Skincare products containing low concentrations of formaldehyde detected by the chromotropic acid method cannot be safely used in formaldehyde-allergic patients

Hauksson, Inese; Pontén, Ann; Gruvberger, Birgitta; Isaksson, Marléne; Engfeldt, Malin; Bruze, Magnus

doi:10.1111/bjd.14241

Cited by 57 publications

(74 citation statements)

References 35 publications

(87 reference statements)

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“…Furthermore, the maximum concentrations of some of the FM I ingredients have been lowered since 2011 according to the IFRA standards. However, despite lower exposure, the situation may be different if products such as scented moisturizers are applied on skin with an existing dermatitis . There were 10 participants with a positive patch test reaction to FM I in 2011 who in 2014 had a negative, irritant or doubtful reaction.…”

Section: Discussionmentioning

confidence: 99%

Validation of a questionnaire algorithm based on repeated open application testing with the constituents of fragrance mix I

et al. 2019

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Summary Background In a European study on contact allergy in the general population, it was hypothesized that the combination of contact allergy to a fragrance together with a history indicating dermatitis at exposure, and thereafter subsequent avoidance of scented products, implied a diagnosis of allergic contact dermatitis. Objectives The primary aim of this study was to validate this hypothesis and algorithm. The secondary aim was to investigate whether there was any association between the outcome of the repeated open application test (ROAT) and the patch test reactivity. Methods In total, 109 patients with and without contact allergy to fragrance mix (FM) I were recruited. Volunteers from six European dermatology clinics participated in the study including a patch test and a ROAT. Results Positive ROAT reactions were noted in 26 of the 44 volunteers with contact allergy to FM I. None of the volunteers reacted to the vehicle (P < 0·001). More individuals with a positive algorithm had positive ROATs than those with a negative algorithm. However, the difference was not statistically significant. The lower the patch test concentration eliciting a positive test reaction, the more likely a positive ROAT and the more likely that the positive ROAT appeared early during the investigative period. Conclusions The algorithm used in this study was not substantiated in this ROAT set‐up. The stronger the patch test reactivity the more likely was a positive ROAT and the more likely it was that the positive ROAT appeared early during the application period. What's already known about this topic? To the best of our knowledge, a scientifically designed and conducted repeated open application test (ROAT) has never been performed before to validate a diagnosis of allergic contact dermatitis partly based on a questionnaire. What does this study add? This is the largest controlled, randomized and blinded ROAT performed to date. Higher patch test reactivity to fragrance mix I indicated a greater likelihood of a positive ROAT. What are the clinical implications of this work? Further refinement of the questions is required in order to diagnose allergic contact dermatitis from fragrances based on a questionnaire.

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Section: Discussionmentioning

confidence: 99%

Validation of a questionnaire algorithm based on repeated open application testing with the constituents of fragrance mix I

et al. 2019

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“…However, this concentration is sufficient to provoke ACD in those allergic to formaldehyde and using these products on healthy skin [18]. It was also shown that these allergic individuals cannot safely use products with low amounts (10–40 ppm) of formaldehyde if they have irritant contact dermatitis, as their dermatitis deteriorates [18]. …”

Section: Discussionmentioning

confidence: 99%

Formaldehyde may be found in cosmetic products even when unlabelled

et al. 2015

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Concomitant contact allergy to formaldehyde and formaldehyde-releasers remains common among patients with allergic contact dermatitis. Concentration of free formaldehyde in cosmetic products within allowed limits have been shown to induce dermatitis from short-term use on normal skin.The aim of this study was to investigate the formaldehyde content of cosmetic products made in Lithuania. 42 samples were analysed with the chromotropic acid (CA) method for semi-quantitative formaldehyde determination. These included 24 leave-on (e.g., creams, lotions) and 18 rinse-off (e.g., shampoos, soaps) products. Formaldehyde releasers were declared on the labels of 10 products. No formaldehyde releaser was declared on the label of the only face cream investigated, but levels of free formaldehyde with the CA method was >40 mg/ml and when analysed with a high-performance liquid chromatographic method – 532 ppm. According to the EU Cosmetic directive, if the concentration of formaldehyde is above 0.05% a cosmetic product must be labelled “contains formaldehyde“. It could be difficult for patients allergic to formaldehyde to avoid contact with products containing it as its presence cannot be determined from the ingredient labelling with certainty. The CA method is a simple and reliable method for detecting formaldehyde presence in cosmetic products.

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“…Skin cleaning care without washing by water is particularly useful in situations where bathing is impossible (eg, disaster or deterioration of physical condition). However, skin inflammation may occur when using leave‐on products, such as moisturizers, despite the use of lower concentrations of cleaning agents . Therefore, to avoid skin irritation, cleaning agents should be removed from the skin as much as possible.…”

Section: Introductionmentioning

confidence: 99%

Comparison of wiping methods for the removal of cleaning agent residue from hair follicles

Aoki

Ogai

Matsumoto

et al. 2019

Skin Research and Technology

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Purpose This study aimed to clarify the influence of different wiping methods on cleaning agent residue in hair follicles when using skin cleaning agents that are “removable‐by‐wiping.” Methods A total of 18 male volunteers were recruited and a cleaning agent containing 10% fluorescein sodium salt (cleaning agent) was used in this study. After gentle washing, the cleaning agent was removed via the washing method (control) or three distinct wiping methods (experiment). Hairs were obtained from the measurement area. The fluorescence intensities of the residual cleaning agent on the hair root and hair bulb were then evaluated after normalizing for autofluorescence from the hair. Fluorescence intensity was used to estimate the amount of cleaning agent residue. Results No significant differences were found among cleaning agent removal methods (hair root: P = 0.67, hair bulb: P = 0.62) with respect to the amount of residual cleaning agent on hair. Conclusion Cleaning agent residual index did not differ according to removal method. Cleaning agent remained in the hair follicle (hair roots, hair bulbs) despite removal from the skin by washing or wiping. Further studies are required to apply “removable‐by‐wiping” cleaning agents for people with vulnerable skin.

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Skincare products containing low concentrations of formaldehyde detected by the chromotropic acid method cannot be safely used in formaldehyde-allergic patients

Abstract: Our results demonstrate that the low concentrations of formaldehyde often found in skincare products by the CA method are sufficient to worsen an existing dermatitis in formaldehyde-allergic individuals.

Cited by 57 publications

References 35 publications

Validation of a questionnaire algorithm based on repeated open application testing with the constituents of fragrance mix I

Validation of a questionnaire algorithm based on repeated open application testing with the constituents of fragrance mix I

Formaldehyde may be found in cosmetic products even when unlabelled

Comparison of wiping methods for the removal of cleaning agent residue from hair follicles

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