Cosmetic allergy

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Allergy Types: Other Allergies: Cosmetic Allergy

Definition

Beauty products — everything from shampoo to makeup to cologne — can help you feel on top of your game. They can also cause irritatedskin or an allergic reaction. In one FDA survey, up to 25% of people said they had a skin reaction to at least one beauty product.

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Problems can range from simple rashes to full-blown allergic reactions. Symptoms can start right after you use something new — or after years of using a product with no problems.

There are two types of skin reactions to beauty products. One, called irritant contact dermatitis, happens when something actually damages your skin. Your skin might burn, sting, itch, or get red right where you used the product. You might get blisters and have oozing, especially if you scratch.

The other kind of reaction actually involves your immune system. It’s called allergic contact dermatitis and symptoms include redness, swelling, itching, and hives. Your skin can get red and raw. You can get an allergic reaction on any part of your body, although it happens most often on the face, lips, eyes, ears, and neck.

It can be hard to tell the two types of reactions apart. You can even have a reaction that’s a combination of the two.

Fragrances and preservatives are often to blame. Even products that say they are “unscented” can have a fragrance used to cover up chemical scents. You may not smell it, but it’s there, and may cause anallergic reaction.

To be sure there’s no perfume, look for products marked “fragrance-free” or “without perfume.”

Almost any product that has water must have some preservatives. The most common are parabens, imidazolidinyl urea, Quaternium-15, DMDM hydantoin, phenoxyethanol, methylchloroisothiazolinone, andformaldehyde. All have been linked to skin allergies.

Causes 

The beauty products most likely to cause skin reactions include bath soaps, detergents, antiperspirants, eye makeup, moisturizers, shampoos, long-wearing lip stains, nail polish (especially those that have formaldehyde), and fingernail glue containing methcrylate.

Hair dyes can also cause skin reactions, especially those containing p-phenylenediamine as well as ammonium persulfate used to lighten hair.

Beauty products that have alpha-hydroxy acids can cause problems for some people, like redness, swelling, blisters, and itching — especially with products that have an AHA level over 10%.

Retin-A wrinkle creams and serums can also cause irritant contact dermatitis in some people.

Many people have “sunscreen sensitivity.” For them, almost all sun-protection products can cause a dermatitis-type reaction. If this is the case for you, talk to a dermatologist about how to best protect your skin from the sun.

http://www.webmd.com/allergies/guide/cosmetics?page=2 

Diagnostics

Irritant reactions reflect a damaging effect of the cosmetic or toiletry on the skin – an example would be the effect of too much soap or shampoo on the skin leading to chapping, dryness and soreness.  Delicate areas of the body where the skin is naturally thinner such as the skin folds, face, and particularly the eyelids are most vulnerable to irritant reactions. Other sorts of cosmetic which can cause irritation include liquid foundation, mascaras, face masks, toners and anti-ageing creams.  Some people suffer from a particularly sensitive skin and experience itching, burning or stinging within minutes of using a product. This is usually a form of irritation rather than allergy and is commoner in people with skin complaints such as rosacea and dermatitis. It may help to use products that say they are for use on sensitive skin as the manufacturer will usually have undertaken further testing to reduce the risk of a reaction occurring. It may, however, be a matter of trial and error to find products that are tolerated.

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Allergic reactions involve the body’s immune system which is meant to fight against infections, but occasionally get the wrong target – in this case an ingredient of the cosmetic. In order to develop an allergy, you have to be exposed to the allergen more than once, and usually repeatedly. This means that you can become allergic to something which you have been using for a long time without problem.  What triggers the allergy process is unclear, but once developed, allergies like this are usually life-long.  Allergic contact dermatitis/eczema appears as itchy, sore, red bumpy skin, which becomes flaky and dry.  If you avoid further contact with the allergen, it should improve within a week or so.  It is worst where the product has been applied to the skin but can sometimes spread to other parts of the body. Treatment with a topical steroid cream will help to clear the rash more quickly.      

Allergic contact dermatitis is an example of a delayed-type allergy and the reaction may not appear until several hours or even days after using the product.  This makes it difficult to work out what has caused the problem. 

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Patch testing can help to identify chemicals in cosmetics that your skin has become allergic to. It involves applying small amounts of allergen to the upper back and observing the skin’s reaction over several days. This sort of test is usually performed in hospital by a dermatologist.  When the allergen has been identified, it should be possible to avoid future contact with it in cosmetics and toiletries as the European Union has passed regulations that require a full list of ingredients to be included on the packaging or container.

A simple method to find out if you could have a reaction to a cosmetic is to apply it to a 50 pence sized area of skin on your elbow crease every morning and night for up to a week. This type of test should not be done with things that you would usually wash off such as shampoos or shower gels, as these will simply irritate the skin.  If redness and small bumps appear, it suggests you may be allergic to something the product. Patch tests are then important to pin point which substance or substances in the product are causing the reaction so that you can avoid them in other products as well.       

Treatment 

Approach Considerations

Topical corticosteroids are the mainstay of treatment, while a variety of symptomatic treatments can provide short-term relief of pruritus. However, the definitive treatment of allergic contact dermatitis is the identification and removal of any potential causal agents; otherwise, the patient is at increased risk for chronic or recurrent dermatitis. Online resources allow the physician to create a list of products free of allergens to which the patient is allergic.

Symptomatic Treatment

Topical soaks with cool tap water, Burow solution (1:40 dilution), saline (1 tsp/pint) can be soothing. Cool compresses with saline or aluminum acetate solution are helpful for acute vesicular dermatitis (eg, poison ivy). Some individuals with widespread vesicular dermatitis may obtain relief from lukewarm oatmeal baths.

Large vesicles may rarely benefit from therapeutic drainage (but not removing the vesicle tops). Puncturing or incising vesicles may introduce bacteria and lead to infection. These lesions should then be covered with dressing soaked in Burow solution.

Emollients (eg, white petrolatum, Eucerin) may be beneficial in chronic cases.

Sedating oral antihistamines may help diminish pruritus via a central effect. Patients should avoid using topical antihistamines, including topical doxepin, because of the apparently high risk of iatrogenic allergic contact dermatitis to these agents; additionally, sedation can occur if large amounts of doxepin cream are applied.

Corticosteroids

Topical corticosteroids are the mainstay of treatment, with the strength of the topical corticosteroid appropriate to the body site. For severe allergic contact dermatitis of the hands, 3-week courses of class I topical corticosteroids are required, while class 6 or class 7 topical corticosteroids typically are used for allergic contact dermatitis of intertriginous areas or the face.

Acute severe allergic contact dermatitis, such as from poison ivy, often needs to be treated with a 2-week course of systemic corticosteroids. Most adults require an initial dose of 40-60 mg. The oral corticosteroid is tapered over a 2-week period, but a complicated tapering regimen probably is not necessary given the short duration of systemic corticosteroid use.

The systemic corticosteroids must be administered for 2 weeks, because shorter courses are notorious for allowing poison ivy dermatitis to relapse. Long-acting intramuscular triamcinolone acetonide (Kenalog) 40-60 mg may be used in place of oral prednisone.

Long-term use of systemic corticosteroids to treat allergic contact dermatitis may produce severe morbidity. Individuals with allergic contact dermatitis should not receive long-term systemic corticosteroids or immunosuppressives unless extensive patch testing and evaluation have failed to identify remedial causes of the severe dermatitis.

Long-term widespread use of potent topical corticosteroids may produce local skin atrophy and systemic adverse effects. In particular, use around the eyes may theoretically cause cataracts, glaucoma, corneal thinning/perforation, and loss of the eye.

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Allergy to corticosteroid molecules without C16-methyl substitution in the D-ring (ie, groups A [eg, hydrocortisone, hydrocortisone-21-butyrate] and D2 [eg, hydrocortisone-17-butyrate] may be much more frequently observed than allergy to those corticosteroid molecules that are halogenated and have a methyl group at C16 (ie, groups D1 [eg, betamethasone dipropionate, clobetasol propionate, diflorasone diacetate, fluticasone propionate, mometasone furoate] and C [eg, desoximetasone, desoxymethasone]). C16-methylated corticosteroids should be preferentially prescribed if topical corticosteroid treatment is indicated.

Topical Immunomodulators

Topical immunomodulators (TIMs) are approved for atopic dermatitis and are prescribed for cases of allergic contact dermatitis when they offer safety advantages over topical corticosteroids. TIMs do not cause cutaneous atrophy, glaucoma, or cataracts when applied near the eye.

Topical tacrolimus is an option in patients with allergic contact eyelid dermatitis not controlled by brief courses of class l or ll topical corticosteroids and allergen avoidance. Pimecrolimus (Elidel cream) is a topical treatment that may be helpful for mild allergic contact dermatitis of the face. Tacrolimus (Protopic 0.1% ointment) is the most helpful TIM for allergic contact dermatitis of the hands.

Phototherapy

Individuals with chronic allergic contact dermatitis that is not controlled well by topical corticosteroids may benefit from psoralen plus ultraviolet-A (PUVA) treatments. Psoralen is a photosensitizer that is ingested prior to light exposure. Narrow-band UVB phototherapy may be as effective. Light at 308 nm can also be delivered to limited chronic areas of dermatitis.

Immunosuppressive Agents

Rarely, chronic immunosuppressive agents, such as azathioprine (Imuran), mycophenolate (CellCept), or cyclosporine (Neoral), are used in recalcitrant cases of severe chronic widespread allergic contact dermatitis or severe hand dermatitis that prevents the individual from working or performing daily activities. Biologicals active on T cells may be helpful in the future.

Disulfiram

Occasionally, an individual who is highly allergic to nickel with severe vesicular hand dermatitis benefits from treatment with disulfiram (Antabuse). The chelating effect of disulfiram is helpful in reducing the body’s nickel burden. Alcohol ingestion may produce severe adverse reactions in patients taking disulfiram.

Diet

Some chemicals tested by the TRUE test may be present in the diet. Individuals with severe dermatitis, particularly if it is a disabling vesicular dermatitis of the hands, may be treated with diets low in minerals and chemicals to which the individual is allergic. A low-nickel diet is the most common, but published diets are available that are low in chromate, cobalt, or balsam of Peru. These diets may be attempted for the occasional allergic patient with severe chronic vesicular dermatitis.

Hospital Admission

Inpatient care rarely is required for allergic contact dermatitis (ACD) unless the dermatitis is so severe that patients cannot care for themselves. Examples may include severe allergic contact dermatitis with marked eyelid swelling that impairs vision or severe allergic contact dermatitis of the penis, which may impede urination. If patients develop chronic severe allergic reactions to their home or workplace, they may require a temporary change of environment until the cause of the dermatitis is identified.

Activity Limitations

Individuals with severe acute allergic contact dermatitis may be incapacitated temporarily and unable to work. Most individuals with allergic contact dermatitis may require light duties or restrictions of duties. They should avoid further contact with the chemicals to which they are allergic or chemicals that cross-react with these materials. Patients also should minimize exposure to irritant chemicals, particularly if the dermatitis is active or recently resolved.

http://emedicine.medscape.com/article/1049216-treatment#showall 

Prophylaxis

  • Keep tract of the products that has caused allergic reactions in the past. Read the product labels carefully; select a product with simple and known formulation. Avoid buying the product which you know can cause allergic reaction.
  • Before trying any new makeup or other products it is wise to perform a mini patch test. For this, test the product on your inner wrist and wait for 24 hours. If no reaction occurs, it might be safe to apply.
  • Select makeup products carefully, as they are in constant contact with your skin. Choose fragrance-free, hypoallergenic or non-comedogenic products.
  • Rather than applying perfumes and deodorants directly on the skin, prefer applying them on your clothes.
  • Maintain personal hygiene; wash off the makeup every night before going to bed. Especially never go to bed with your foundation and eye makeup.
  • Make appropriate sense of the product labels, read all the ingredients carefully. Remember ‘fragrance free’ products might have small amount of fragrance to mask the unpleasant smell of the chemicals. When it is mentioned ‘natural’ on a product, it is made from plant or animal extracts and not made chemically.

It is important to remember that no cosmetic product can ever guarantee that it is allergic free. So to be on a safer side it is better to take prevention rather than treating the reactions as like other allergies cosmetic allergy is also not curable but only treatable.

http://www.home-remedies-for-you.com/articles/2135/wellness/cosmetic-allergy-prevention.html

Useful advice

Cosmetic Reactions Home Remedies And Effective Natural Cures

Commercially available cosmetic products like moisturizers, shampoos, make-up, perfumes, and deodorants often contain harsh chemicals that may irritate the skin and cause skin rashes to erupt. The most common forms of reactions caused by cosmetics are irritant contact dermatitis and allergic contact dermatitis. While some cosmetics may irritate the skin immediately after application, some others may produce an allergy after a prolonged period of usage.

The most common symptoms of cosmetic reactions are appearance of red, scaly patches on the skin, swelling and roughness of the skin, oozing blisters, itching, and flaking of the upper layer of the skin.

The areas most commonly affected by such reactions are the face, neck, ears and the trunk. It is always a good idea to purchase cosmetics that are labeled “hypoallergenic”, as there is a smaller chance of skin reactions in using such products.

You should also make it a habit to cleanse your face properly at the end of your day and wipe off all traces of make-up before going to bed. Discard any cosmetic product if its color or consistency has changed. Do not experiment with too many brands of cosmetics at the same time or switch from one to another too frequently.

Tips For Coping Up With Cosmetic Reactions At Home

There are a few simple remedies that you may follow at home to treat cosmetic reactions. One of the most effective ways of soothing inflamed skin is to apply the juice of aloe vera leaves on the affected area. This juice has natural soothing and hydrating properties and brings immediate relief from excessive dryness and itching of the skin. You may also grate a fresh cucumber and apply the juice on the affected portion of the skin for quick relief from dryness, burning, and itching.

Massaging the area gently with a few cubes of frozen rose water is also useful in treating skin rashes. You may also massage your skin with a little olive oil to treat cosmetic reactions naturally. For another remedy, mix a cup of uncooked oatmeal in a tub of bathwater and soak your entire body in this for 15 minutes.

This prevents excessive dryness of the skin as well as soothes inflamed, itchy skin. Massaging your entire body with a small quantity of vitamin E oil immediately after bathing and then gently patting your skin dry also helps to prevent cosmetic reactions. You may also mix a tablespoon of sandalwood powder with the juice of a fresh lemon and apply this paste on the affected area.

http://www.diethealthclub.com/blog/home-remedies/home-remedies-for-cosmetic-reactions.html 

Outcome 

If the source of a cosmetic reaction is an irritant, then it seems likely that by avoiding that substance in other products would be prudent. A doctor can help someone decide which ingredient on the label is likely to be a problem. If a reaction is due to an allergy to an ingredient that was documented by patch testing, then it is very important to avoid that particular ingredient by carefully perusing the cosmetic label. Sometimes this can be challenging because certain additives may have a number of brand names.

http://www.medicinenet.com/cosmetic_allergies/page3.htm

Complications

Cosmetic allergy can lead to the following complications:

  • Chronic itchy, scaly skin. A skin condition called neurodermatitis (lichen simplex chronicus) starts with a patch of itchy skin. You scratch the area, which makes it even itchier. So you keep scratching. Eventually, you may scratch simply out of habit. This condition can cause the affected skin to become discolored, thick and leathery.

Infection. If you repeatedly scratch a rash, you may cause it to become wet and oozing. This creates a good place for bacteria or fungi to grow and may cause an infection.

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