2‐Hydroxyethyl methacrylate (HEMA): A clinical review of contact allergy and allergic contact dermatitis—Part 1. Introduction, epidemiology, case series and case reports

Abstract

Abstract2‐Hydroxyethyl methacrylate (HEMA) has been increasingly recognised as a contact allergen and was added to the European baseline series in 2019. In this article (2 parts), the results of an extensive literature review of the clinical aspects of contact allergy/allergic contact dermatitis to HEMA are presented. In part 1, the epidemiology of HEMA contact allergy is discussed and detailed information on published case series and case reports presented. HEMA is an important cause of contact allergy/allergic contact dermatitis in North America and Europe with recent prevalences of >3% in the USA + Canada and 1.5%–3.7% in Europe. Currently, most cases are caused by nail cosmetics, both in consumers and professional nail stylists. In our literature review, we have found 24 studies presenting case series of patients with allergic contact dermatitis attributed to HEMA and 168 case reports. However, the presence of HEMA in the products causing ACD was established in only a minority. Part 2 will discuss cross‐ and co‐sensitisation, and other skin reactions to HEMA, will assess whether HEMA is the most frequent (meth)acrylate allergen and how sensitive HEMA as a screening agent is, investigate the presence of HEMA in commercial products and provide practical information on patch testing procedures.

Presence of 2‐hydroxyethyl methacrylate (HEMA) and other (meth)acrylates in nail cosmetics, and compliance with EU legislation: An online market survey

“…In most patients, the reactions to HEMA were considered to be relevant (indicating that HEMA had either caused the allergic contact dermatitis or contributed to it), although the presence of HEMA in the culprit nail cosmetics had not been ascertained, for example, from information on the material safety data sheet, ingredient label, from information obtained from the manufacturer or from chemical analyses. 1 Few data are available on the qualitative and quantitative presence of HEMA and other acrylates in nail cosmetics. 2 In some case series of ACD from cosmetic nail products, ingredient labels had confirmed the presence of patch test-positive (meth)acrylates in the cosmetics responsible for the allergic reactions.…”

“…During the last 15–20 years, allergic contact dermatitis (ACD) from acrylates‐containing nail cosmetics such as acrylic nails, gel nails and gel nail polish has been increasingly reported 1 . Many of these patients had positive patch tests to 2‐hydroxyethyl methacrylate (INCI name HEMA), either tested in a baseline series or in a (meth)acrylate series.…”

“…Many of these patients had positive patch tests to 2‐hydroxyethyl methacrylate (INCI name HEMA), either tested in a baseline series or in a (meth)acrylate series. In most patients, the reactions to HEMA were considered to be relevant (indicating that HEMA had either caused the allergic contact dermatitis or contributed to it), although the presence of HEMA in the culprit nail cosmetics had not been ascertained, for example, from information on the material safety data sheet, ingredient label, from information obtained from the manufacturer or from chemical analyses 1 …”