Characteristics, Detection, and Prevalence of Lanolin-Induced Contact Dermatitis

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• Lanolin, a complex mixture used frequently for its emollient properties, is a weak sensitizer, with an estimated 0.4% of the European population demonstrating contact allergy to it. Despite this low prevalence, certain patients are susceptible to lanolin contact allergy, including the young and elderly and those with stasis dermatitis, leg ulcers, perianal/genital dermatitis, or atopic dermatitis. Lanolin may produce a false-negative patch test in these patients when it is tested on normal skin.
• Lanolin is the contact allergen of the year, and special considerations need to be taken when patch testing for lanolin contact allergy.

Abstract

Lanolin is a complex mixture of high molecular weight esters, aliphatic alcohols, sterols, fatty acids, and hydrocarbons that has been widely used for centuries for its emollient properties. The purification of crude lanolin into lanolin wax and the processing of this wax into various derivatives began in 1882 and continue to this day with newer highly purified anhydrous lanolins. Controversy as to lanolin's allergenicity began in the 1920s and remains an issue. The most appropriate patch test preparation(s) for detecting allergy remain disputed. Detection of lanolin-induced contact dermatitis in diseased skin by patch testing on normal skin may lead to false negative results. Patients with a positive patch test to lanolin may tolerate use of lanolin on normal skin. Although lanolin is a weak sensitizer and the frequency of contact allergy to it in the European population reportedly is 0.4%, there are high-risk concomitant conditions: stasis dermatitis, leg ulcers, perianal/genital dermatitis, and atopic dermatitis (AD). Children and the elderly are also at greater risk of developing contact allergy to lanolin, partly because of comorbidities (AD and stasis dermatitis/leg ulcers, respectively). Finally, in the United States, non-Hispanic white patients are more likely than their non-Hispanic black counterparts to be lanolin allergic.

Dermatitis

Lanolin

Dermatitis 2023 Jan 11;34(1)4-12, BA Jenkins, DV Belsito 

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Benjamin Hidalgo-Matlock
Skin Care Physicians of Costa Rica

Clinica Victoria en San Pedro: 4000-1054
Momentum Escazu: 2101-9574

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