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Contact Dermatitis to Personal Care Products in Men and Women
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This retrospective cross-sectional analysis of the North American Contact Dermatitis Group database demonstrates an increased proportion of personal care product (PCP)-related dermatitis from 16.9% and 21.9% of patch tests in men and women, respectively, in 1996–1998 to 35.1% and 49.4% of patch tests in men and women, respectively, in 2015–2016 . Over the two decades of study, rates of PCP-related dermatitis increased by over 2.7 fold. The distribution of dermatitis in men was more likely to include the extremities and trunk versus women, in whom scalp, face, and neck dermatitis was more likely. Men were approximately twice as likely to have allergens related to soaps than women, who were more likely to have a hair care product-associated allergen.
- With increasing marketing of PCPs "for men", rates of dermatitis secondary to PCPs have increased. Men and women differ in the types of products in which allergens are encountered and the distribution of dermatitis.
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Personal care products (PCP) are well-known causes of both allergic contact dermatitis (ACD) and irritant contact dermatitis (ICD). Historically, women have had PCP-related dermatitis at a higher prevalence than men, but this study demonstrates that not only is PCP-related dermatitis on the rise, it is also increasingly being seen in men as well. In this study, the NACDG evaluated men and women and assessed variations between them. They found that in comparison with women who had PCP-related dermatitis, men were older and more commonly had trunk and extremity involvement. They were also more likely to have soaps as a source of the dermatitis. This vehicle for the allergen correlates with the more common distribution found in men on the trunk and extremities. Women, on the other hand, were twice as likely to have hair care products as allergens, and this correlates with the more common exposure pattern seen in women on the head and neck. The most common PCP-related allergens were the same for both sexes. These included primarily preservatives, fragrances, and hair dye. Methylisothiazolinone was the most common allergen identified. This is a well-known allergen in PCP and is not found in the FDA-approved screening series. Fragrance mix and balsam of Peru were also on the list as were quaternium-15 and paraphenylenediamine. The authors cite that there is an increase in PCPs that are specifically being marketed "for men." They also comment on past studies that demonstrate that men use half as many PCPs daily with almost half as many ingredient exposures when compared with women; however, this seems to be changing. Overall, PCP-related dermatitis was found in 28.8% of men and 39.5% of women, and this was an increase from past studies. Though the exact cause for the increase in frequency of PCP-related dermatitis is unknown, it may be attributed to several factors, including increased product usage, the use of more ingredients that result in allergy, or increases in patch testing. The study demonstrates that PCP allergy is increasingly being seen in both men and women. This reminds us to keep patch testing on our list of tools to utilize when assessing both women and men with dermatitis. Inquiring about PCPs is an important first step to making the diagnosis, and testing to these products is necessary in order to identify and avoid allergens so as to eliminate the resultant dermatitis.
BACKGROUND
Personal care products(PCPs) are commonly responsible for allergic(ACD) and irritant contact dermatitis(ICD). PCP use was historically associated with women but increasingly, male-targeted PCPs are being marketed.
OBJECTIVE
To characterize and compare males and females with PCP-related contact dermatitis(MPCP, FPCP).
METHODS
Retrospective cross-sectional analysis of North American Contact Dermatitis Group(NACDG) data (1996-2016).
RESULTS
4680/16,233 males (28.8%) and 12,730/32,222 (39.5%) females had a PCP identified as a source of ICD or a positive patch test reaction. The proportion of PCP-related dermatitis in both sexes significantly increased (>2.7 fold) over the decade of study. As compared to FPCP, a larger proportion of MPCP were older and/or had trunk/extremity dermatitis(p<0.0001). MPCP were twice as likely to have soaps as a source while FPCP were twice as likely to have hair care products(p values<0.001). The most common PCP-related NACDG allergens for both sexes were methylisothiazolinone(MI) (MPCP:28.8%, FPCP:21.5%), fragrance mix I (22.3%, 20.1%), balsam of Peru (18.5%, 14.1%), quaternium-15 (16.1%, 12.3%), and paraphenylenediamine (11.5%, 11.1%).
LIMITATIONS
Patient population referred for suspected contact dermatitis.
CONCLUSIONS
PCP-related dermatitis is increasing. Sites of involvement and relevant PCP sources are distinct between sexes. Male and female variation in exposure history may explain differences in reactivity to some allergen groups.
Contact Dermatitis to Personal Care Products is Increasing (but Different!) in Males and Females: North American Contact Dermatitis Group (NACDG) Data, 1996–2016
J Am Acad Dermatol 2020 Oct 08;[EPub Ahead of Print], EM Warshaw, JP Schlarbaum, JI Silverberg, JG DeKoven, AF Fransway, JS Taylor, HI Maibach, JF Fowler, AR Atwater, MJ Reeder, KA Zug, DV Belsito, D Sasseville, VA DeLeo, MD Prattposted by dermatica at
October 31, 2020
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