Contact cheilitis from bisabolol and polyvinylpyrrolidone/hexadecene copolymer in lipstick

Allergic contact cheilitis caused by lauryl PCA

“…They consist of a blend of waxes and mineral oils, most often supplemented with ultraviolet filters, flavours, preservatives, and antioxidants. Contact allergens responsible for allergic contact dermatitis caused by lip balms include esters, such as isopalmityl diglyceryl sebacate, glyceryl isostearate, diisostearyl malate, and ditrimethylolpropane triethylhexanoate, dipentaerythritol fatty acid ester, ceresin wax, carauba wax, cera alba, colophonium (rosin), castor oil, gallates used as antioxidants, propolis, peppermint oil, menthoxypropanediol, citral, vanillin, bisabolol, polyvinylpyrrolidone/hexadecene, benzophenone‐3, and D & C Yellow 11 …”

Patch testing with constituents of Compositae mixes

“…Hausen mentioned coumarins and flavonoids from German chamomile as alternative sensitizers, and the coumarin herniarin has been reported to elicit positive reactions in clinical studies (10,25,26). Furthermore, the sesquiterpene alcohol bisabolol or one of its oxidation products has been reported as allergenic (27), and, more recently, clinical studies have suggested that bisabolol is an important chamomile allergen (28,29). In an American study by Jacob et al, 4 of 7 children with selfreported intolerance to a moisturizer containing bisabolol tested positive to the moisturizer, bisabolol, and the sesquiterpene lactone mix and/or CM 6%, and improved clinically after avoidance of the cream (29).…”

Reactions to Aquaphor®: Is Bisabolol the Culprit?

“…Because of its wound‐healing, anxiolytic, and smooth muscle relaxant properties, bisabolol is used in many herbal remedies (3). It is also found in topical creams/emollients and cosmetics for sensitive skin as an “anti‐irritant agent” as a result of its anti‐inflammatory qualities (4).…”

“…To our knowledge, testing for bisabolol is not currently being performed in the U.S., and the concentration for bisabolol testing has not yet been standardized. We acknowledge the difficulty in performing investigative patch testing with nonstandardized substances in children, but developing standardized patch testing for this chemical as an allergen is both needed and warranted, especially as little data confirming bisabolol’s efficacy as an “anti‐irritant” are found (4).…”

“…Of note, ACD to bisabolol in cosmetics and emollients has been reported twice in European adults (3,4). Wilkinson et al (3) were the first to report a case of ACD to bisabolol found in a cosmetic which resulted in periorbital swelling (notably they tested their patient with bisabolol 1% pet: purity 87%–93%), and Pastor et al (4) described a second case of contact cheilits caused by a lipstick containing this chemical (they tested their patient with bisabolol 5% pet). To the best of our knowledge, the three children described here are the only existing reports of potential pediatric ACD to bisabolol in the literature and the first reported cases in the U.S.…”