Allergic Contact Dermatitis after the Use of Cosmetics Containing Parabens: Systematic Review and Meta-analysis

Abstract

Parabens are among the most widely used preservatives in cosmetic formulations. The aim of this study was to investigate the relationship between allergic contact dermatitis (ACD) and the use of parabens in cosmetics. A systematic review was performed with searches in PubMed, Scopus and Science Direct, in addition to a manual search. Interventional or observational studies that assessed the incidence of ACD in individuals using parabens were included. The quality of the articles was assessed and the data were extracted for a qualitative synthesis and single-arm meta-analysis. Fourteen studies (8 longitudinal, 3 crosssectional, 1 quasi experimental and 2 case reports) were included in the systematic review and had their data extracted. Twelve studies reported ACD after the use of parabens and were included in the single-arm metaanalysis, resulting in an ACD incidence of 0.9%[95%CI: 0.4-2.0%], thus classified as a rare event. This result was related to already sensitized skin in most cases. In addition, the concentration of parabens in the contact test was above that recommended in cosmetics. The incidence of ACD due to parabens is rare, but further studies with control groups and at the usual concentrations of parabens are needed to better evaluate the results. HIGHLIGHTS• There are few studies with a control group evaluating the incidence of ACD in the healthy population.• Skin reactions to cosmetic products containing parabens in their formulations are rare.• In the few cases in which ACD was associated with the use of cosmetics containing parabens, the reaction was often attributed to the application of parabens on already damaged skin.