Conference Coverage

Contact dermatitis gets personal




Parabens have been eliminated from many personal care products because of health concerns, but from a contact dermatitis standpoint, they have “very low rates of irritancy and allergenicity” and are considered safe and well tolerated, according to Jonathan I. Silverberg, MD, of Northwestern University, Chicago.

“I almost never see a positive reaction to parabens,” Dr. Silverberg said in a presentation on contact dermatitis at the Hawaii Dermatology Seminar provided by Global Academy for Medical Education/Skin Disease Education Foundation.

However, the confirmation of estrogenic activity associated with parabens has led to their replacement in many products – especially personal care products – with other

Dr. Jonathan Silverberg of Northwestern University, Chicago
Dr. Jonathan Silverberg
preservatives that may cause skin reactions, he said. One of these is methylisothiazolinone, which was named the Contact Allergen of the Year by the American Contact Dermatitis Society in 2013. Methylisothiazoline/methylisothiazolinone (MCI/MI) is active against bacteria, yeast, fungi, and algae, and is used in a range of products, especially shampoos, but is also found in hair gels, cosmetics, sunscreens, baby wipes, antibacterial washes, and household cleaning products.

“MCI/MI is now a common cause of contact dermatitis and can cause severe reactions,” said Dr. Silverberg, director of the Northwestern Medicine Multidisciplinary Eczema Center in Chicago.

An alternative to MCI/MI – methyldibromoglutaronitrile/phenoxyethanol (Euxyl K 400) – also appears in personal care products, such as soaps and shampoos, as well as industrial products such as paints, glues, wood preservatives, and metal-working fluids, Dr. Silverberg noted. This preservative is relatively uncommon in the United States, and in Europe it has been banned from leave-on products since 2005 and from rinse-off products since 2007, he said.

Another paraben alternative, iodopropynyl butylcarbamate, is a relatively uncommon preservative, but it frequently occurs as a positive patch test reaction, Dr. Silverberg said.

Lanolin, a natural ingredient used in topical skin emollients and cosmetics, also has been associated with skin reactions, he added. In addition to personal care products, the increasing range of personal technology products can be sources of contact dermatitis, Dr. Silverberg pointed out. Consider nickel exposure not only from jewelry, but from items such as iPads, iPhones, laptops, and Xbox controllers, when evaluating contact dermatitis in adults and children, he said.

Dr. Silverberg disclosed relationships with companies including AbbVie, Anacor, Celgene, Chugai, Galderma, GlaxoSmithKline, Lilly, Puricore, Medimmune-AstraZeneca, Pfizer, Proctor & Gamble, Puricore, Hoffmann-La Roche, and Regeneron-Sanofi.

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