Contact Dermatitis - Cosmetics
Dermatitis most commonly occurs from hair dyes, nail polishes, perfumes,
lipsticks and sunscreen agents. The chief site of the eruption is the
eyelids area, with ears and neck next.
Eye makeup, such as mascara, eye shadow and eye pencil,seldom causes
dermatitis (although eyeliner often does)whereas nail polish, while seldom
causing trouble around the fingernails, affects the eyelids first. Lower
eyelid dermatitis is often form wetting solutions or eye drops.Various
formaldehyde resins are used in nail lacquers and nail lacquers and nail
hardeners, as are sulfonamide derivatives, both of which sensitize.
Lipsticks contain waxes and fats (occasionally cocoa butter sensitizes),
perfumes (occasionally sensitize), and dyes (especially tetrabromofluorescein),
which may occasionally dry the lips and produce photosensitivity. Special
lipsticks are available that contain neither fluorescein dyes, nor perfumes,
like, for example, Almay (Texas Pharmacal) or Ar-Ex.
Sunscreen preparations containing PABA (para-aminobenzoic acid), hydroquinone
or digalloy trioleate can sensitize, and in some cases, photosensitize.
Bleaching creams are sensitizers too, either mercury, or hydroquinone
being the culprit.
Toothpaste and mouthwashes can cause dermatitis from oils,cinnamon or
other flavoring, or antiseptics.
Hair dyes are mostly of the permanent or "oxidation" type,
containing para-phenylene diamine (PPDA), soap, ammonia and other modifiers
which penetrate and color the hair when mixed with 20 volumes of peroxide.
This type of dye accepts shampoos and cold waves and sensitizes most commonly.
The azo and aniline dyes produce a semipermanent coloring which is tolerated
well in most PPDA-sensitive patients, but lasts through only a few washings.
Metallic hair dyes (Romans used a lead comb dipped in vinegar to darken
gray hair) are also referred to as hair "restorers" and are
mostly still based on lead and do not sensitize. Vegetable rinses are
ususally made form henna, which is non-sensitizing, although some pyrogallol
combinations are sensitizing. Methylene PPDA can cross-react with PABA
in sunscreens, local anesthetics and sulfonamides-thiazides (Diruil),
tolbutamide (Orinase), chlorpropamide (Diabinase) and saccharin.
Permanent-wave solution, usually thioglycolates, are alkaline reducing
agents which make the hair malleable; the hair is "waved" on
rollers and then "fixed" with an oxidizer (hydrogen peroxide,
perborate, bromates of citric acid). Thioglycolates rarely sensitize,
but do occasionally cause primary irritation if not carefully mopped up,
and can split and break the hair.
The adhesive used to attach toupees and false eyelashes occasionally
causes dermatitis, in which case Duo Surgical Adhesive (Johnson and Johnson)
sometimes is tolerated well.Bleaching or freckle creams usually contain
mercury or quinones, and all can sensitize; Benzoquin (Elder) is a very
potent sensitizer. Face powders and rouge rarely cause dermatitis. Sunscreens,
at least those made of PABA (Pre-Sun, Sundown, PABA gel, Sunbrella, etc.)
or digalloyltrioleate (Sundare, Sunswept and A-Fil), can sensitize and
photosensitize. The benzophenones, e.g., Solbar or Uval,seem promising,
although there have been sensitizing cases.Sundare, RVPaque, RVP, Almay
Sunburn Preventative, Liquid Sunshine (H. Rubenstein), Sun-Proof Cream
(Ardena), Sun-TanGelee (rexall) and Sun Bath (Revlon) are generally acceptable.
Patients should be advised to apply perfume to their clothes if possible
rather than to their skin and certainly should avoid using photosensitizing
perfumes (e.g. Shalimar) on their skin in bright sun.
Hypoallergenic cosmetics are manufactured by several companies, two of
the best being the Almay division of Schieffelin & Company and the
Texas Pharmacal Company.
Source: http://www.telemedicine.org
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