentrations ≤10%, at final formulation pH≥3.5, when formulated to avoid increasing sun sensitivity or when directions for use include the daily use of sun protection. These ingredients are safe for use in salon products at concentrations ≤30%, at final formulation pH ≥3.0, in products designed for brief, discontinuous use followed by thorough rinsing from the skin, when applied by trained professionals, and when application is accompanied by directions for the daily use of sun protection.

This Annual Review of Cosmetic Ingredient Safety Assessments updates and affirms the findings of the Cosmetic Ingredient Review (CIR) Expert Panel's assessment of almost 30 compounds used in cosmetic ingredients. The review also summarizes new findings from epidemiology studies of hair dyes. The CIR Expert Panel's re-review process is intended to uncover any new data since the last safety assessment. In some cases, newly available data are largely redundant compared with the data available in the original safety assessment. In other cases, new data present new safety issues. If after considering the newly available information, the CIR Expert Panel decides to not reopen a safety assessment, this finding, along with any background material, is summarized and announced publicly. To assure that the scientific community is aware of any new information and the decision not to reopen, this Annual Review of Cosmetic Ingredient Safety Assessments is prepared. A list of reference sources is provided after each ingredient re-review summary that updates the available published literature and includes any unpublished data made available since the original safety assessment. The re-review also captures information on the industry's current practices of ingredient use, updating the data available in the earlier report. Although this material provides the opinion of the CIR Expert Panel regarding the new data described, it does not constitute a full safety review. The CIR Expert Panel has assessed the safety of over 2100 cosmetic ingredients since its inception in 1976. These safety assessments were published in the

The clinical features and the results of follow-up studies strongly suggest that these reactions are IgE mediated.