Allergy To Cosmetics and Toiletries

The purpose of cosmetics and toiletries is to make us look good and feel clean. They are used safely by millions of people of all ages worldwide. While many people have no problem, mild rashes and irritation may be quite common and under-recognised.

Irritant and allergic reactions may occur. 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.

Allergic reactions involve the body's immune system which is meant to fight against infections, but occasionally get the wrong target, the so-called 'allergen'- 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 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 offending product has been applied to the skin but can sometimes spread to other parts of the body.

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

Patch testing can help determine when your skin has become allergic to a specific external substance. It involves applying small amounts of allergen to the upper back under special dressings and observing the skin's reaction after several days. This sort of test requires special expertise and is usually performed in hospital by a dermatologist. When the allergen has been correctly identified, it should be possible to avoid future contact with it in cosmetics and toiletries as the EU has passed regulations for the mandatory ingredient labelling of these items.

A simple method to find out if you could have an allergy to a cosmetic is to apply it to a 50 pence sized area of your elbow crease every morning and night for up to a week. This is called a repeat open application test. 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 allergic reaction.

The most common ingredients in cosmetics which cause allergic reactions are fragrances and preservatives. There are many different types of fragrance and at the moment, they are all simply labelled as 'parfum'.

Many cosmetics also contain plant extracts for fragrance and these are labelled individually. Plant extracts which may cause allergic reactions include tea tree oil, arnica, chamomile, citrus extracts, lavender and peppermint.

Preservative chemicals are needed in most cosmetics and toiletries to stop them degrading and becoming contaminated. They often have long names e.g. methyldibromoglutaronitrile, imidazolidinyl urea, quaternium 15, methylchlorisothiazolinone.

Hair dye is another common cause of allergic contact dermatitis, and this is almost always caused by phenylene diamine chemicals. Strong allergic reactions can develop to phenylene diamines causing a lot of swelling and redness of the face and neck as well as the scalp. This sort of allergy often affects people who have coloured their hair for years without any problem. As phenylene diamines are present in all permanent and semi-permanent chemical dyes, finding a substitute is not easy. Temporary hair colorants which last for about 6 washes do not contain phenylene diamines and may be a suitable alternative, although some people are also allergic to these.

Other things which occasionally cause allergic reactions include nail varnish resin, sunscreens and lanolin. Do not be mislead by the description of products as 'hypoallergenic'or 'natural', as these can contain an array of common allergens.

The management of suspected contact dermatitis involves temporarily stopping use of all cosmetics on the affected area and treating the skin with a steroid cream. A gentle soap substitute such as emulsifying ointment or an aqueous cream can be used instead of soap for washing and also left on the skin as a moisturiser. In most cases, a mild steroid is all that will be needed, and these can be bought from a pharmacist without prescription, but more severe reactions require medical attention and may need treatment with a short course of steroid tablets. When the reaction has settled, patch testing should be performed by a specialist in order to correctly identify the allergen, and minimise the chance of suffering another attack.

Updated 4/2008