Article

Contact dermatitis from fatty alcohols. Contact Dermatitis 35: 287-289

Authors:
  • Istituto Dermopatico dell'Immacolata, IDI-IRCCS
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Abstract

The aim of this study was to investigate the frequency of sensitization to fatty alcohols in a group of patients with suspected cosmetic or medicament contact dermatitis. From May 1992 to September 1995, we patch tested a series of 5 fatty alcohols on 146 patients. These included 108 females and 38 males aged from 13 to 72 years (mean age 42.5). These patients, who had previously been tested with the GIRDCA standard series, were selected because their clinical lesions or histories indicated topical preparations as the possible source of their contact dermatitis. High-grade fatty alcohols (> 99% pure) were used for testing. 34 patients (23.2%), 25 female and 9 male aged from 14 to 72 years, showed a positive patch test to fatty alcohols, 33 of them to oleyl alcohol. A total of 39 reactions were detected with 5 patients showing more than 1 positive reaction. Our results show that sensitization to oleyl alcohol is not rare in patients with contact dermatitis due to cosmetics or topical medicaments.

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... Myristyl alcohol, cetyl alcohol, cetylic alcohol, stearyl alcohol and oleyl alcohol are reported to be contact allergens. Myristyl alcohol has been reported as a contact allergen both in medicaments and metal working fluid (Edman and Möller, 1986;Pecegueiro et al., 1987;Tosti et al., 1996;Geier et al., 2006). Cetyl alcohol is a wellrecognized contact allergen (Blondeel et al., 1978;Tosti et al., 1996;Oiso et al., 2003;Aakhus and Warshaw, 2011). ...
... Myristyl alcohol has been reported as a contact allergen both in medicaments and metal working fluid (Edman and Möller, 1986;Pecegueiro et al., 1987;Tosti et al., 1996;Geier et al., 2006). Cetyl alcohol is a wellrecognized contact allergen (Blondeel et al., 1978;Tosti et al., 1996;Oiso et al., 2003;Aakhus and Warshaw, 2011). One study reports cetylic alcohol to be a contact allergen (Le Coz et al., 1998). ...
... One study reports cetylic alcohol to be a contact allergen (Le Coz et al., 1998). Stearyl alcohol is reported to be a very weak contact allergen (Tosti et al., 1996;Yesudian and King, 2001;Thormann et al., 2009). Oleyl alcohol is reported to be a contact allergen, e.g. in cosmetic products (Andersen and Broesby-Olsen, 2006) and metal-working fluids (Tosti et al., 1996;Geier et al., 2006). ...
Article
Suggested citation: EFSA Panel on Contaminants in the Food Chain (CONTAM); Scientific Opinion on the evaluation of the substances currently on the list in the annex to Commission Directive 1996/3/EC as acceptable previous cargoes for edible fats and oils – Part II of III. ABSTRACT Shipping of edible fats and oils into Europe is permitted in bulk tanks, in which substances, included in a positive list, had been previously transported. The European Commission requested EFSA to evaluate the list of substances in the Annex to Commission Directive 96/3/EC as acceptable previous cargoes for edible fats and oils, taking into account its review of the Scientific Committee on Food (SCF) criteria for acceptable previous cargoes and criteria proposed by the Codex Committee for Fats and Oils. This is the second of three scientific opinions by the Panel on Contaminants in the Food Chain (CONTAM Panel), in which thirty-five of these substances or groups of substances have been evaluated. The CONTAM Panel concluded that fatty acids, fatty alcohols, fatty alcohol blends, fatty acid methyl esters, fatty acid esters, and animal, marine and vegetable and hydrogenated oils and fats, all as specified, and acid oils and fatty acid distillates, acetic acid, sulphuric acid, formic acid, acetic anhydride, acetone, n-heptane, n-hexane, cyclohexane, pentane, iso-propanol, propyl alcohol, methyl isobutyl ketone, methyl ethyl ketone, n-propyl acetate, ammonium hydroxide, limonene, methyl tert-butyl ether, urea ammonia nitrate solution, calcium chloride solution, magnesium chloride solution, potable water, potassium hydroxide, sodium hydroxide, silicon dioxide, sorbitol, molasses and beeswax would not be of health concern as previous cargoes. However, because of its insolubility in water and high melting point, silicon dioxide is not suitable for transport in tankers for edible fats and oils. There was insufficient information available on the composition of wine lees for the CONTAM Panel to conclude that it would not be of health concern when used as a previous cargo. The CONTAM Panel made several recommendations regarding the way in which the substances are described in the Annex to Commission Directive 96/3/EC, to correct inaccuracies and to better reflect current transport practices.
... Because it is not routinely tested, oleyl alcohol may be a more frequent allergy than the few reports suggest [65]. Tosti et al. (1996) evaluated 146 individuals with a potential allergy to topical treatments containing five fatty alcohols and identified 34 positive responses, 33 of which were caused by oleyl alcohol (30%) in petrolatum. All of the controls were negative when we tested with 10% petrolatum [66]. ...
... Tosti et al. (1996) evaluated 146 individuals with a potential allergy to topical treatments containing five fatty alcohols and identified 34 positive responses, 33 of which were caused by oleyl alcohol (30%) in petrolatum. All of the controls were negative when we tested with 10% petrolatum [66]. ...
Article
Full-text available
A considerable amount of literature has been published on several aspects of lipsticks production. To date, there is no collation of studies related to lipsticks production that has been published. This review was conducted to examine information about the history of lipsticks; ingredients used in the preparation of lipsticks, focusing on the natural and chemical ingredients; methods of preparation for the lipsticks; and the characterization of the lipsticks. A literature search for English language articles was conducted by searching electronic databases including Web of Science, Scopus, PubMed, and Google Scholar. Overall, the evidence indicates that lipsticks have been used since ancient times and are among the highest demand cosmetics. The findings of this review summarize those of earlier studies that explained the use of different types of ingredients in the manufacturing processes of lipsticks. It highlights the importance of using green technology and ingredients to fabricate lipsticks to avoid potential side effects such as skin irritation and allergy reaction.
... Even though emulsifiers are widely used in cosmetics and topical products, contact allergic reactions to these are relatively uncommon (10,11). Among allergic reactions to emulsifiers, reaction to oleyl alcohol seems to be more common (12). Oleyl alcohol is a long-chain fatty alcohol often used as an emulsifier in the production of lubricants, papers, printing inks, cutting fluids, and cosmetics but only rarely used in topical drugs. ...
... Oleyl alcohol might be a more common allergen than the relatively few reports indicate, as it is not tested on a routine basis. In 1996, Tosti et al. (12) tested 146 patients with suspected allergy to topical preparations with 5 fatty alcohols and found 34 positive reactions, of which 33 were due to oleyl alcohol 30% in petrolatum. We tested with 10% in petrolatum, and all the controls were negative. ...
Article
Full-text available
We report an atopic dermatitis patient with recurrent hand dermatitis who developed a severe allergic contact dermatitis from the use of Elidel cream. Diagnostic patch tests showed an isolated contact allergy to the emulsifier oleyl alcohol present in the product. Pimecrolimus appeared to have had an aggravating effect on the dermatitis in spite of its immunosuppressive effects. The initial clinical appearance of the patient's widespread dermatitis was atypical with resemblance to subacute cutaneous lupus erythematosus. Even though emulsifiers are widely used in topical products, contact allergic reactions to these are relatively uncommon.
... It was shown in various studies that in the case of contact allergies there was generally an allergy to components such as Peru balsam and lanoline in wound ointments, topical antibiotics, wound dressings and bandages whereby there was a clear relationship between the duration of the ulcers and the occurrence of contact allergies. [53][54][55][56][57][58][59][60][61] One should always consider the possibility of contact allergy when there are indications of slow wound healing. This often manifests in the form of eczema. ...
... It was shown in various studies that in the case of contact allergies there was generally an allergy to components such as Peru balsam and lanoline in wound ointments, topical antibiotics, wound dressings and bandages whereby there was a clear relationship between the duration of the ulcers and the occurrence of contact allergies. [53][54][55][56][57][58][59][60][61] One should always consider the possibility of contact allergy when there are indications of slow wound healing. This often manifests in the form of eczema. ...
... It was shown in various studies that in the case of contact allergies there was generally an allergy to components such as Peru balsam and lanoline in wound ointments, topical antibiotics, wound dressings and bandages whereby there was a clear relationship between the duration of the ulcers and the occurrence of contact allergies. [53][54][55][56][57][58][59][60][61] One should always consider the possibility of contact allergy when there are indications of slow wound healing. This often manifests in the form of eczema. ...
Article
Representative chemicals from the long chain alcohols category have been extensively tested to define their toxicological hazard properties. These chemicals show low acute and repeat dose toxicity with high-dose effects (if any) related to minimal liver toxicity. These chemicals do not show evidence of activity in genetic toxicity tests or to the reproductive system or the developing organism. These chemicals also are not sensitizers. Irritation is dependant on chain length; generally, alcohols in the range C(6-)C(11) are considered as irritant, intermediate chain lengths (C(12-)C(16)) alcohols are considered to be mild irritants and chain lengths of C(18) and above are considered non-irritants. These chemicals are broadly used across the consumer products industry with highest per person consumer exposures resulting from use in personal care products. Margins of exposure adequate for the protection of human health are documented for the uses of these chemicals.
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Over a period of 19 months, 33 cases of acute allergic contact dermatitis from Veet epilating waxes and/or the accompanying tissue (Reckitt Benckiser, Massy, France) were observed in France and Belgium. The lesions started on the legs and spread to other parts of the body, especially the face, and were sometimes so severe that hospitalization and/or systemic corticosteroids were required. Primary sensitization occurred as early as after the first application in several patients. Patch tests were performed in 26 of the patients and produced strong positive reactions to the tissue (25 times) and/or the wax (13 times). The allergenic culprits in the wax were modified-colophonium derivatives (colophonium in the standard series testing negatively in all except 4 patients), while methoxy PEG-22/dodecyl glycol copolymer and to a lesser degree lauryl alcohol turned out to be the main causal allergens in the tissue.
Article
The leading complication of leg ulcers is the development of peri-lesional eczema. The etiological diagnosis is often difficult due to the large number of topical agents used. Fifty patients, 35 women and 15 men, mean age 67.8 years, range 37-91 years, with leg ulcers of variable duration (15 days to 32 years, median 2 years) underwent explorations using the standard EECDRG battery in search of contact allergies. Eighteen potential allergens and the topical agents employed were tested. Readings were made at 48, 72, 96 or 120 hours. Sensitization rate was 76 p. 100 (90 p. 100 of the patients with a history of contact dermatitis and 50 p. 100 in those without such history). The respective percentages of positive tests were: balm of Peru 40 p. 100, fragrance-mix 28 p. 100, Amerchol L101 18 p. 100, lanoline alcohols 14 p. 100, colophane 12 p. 100, glycol propylene and parabens-mix 8 p. 100, stearylic alcohol, thiomersal, clioquinol and sorbic acid 6 p. 100, cetyl-stearylic alcohol, cetylic alcohol, eosin, cetrimide, chlorocresol, budesonide, tixocortol pivalate, bufexamac, formaldehyde, nickel, thiuram-mix and P.P.D. 4 p. 100, hexamidine, chlorhexidine, neomycin, benzocaine, potassium bichromate and cobalt 2 p. 100, triethanolamine, ethanol and other allergens in the EECDRG battery 0 p. 100. Tests were positive in 29 cases with commercial formulations, Biafine (8 cases), Parfenac (7 cases), and Rifocine ampoules (3 cases). Among 13 of the 29 cases, tests were positive with one or more allergens common to the product and the complementary battery. Contact sensitization rate is high in leg ulcer patients. Most of the tests had a relationship with leg ulcers. The number one causal agent is balm of Peru. Thirty percent of all the patients are sensitized to at least one excipient, generally lanoline. Allergy tests are positive in 22 p. 100 for one or more antiseptics and in 18 p. 100 for preservatives. Allergy to latex and neomycin is unusual, but sensitization to steroid anti-inflammatory agents was not tested. The main active ingredient in a topical agent is not always the allergen and a detailed test must be performed, generally with a complementary battery adapted to common prescriptions for leg ulcers.
Chapter
Contact allergy to ingredients of cosmetics is one of the most frequent causes of contact allergy. While patients may report reactions to fragrance items, preservative allergy may not be suspected. The reaction typically resembles eczema on the face or hands, although any body site may be affected. Products left on the skin are much more likely to cause allergic reactions than rinse-off products. Common allergens include fragrances (e.g., hydroxyisohexyl-3-cyclohexene carboxaldehyde, isoeugenol, etc.), preservatives (e.g., formaldehyde and formaldehyde-releasers, MCI/MI, paraben esters, etc.); hair dye chemicals (e.g., p-phenylenediamine), and less frequent allergens such as lanolin and propylene glycol. Patch testing is mandatory where allergy is suspected or in localized/difficult-to-treat eczema. Sometimes a repeated open application test (ROAT) is required when the patch tests are surprisingly negative. Mandatory ingredient labeling of cosmetic items in the EU facilitates allergen avoidance and EU-set limits on the concentration of known allergens seem to be reducing the incidence of allergic contact dermatitis to certain preservatives.
Chapter
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The functions of alkyl benzoates in cosmetics include fragrance ingredients, skin-conditioning agents—emollient, skin-conditioning agents—miscellaneous, preservatives, solvents, and plasticizers. The Cosmetic Ingredient Review Expert Panel reviewed the relevant animal and human data and noted gaps in the available safety data for some of the alkyl benzoates. Similar structure activity relationships, biologic functions, and cosmetic product usage allowed the available data of many of the alkyl benzoates to be extended to the entire group. Carcinogenicity data were not available, but available data indicated that these alkyl benzoate cosmetic ingredients are not genotoxic. Also benzoic acid and tested component alcohols were not reproductive or developmental toxicants, are not genotoxic in almost all assays, and are not carcinogenic. These ingredients were determined to be safe in the present practices of use and concentration.
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Oleyl alcohol is a non-ionic unsaturated fatty alcohol, commonly used as an emollient, emulsifying and thickening agent in lipsticks, creams and lotions for hair, and topical medicaments. We report a case of allergic contact cheilitis in a child caused by a lipstick. For diagnostic purposes the child was patch tested with the SIDAPA (Italian Society of Allergological, Occupa- tional and Environmental Dermatology) standard series, with the integrative SIDAPA "cheilitis" series, with the stick as is and with the single constituents of the lipstick. The tests showed a strongly positive reaction (+++) to lipstick and to oleyl alcohol 5% pet. This concentration was ideal to elicit an allergic positive reaction and seems to be appropriate to test oleyl alcohol in children.
Article
Background: Nickel is the most common allergen found by patch testing; however, not all cases of nickel allergy are type 4 (delayed) allergies. Contact urticaria (CU) to nickel (immediate reaction) has been reported; however, few seem to evaluate it as per a recent published survey of American Contact Dermatitis Society members. Objective: The aim of the study was to present a series of patients who had clinical histories suggestive of nickel allergy and yet were patch test negative but prick test positive to nickel, thus demonstrating CU. Methods: We reviewed the charts of 11 patients who were patch test negative but prick test positive. Results: All 11 patients demonstrated evidence of CU by prick testing (or closed chamber test in 1). None were patch test positive to nickel 2.5% or 5.0%. Four patients' histories mentioned reactions to various jewelry/earrings within minutes, whereas 2 histories mentioned reacting within a few hours. These histories are consistent with CU. Others (except 1 patient) recalled reacting to jewelry/earrings but did not recall a time frame. Conclusions: Our series suggests that CU to nickel may be far more common than anticipated and should be evaluated with prick testing when patients' history suggests nickel allergy and yet they are patch test negative.
Article
Background: The evidence on the safety of topical preparations containing emulsifiers is limited. Objectives: The aims of the study were to assess (1) the prevalence of sensitization to some emulsifiers commonly found in topical products, (2) the sensitization to emulsifiers in relation to sex, age, and predisposing factors, and (3) the frequency of concomitant sensitization to other common allergens. Methods: All consecutive patients presenting to the Allergy Unit of our Dermatological Department for allergological investigation were enrolled. All patients were patch tested with the Italian Società Italiana di Dermatologia Allergologica Professionale ed Ambientale baseline series and an additional emulsifiers series. Doubtful patch test reactions were not considered. Results: Of 310 patients, 50 (16%) were sensitized to emulsifiers with 72 positive reactions. Lauryl polyethylene glycol/polypropylene glycol-18/18 methicone gave 26 positive reactions, glyceryl oleate 19, myristyl alcohol, and Amerchol L101 11. Concomitant sensitization to emulsifiers was found in 16 patients. Patients allergic to emulsifiers showed concomitant allergic reactions to allergens commonly found in cosmetics. No significant differences by sex, age, atopic diathesis, and clinical pattern at presentation were noticed. Conclusions: Contact allergy to emulsifiers is more frequent than reported. Patients allergic to emulsifiers show frequent positive patch tests to other constituents of cosmetics and topical products.
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Article
Emulsifiers are common constituents of most topical preparations. To study the sensitization rate in a population with frequent use of these agents, we selected 47 patients with chronic or recurrent (> 1 year) inflammatory skin disease (leg ulcers, contact dermatitis, atopic dermatitis, psoriasis) for patch testing with the following emulsifiers: Tween 40 (polyoxyethylene sorbitan monopalmitate). Tween 80 (polyoxyethylene sorbitan monooleate), Span 60 (sorbitan monostearate), Span 80 (sorbitan monooelate), Arlacel 83 (sorbitan sesquioleate), Atlas G 2162 (polyoxyethylene oxypropylene stearate), Atlas G 1441 (polyoxyethylene sorbitol lanolin derivative), triethanolamine, Lanette O (cetylstearyl alcohol), Lanette N. 12 patients had at least 1 positive reaction (25.5%) at 3 or 4 days. Among them, 10 had leg ulcers (43.4% of the leg ulcer group), and 2 had contact dermatitis (13.3% of the contact dermatitis group). No positive reaction was observed in the other patients. When the patients were tested with their own topical preparations or wound dressings, 6 of them, all with leg ulcers, had positive reactions. These results show a surprisingly high prevalence of sensitization to emulsifiers in patients with chronic leg ulcers, in contrast to patients with other inflammatory skin diseases.
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