Summary Immediate skin reactions are common in dermatological practice, but may often be overlooked. The main objective of this article is to provide an update of the literature concerning immediate‐type reactions or contact urticaria/contact urticaria syndrome caused by cosmetic ingredients in terms of immediate clinical symptoms, positive reactions following open, scratch or, most often, prick testing, and sometimes the detection of specific IgE antibodies. To this end, a selective search in different medical literature databases was performed. This yielded a list of cosmetic ingredients causing immediate reactions, including hair dyes and bleaches, preservatives, fragrance and aroma chemicals, sunscreens, hair glues, plant‐derived and animal‐derived components, permanent makeup and tattoos, glycolic acid peel, lip plumper, and alcohols. Many of the reported cases, however, lack appropriate controls and detailed investigation. Contact urticaria may occur with or without systemic symptoms, which are sometimes life‐threatening.

Ethylhexylglycerin is a rare, but highly relevant, cosmetic sensitizer, even in those products advertised to be safe for consumers. Targeted patch testing with ethylhexylglycerin 5% pet. is very useful, and routine patch testing in a cosmetic series may be considered. Higher test concentrations might be indicated in selected cases.

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