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Cetearyl isononanoate, an underestimated contact allergen?

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... Alhydran ® has an anti-itch effect, as demonstrated in a study conducted in the Netherlands [34]. The mechanism of action is a combination of the moisturizing effect of the Aloe Vera gel with an occlusive and emollient effect provided by the fatty ingredients, such as cetearyl alcohol and caprylic triglyceride, and both can be obtained naturally, are present in many skincare products and are often used in formulations for sensitive skin [17,[34][35][36]. ...
... TEDRA ® is a water-based moisturizer that primarily contains glycerin, dimethicone (polysiloxanes) and cetearyl hexanoate (cetearyl alcohol). Cetearyl hexanoate has strong emollient properties and also provides occlusive effects, whilst glycerin is a strong humectant [36,[42][43][44]. Three different compositions of the TEDRA ® moisturizer were tested: the commercially available composition, which is from here on called 'TEDRA ® ', and two compositions not commercially available: TEDRA ® NT1 and the TEDRA ® NT3. ...
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Non-invasive scar management typically involves pressure therapy, hydration with sili-cones or moisturizers, and UV protection. Moisture loss from scars can lead to hypertrophic scar formation. Pressure therapy reduces blood flow, fibroblast activity, and transforming growth factor beta 1 (TGF-β1) release. This study examined various moisturizers and liquid silicone gel's impact on microcirculation. 40 volunteers participated in a study where superficial abrasions were created to induce trans epidermal water loss (TEWL). Five moisturizers (TEDRA ® , TEDRA ® NT1, TEDRA ® NT3, Alhydran ® , Lipikar ®) and BAP Scar Care ® silicone gel were tested. TEWL, hydration, and blood flow were measured up to 4 h post-application. Results showed that silicone had the least impact on occlusion and hydration. Alhydran ® reduced blood flow the most, while Lipikar ® increased it the most. TEDRA ® NT1 had reduced flow compared to TEDRA ® and TEDRA ® NT3. All TEDRA ® products exhibited high hydration, and all but silicone showed good occlusion. Moisturizers influenced skin microcirculation, with some causing decrease, while others increased flow. However, the clinical impact on scarring remains unclear compared to the evident effects of hydra-tion and occlusion. More research is necessary to study moisturizers alone and with pressure therapy on scars, along with potential adverse effects of increased microcirculation on scars.
... C12-15 alkyl benzoate has emollient, antimicrobial, and skinconditioning properties and can be an occasional sensitizer, with at least one case of contact allergy reported [51]. Scientific evidence supporting the allergenic character of the remaining conditioning agents, cetearyl isononanoate, cetearyl ethylhexanoate, panthenol, capryloyl glycine, and cetyl PEG/PPG-10/1 dimethicone, was also found [52][53][54][55][56][57][58]. Despite being used in some skin conditions for restoring skin-barrier function, lanolin has been associated with some cases of sensitization [59,60]. ...
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Sensitive skin is characterized by symptoms such as stinging and tingling in response to stimuli that usually do not cause unpleasant sensations. Epidemiological studies show that individuals with sensitive skin are more prone to developing skin allergies, although the link between both conditions is unknown. Aiming to evaluate the presence of allergens in facial-skin products for sensitive skin, a pool of 88 cosmetic products from international brands marketed in pharmacies and parapharmacies was analyzed. A list of allergens identified in product labels was compiled and grouped according to their function. Fragrances were the most common allergens, followed by skin-conditioning agents, surfactants, and preservatives. Fragrances presenting the highest use percentages were linalool, benzyl alcohol, geraniol, and citronellol. Overall, the majority of cosmetic formulations were absent of fragrance allergens, being present only in 7% of products. Other allergens were found in most products (95%). This finding should be interpreted with caution, since many of these compounds are rare sensitizers and studies demonstrating their risk for individuals with sensitive skin are lacking. With this study, useful information for health professionals is provided to support their advice and to help consumers choosing cosmetic products.
... Cetearyl alcohol, a mixture of cetyl and stearyl alcohol, is widely used as an emulsifier and an occasional allergen [215]. Various derivatives similar to lanolin alcohols exist, some of which were identified as contact allergens, such as cetearyl isononanoate [216]. Low-molecular weight polyethylene glycol is widely used in Turkey and has been found to be linked with nitrofurazone sensitisation, but has also been relevant when used in minoxidil solutions, and antiherpetic and corticosteroid creams [217]. ...
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Contact allergy (sensitisation) and allergic contact dermatitis (ACD) resulting from it have a considerable public health impact. For the present review, all pertinent articles were systematically searched via Medline and Web of Science™; additionally, all available issues of the journals “Contact Dermatitis” and “Dermatitis” were manually searched, covering the years 2018–2019, thereby extending and re-focusing a previous similar review. New allergens, or previously described allergens found in a new exposure context or of other current importance, are described in sections according to substance classes, e.g., metals, preservatives, fragrances. As a common finding in many investigations, a lack of information on product composition has been noted, for instance, regarding a newly described allergen in canvas shoes (dimethylthiocarbamylbenzothiazole sulfide) and, most notably, absence of co-operation from manufacturers of glucose-monitoring devices and insulin pumps, respectively. These latter devices have been shown to cause severe ACD in a considerable number of diabetic patients caused by the liberation of isobornyl acrylate and N,N’-dimethylacrylamide, respectively, as demonstrated by an international collaboration between dermatologists and chemists. Improved and complete ingredient labelling for all types of products, and not just as we have with cosmetics at present (apart from full listing of fragrance substances) in Europe, must be put on the legislative agenda.
Article
Kontaktallergie (Sensibilisierung) und daraus resultierende allergische Kontaktdermatitis (ACD) sind von erheblicher Tragweite aus Sicht des Gesundheitswesens. Für die vorliegende Übersichtsarbeit hierzu wurden alle passenden Artikel aus dem Zeitraum 2018–2019 per systematischer Suche in Medline und Web of Science<sup>TM</sup> ermittelt; außerdem wurden alle verfügbaren Ausgaben der Fachzeitschriften „Contact Dermatitis“ und „Dermatitis“ manuell durchsucht und so eine frühere, ähnliche Übersichtsarbeit fortgeschrieben und neu fokussiert. Neue Allergene ebenso wie bekannte Allergene, die in neuem Expositionskontext gefunden wurden oder deren Bedeutung in sonstiger Hinsicht neu bewertet wurde, werden in Abschnitten nach Substanzklasse gegliedert beschrieben (z. B. Metalle, Konservierungsmittel, Duftstoffe). Als gemeinsames Ergebnis zahlreicher Untersuchungen fällt sowohl ein Mangel an Informationen über die Produktzusammensetzung auf, z. B. in Bezug auf ein neu beschriebenes Allergen in Leinenturnschuhen (Dimethylthiocarbamylbenzothiazolsulfid), als auch vor allem die mangelnde Kooperativität von Herstellern von Blutzuckermessgeräten bzw. Insulinpumpen. Zu den letztgenannten Geräten hat eine internationale Zusammenarbeit zwischen Dermatologen und Chemikern gezeigt, dass sie bei zahlreichen Diabetikern schwere ACD verursachen, indem sie Isobornylacrylat bzw. N,N’-Dimethylacrylamid freisetzen. Eine verbesserte und vollständige Deklaration der Inhaltsstoffe für Produkte alle Art – und nicht nur, wie wir es derzeit in Europa haben, bei Kosmetika (abgesehen von der vollständigen Auflistung der Duftstoffe) – muss auf die legislative Agenda gesetzt werden.