Background: Facial allergic contact dermatitis caused by cosmetic products is common. New allergens in cosmetics continuously emerge.Objectives: To investigate characteristics of patients with facial dermatitis (FD) between 2010 and 2019 including patch test results from cosmetic-related allergens and a new test series with cosmetic-relevant natural ingredients (CRNIs).Methods: This is a retrospective study analysing demographics, clinical characteristics according to MOAHLFA index (male; occupation; atopic dermatitis; hand; leg; face; age ≥ 40 years), and patch test results to 27 cosmetic-relevant allergens in FD patients. A prospective study evaluating a screening test series with CRNIs in consecutive FD patients for 1 year was also conducted. These patients received a questionnaire for collecting extra characteristics (eg, concerning quality of life).Results: Of 8740 tested patients, 2292 (26.2%) had FD. Of these, 30.6% had cosmeticinduced FD. The most common cosmetic-related allergens were fragrances and preservatives. The most common patch test-positive CRNIs were hydroperoxides of limonene and linalool, and propolis. Potato and peanut were rare, but the most common prick test-positive CRNIs, however, without any relation to the use of cosmetic products. FD affected nearly all patients' quality of life and caused limitations to their daily life.Conclusions: Updated management and quick diagnosis of FD is important to avoid negative impact on patients' quality of life.cosmetic products, facial dermatitis, natural ingredients, patch test, skin prick test
| INTRODUCTIONThe lifetime prevalence of facial dermatitis (FD) is around 10% in the general population. 1 Many FD patients present in dermatology clinics for diagnosis and treatment. 1 FD may have a negative impact on patients quality of life in addition to socioeconomic consequences. 2,3 Compared with hand dermatitis, surprisingly few studies have recently focused on the frequency, characteristics, and potential impact of FD and facial allergic contact dermatitis (FACD). 1,4,5 Cosmetics are probably the most common reason that FD patients present for patch testing, as allergic contact dermatitis is suspected. 4 Many ingredients in cosmetic products are contact allergens and have been shown to be common causes of FACD, especially fragrances and preservatives. [5][6][7] However, investigations of FACD may have a certain complexity due to the many ingredients and potential allergens present in cosmetics, and the cause of the allergy may be overlooked. New allergens, such as natural ingredients, continuously emerge in cosmetic products and could potentially make investigation and causes of FD even more comprehensive as they may also give rise to contact urticaria and/or protein contact dermatitis in FD patients. Cosmetics labelled as "natural" with plant protein derivatives, for example, wheat and oat, and animal protein derivatives, for example, milk, known to have the potential to cause immediate-type allergy when ingested, are increasing in popularity as cosm...