Concomitant contact allergy to formaldehyde and formaldehyde-releasers remains common among patients with allergic contact dermatitis. Concentration of free formaldehyde in cosmetic products within allowed limits have been shown to induce dermatitis from short-term use on normal skin.The aim of this study was to investigate the formaldehyde content of cosmetic products made in Lithuania. 42 samples were analysed with the chromotropic acid (CA) method for semi-quantitative formaldehyde determination. These included 24 leave-on (e.g., creams, lotions) and 18 rinse-off (e.g., shampoos, soaps) products. Formaldehyde releasers were declared on the labels of 10 products. No formaldehyde releaser was declared on the label of the only face cream investigated, but levels of free formaldehyde with the CA method was >40 mg/ml and when analysed with a high-performance liquid chromatographic method – 532 ppm. According to the EU Cosmetic directive, if the concentration of formaldehyde is above 0.05% a cosmetic product must be labelled “contains formaldehyde“. It could be difficult for patients allergic to formaldehyde to avoid contact with products containing it as its presence cannot be determined from the ingredient labelling with certainty. The CA method is a simple and reliable method for detecting formaldehyde presence in cosmetic products.

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A 33-year-old female patient presented to our clinic with a 1-year history of erythematous and itchy plaques on the both eyelids, the perioral area, and the neck (Figure 1). She associated her symptoms with food, spices and coffee, but not with cosmetics, as she stated that she used only "hypoallergenic cosmetic products for sensitive skin". She has no other health problems or atopy. Prick tests with inhalant allergens and food gave negative results. Patch tests were performed with the European baseline series and a cosmetic series (Chemotechnique Diagnostics, Vellinge, Sweden), as well as with her creams (all "as is") Noreva Global Exfoliac 6 and Noreva Recovery Cream, and "semi-open" with Noreva Exfoliac Gel, Noreva Actipur Wash (all by Noreva Laboratoires, Paris, France), and ODA Wash (ODA, Elektrėnai, Lithuania). We performed patch tests by the use of Finn Chambers (SmartPractice Europe, Barsbüttel, Germany) covered with Mefix (Mölnlycke Healthcare, Göteborg, Sweden), and read them according to ICDRG guidelines on day (D) 2, D3, and D7. Positive reactions to Noreva Exfoliac Global 6 cream (+++), drometrizole, propyl gallate, dodecyl gallate, 3-(dimethylamino)-1-propylamine (all + reactions) were detected. All positive reactions were considered to be not clinically relevant to the present dermatitis, with the exception of Noreva Exfoliac Global 6 cream. The Noreva Laboratoires representative was contacted, and ingredients were kindly provided and patch tested. Tests were read on D3 and D7. A +++ positive reaction to bakuchiol 0.1% pet. appeared at D3. Ten controls were 398 MALINAUSKIENE ET AL.

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