CoChat
Sign Up
Cited by 36Contact Dermatitis and AllergiesDrug-Induced Adverse ReactionsDermatology and Skin Diseases

The DOI matches its Crossref record.

Contact dermatitis associated with preservatives: Retrospective analysis of North American Contact Dermatitis Group data, 1994 through 2016

Open access
Atwater, Amber Reck, Petty, Amy J., Liu, Beiyu, Green, Cynthia L., Silverberg, Jonathan I., DeKoven, Joel G., Belsito, Donald V., Reeder, Margo J., Sasseville, Denis, Taylor, James S., Maibach, Howard I., Zirwas, Matthew J., Marks, James G., Zug, Kathryn A., Fowler, Joseph F., Pratt, Melanie D., DeLeo, Vincent A., Warshaw, Erin M.·2021·Journal of the American Academy of Dermatology
DOI 10.1016/j.jaad.2020.07.059PMC PMC8087451
Open this paper in CoChat — free account

Abstract

Background Preservatives are often necessary components of commercial products. Large-scale North American studies on preservative allergy are limited. Objective To evaluate demographics, positive patch test reactions (PPTRs), clinical relevance, and trends for preservatives tested by the North American Contact Dermatitis Group. Methods We conducted a retrospective cross-sectional analysis of North American Contact Dermatitis Group patch testing results of preservatives from 1994 through 2016. Results A total of 50,799 patients were tested; 11,338 (22.3%) had a PPTR to at least 1 preservative. The most frequent reactions were to methylisothiazolinone 0.2% aqueous (aq) (12.2%), formaldehyde 2% aq (7.8%), formaldehyde 1% aq (7.8%), quaternium-15 2% petrolatum (pet) (7.7%), and methyldibromo glutaronitrile/phenoxyethanol 2% pet (5.1%). Paraben mix 12% pet (1%), iodopropynyl butylcarbamate 0.1% pet (0.4%), benzyl alcohol 1% pet (0.3%), and phenoxyethanol 1% pet (0.2%) had the lowest PPTRs. Linear regression analysis of preservatives tested showed that only methylchloroisothiazolinone/methylisothiazolinone 0.01% aq (parameter estimate, 0.42; 95% CI, 0.17-0.66; P < .005) had a significant increase in PPTRs over time. Limitations Collected variables are dependent on clinical judgment. Results may be prone to referral selection bias. Conclusions This large North American study provides insight on preservative PPTRs and trends from 1994 through 2016.

Overview

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Integrity signals

Registry

Crossref · 10.1016/j.jaad.2020.07.059

Cites

Statistics

Verification

Claims the paper makes

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

  • Methylchloroisothiazolinone/methylisothiazolinone (MCI/MI) is one of the most widely used preservatives in industrial, cosmetic, and household products.

    “Methylchloroisothiazolinone/ methylisothiazolinone (MCI/MI) is one of the most widely used preservatives in industrial, cosmetic, and household products. 22,28”

    From Allergens Causing Allergic Contact Dermatitis in Cosmetic Products: A Systematic Review (2024) · cites this paper as [22]

    The Discussion > Common Preservative Allergens (page unavailable) identifies MCI/MI as a preservative used in cosmetics and discusses limits on its use in cosmetic products. It does not establish that MCI/MI is one of the most widely used preservatives or address its use in industrial and household products; the reported patch-test reaction frequencies do not measure product use. (LLM, conf=0.83)

    Experimental — accuracy not yet measured

  • Formaldehyde is an allergen commonly used as a preservative in cosmetics, household products, and industrial products.

    “Formaldehyde is an allergen commonly used as a preservative in cosmetics, household products, and industrial products. 22”

    From Allergens Causing Allergic Contact Dermatitis in Cosmetic Products: A Systematic Review (2024) · cites this paper as [22]

    The Conclusion identifies formaldehyde as one of the most common preservative allergens, and the Discussion (Common Preservative Allergens) discusses formaldehyde and formaldehyde releasers in cosmetics. Our copy does not establish that formaldehyde is commonly used as a preservative in household or industrial products; its reference to consumer products does not identify those uses. Page numbers were not available in the indexed passages. (LLM, conf=0.86)

    Experimental — accuracy not yet measured

  • Methylchloroisothiazolinone can be found in products such as detergent, shampoo, conditioner, cleansing wipes, make-up remover, face and body cream, deodorant, foundation, mascara, eye shadow, colour, and sunscreen.

    “Methylchloroisothiazolinone can be found in products such as detergent, shampoo, conditioner, cleansing wipes, make-up remover, face and body cream, deodorant, foundation, mascara, eye shadow, colour, and sunscreen. 22”

    From Allergens Causing Allergic Contact Dermatitis in Cosmetic Products: A Systematic Review (2024) · cites this paper as [22]

    The Discussion (Common Preservative Allergens; page not available in our copy) discusses methylchloroisothiazolinone/methylisothiazolinone (MCI/MI) in cosmetics, including rinse-off and leave-on products. It does not identify the listed products as containing methylchloroisothiazolinone, nor establish the claim for that ingredient separately from the MCI/MI mixture. (LLM, conf=0.83)

    Experimental — accuracy not yet measured

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

The self-check needs the paper’s full text.

Citations

Cites

No references could be resolved yet.

Research works printed but not linked: 40

  1. Deza, 2017, Allergic contact dermatitis in preservatives: current standing and future options, Curr Opin Allergy Clin Immunol, 17, 263, 10.1097/ACI.0000000000000373 · DOI
  2. Sasseville, 2004, Hypersensitivity to preservatives, Dermatol Ther, 17, 251, 10.1111/j.1396-0296.2004.04028.x · DOI
  3. Yim, 2014, Contact dermatitis caused by preservatives, Dermatitis, 25, 215, 10.1097/DER.0000000000000061 · DOI
  4. Cheng, 2014, Contact sensitivity to preservatives in Singapore: frequency of sensitization to 11 common preservatives 2006-2011, Dermatitis, 25, 77, 10.1097/DER.0000000000000031 · DOI
  5. Svedman, 2012, Follow-up of the monitored levels of preservative sensitivity in Europe: overview of the years 2001-2008, Contact Dermatitis, 67, 312, 10.1111/j.1600-0536.2012.02140.x · DOI
  6. Schnuch, 2011, Contact allergy to preservatives. Analysis of IVDK data 1996-2009, Br J Dermatol, 164, 1316, 10.1111/j.1365-2133.2011.10253.x · DOI
  7. Yu, 2016, Patch testing for methylisothiazolinone and methylchloroisothiazolinone-methylisothiazolinone contact allergy, JAMA Dermatol, 152, 67, 10.1001/jamadermatol.2015.3606 · DOI
  8. DeKoven, 2018, North American Contact Dermatitis Group patch test results: 2015-2016, Dermatitis, 29, 297, 10.1097/DER.0000000000000417 · DOI
  9. Maouad, 1999, Significance-prevalence index number: a reinterpretation and enhancement of data from the North American contact dermatitis group, J Am Acad Dermatol, 41, 573
  10. Fasth, 2018, Ten-year trends in contact allergy to formaldehyde and formaldehyde-releasers, Contact Dermatitis, 79, 263, 10.1111/cod.13052 · DOI
  11. Buckley, 2003, The frequency of fragrance allergy in patch-tested patients increases with their age, Br J Dermatol, 149, 986, 10.1111/j.1365-2133.2003.05491.x · DOI
  12. DeKoven, 2017, North American Contact Dermatitis Group patch test results 2013-2014, Dermatitis, 28, 33, 10.1097/DER.0000000000000225 · DOI
  13. Veverka, 2018, Trends in patch testing with the Mayo Clinic standard series, 2011-2015, Dermatitis, 29, 310, 10.1097/DER.0000000000000411 · DOI
  14. Isaksson, 2017, Multicenter patch testing with methylisothiazolinone and methylchloroisothiazolinone/methylisothiazolinone within the International Contact Dermatitis Research Group, Dermatitis, 28, 210, 10.1097/DER.0000000000000272 · DOI
  15. Flury, 2018, The methylisothiazolinone contact allergy epidemic in Australia, Contact Dermatitis, 79, 189, 10.1111/cod.13025 · DOI
  16. Castanedo-Tardana, 2013, Methylisothiazolinone, Dermatitis, 24, 2, 10.1097/DER.0b013e31827edc73 · DOI
  17. Gimenez-Arnau, 2016, Opinion of the Scientific Committee on Consumer Safety (SCCS)—opinion on the safety of the use of methylisothiazolinone (MI) (P94), in cosmetic products (sensitisation only), Regul Toxicol Pharmacol, 76, 211, 10.1016/j.yrtph.2016.01.001 · DOI
  18. Burnett, 2010, Final report of the safety assessment of methylisothiazolinone, Int J Toxicol, 29, 187s, 10.1177/1091581810374651 · DOI
  19. Urwin, 2017, Methylisothiazolinone: the epidemic is declining—but not gone, Contact Dermatitis, 76, 301, 10.1111/cod.12750 · DOI
  20. Engfeldt, 2015, Swedish experiences from patch testing methylisothiazolinone separately, Acta Derm Venereol, 95, 717, 10.2340/00015555-2029 · DOI
  21. Gimenez-Arnau, 2017, Contact allergy to preservatives: ESSCA∗ results with the baseline series, 2009-2012, J Eur Acad Dermatol Venereol, 31, 664, 10.1111/jdv.14063 · DOI
  22. Ponten, 2013, Patch testing with 2.0% (0.60 mg/cm2) formaldehyde instead of 1.0% (0.30 mg/cm2) detects significantly more contact allergy, Contact Dermatitis, 68, 50, 10.1111/j.1600-0536.2012.02169.x · DOI
  23. Hauksson, 2010, Routine diagnostic patch-testing with formaldehyde 2.0% (0.6 mg/cm2) may be an advantage compared to 1.0%, Acta Derm Venereol, 90, 480, 10.2340/00015555-0925 · DOI
  24. Ponten, 2015, Formaldehyde, Dermatitis, 26, 3, 10.1097/DER.0000000000000075 · DOI
  25. Svedman, 2012, ‘Calibration’ of our patch test reading technique is necessary, Contact Dermatitis, 66, 180, 10.1111/j.1600-0536.2011.02044.x · DOI
  26. Boyer, 2013, Amended safety assessment of formaldehyde and methylene glycol as used in cosmetics, Int J Toxicol, 32, 5s, 10.1177/1091581813511831 · DOI
  27. Becker, 2017, Quaternium-15, Int J Toxicol, 36, 52s, 10.1177/1091581817717643 · DOI
  28. 2008, Annual review of cosmetic ingredient safety assessments: 2005/2006, Int J Toxicol, 27, 77
  29. 2003, Annual review of cosmetic ingredient safety assessments—2001/2002, Int J Toxicol, 22, 1
  30. 2006, Annual review of cosmetic ingredient safety assessments—2004/2005, Int J Toxicol, 25, 1
  31. de Groot, 2010, Formaldehyde-releasers in cosmetics in the USA and in Europe, Contact Dermatitis, 62, 221, 10.1111/j.1600-0536.2009.01623.x · DOI
  32. Beene, 2017, Prevalence of preservatives across all product types in the contact allergen management program, Dermatitis, 28, 81, 10.1097/DER.0000000000000259 · DOI
  33. Ham, 2019, Undeclared formaldehyde levels in patient consumer products: formaldehyde test kit utility, Cutan Ocul Toxicol, 38, 112, 10.1080/15569527.2018.1471485 · DOI
  34. Hauksson, 2016, Formaldehyde in cosmetics in patch tested dermatitis patients with and without contact allergy to formaldehyde, Contact Dermatitis, 74, 145, 10.1111/cod.12493 · DOI
  35. Isaksson, 2019, Patch testing with formaldehyde 2.0% (0.60 mg/cm2) detects more contact allergy to formaldehyde than 1.0, Dermatitis, 30, 342, 10.1097/DER.0000000000000510 · DOI
  36. Schwensen, 2015, Failures in risk assessment and risk management for cosmetic preservatives in Europe and the impact on public health, Contact Dermatitis, 73, 133, 10.1111/cod.12446 · DOI · Paper page
  37. Johansen, 2008, Decreasing trends in methyldibromo glutaronitrile contact allergy—following regulatory intervention, Contact Dermatitis, 59, 48, 10.1111/j.1600-0536.2008.01364.x · DOI
  38. Castelain, 2012, Parabens: a real hazard or a scare story?, Eur J Dermatol, 22, 723, 10.1684/ejd.2012.1835 · DOI
  39. Fransway, 2019, Parabens, Dermatitis, 30, 3, 10.1097/DER.0000000000000429 · DOI
  40. Warshaw, 2013, Positive patch test reactions to carba mix and iodopropynyl butylcarbamate: data from the North American Contact Dermatitis Group, 1998-2008, Dermatitis, 24, 241, 10.1097/DER.0b013e3182a5a1d4 · DOI

Cited by

Sorted by citations

Metadata

Authors
Atwater, A. R., Petty, A. J., Liu, B., Green, C. L., Silverberg, J. I., DeKoven, J. G., Belsito, D. V., Reeder, M. J., Sasseville, D., Taylor, J. S., Maibach, H. I., Zirwas, M. J., Marks, J. G., Zug, K. A., Fowler, J. F., Pratt, M. D., DeLeo, V. A., & Warshaw, E. M.
Affiliations
  • Duke University (US)
  • Duke Medical Center (US)
  • George Washington University (US)
  • Sunnybrook Health Science Centre (CA)
  • Columbia University Irving Medical Center (US)
  • University of Wisconsin–Madison (US)
  • Montreal General Hospital (CA)
  • Cleveland Clinic (US)
  • University of California, San Francisco (US)
  • Pennsylvania State University (US)
  • Dartmouth–Hitchcock Medical Center (US)
  • University of Louisville (US)
  • University of Ottawa (CA)
  • University of Southern California (US)
  • University of Minnesota (US)
Corresponding author
Atwater, Amber Reck
ORCID
Venue
Journal of the American Academy of Dermatology
Publisher
Elsevier BV
Published
2021-04
Volume
84
Issue
4
Pages
965-976
ISSN
0190-9622 (ISSN-L)
DOI
10.1016/j.jaad.2020.07.059
PMC
PMC8087451
OpenAlex
W3126856229
Cited by
36
References
0
Citations by year
2026: 4 · 2025: 4 · 2024: 9 · 2023: 12 · 2022: 6 · 2021: 1
FWCI
6.22
Type
journal article
Language
en
Open access
Licence
Locations
  • Journal of the American Academy of Dermatology (publishedVersion)
  • PubMed (publishedVersion)
  • PubMed Central (acceptedVersion)
  • eScholarship (California Digital Library) (submittedVersion)
Funders
  • National Cancer Institute (F30CA213799)
  • National Institute of General Medical Sciences (T32GM007171, T32GM145449)
Topics
  • Health Sciences › Medicine › Dermatology › Contact Dermatitis and Allergies
  • Health Sciences › Medicine › Pharmacology (medical) › Drug-Induced Adverse Reactions
  • Health Sciences › Medicine › Dermatology › Dermatology and Skin Diseases
Keywords
contact dermatitis, preservative allergy, methylisothiazolinone, formaldehyde, quaternium-15, methyldibromo glutaronitrile, phenoxyethanol, parabens, benzyl alcohol, North American Contact Dermatitis Group
MeSH terms
Canada, Cross-Sectional Studies, Female, Hand Dermatoses, Humans, Hypersensitivity, Immediate, Male, Middle Aged, Dermatitis, Occupational, Organ Specificity, Patch Tests, Preservatives, Pharmaceutical, Retrospective Studies, United States, Linear Models, Dermatitis, Allergic Contact, Age Distribution, Sex Distribution

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review