Periocular Contact Dermatitis

[Scout]

http://www.ncbi.nlm.nih.gov/pubmed/1...ubmed_RVDocSum

Journal of the European Academy of Dermatology and Venereology . 2008 Aug 29. [Epub ahead of print]

Periocular dermatitis: a report of 401 patients.

Temesvári E, Pónyai G, Németh I, Hidvégi B, Sas A, Kárpáti S.

Faculty of Medicine, Department of Dermatology, Venerology and Dermatooncology, Semmelweis University, Budapest, Hungary.

Background Periocular contact dermatitis may appear as contact conjunctivitis, contact allergic and/or irritative eyelid and periorbital dermatitis, or a combination of these symptoms. The clinical symptoms may be induced by several environmental and therapeutic contact allergens.

Objectives The aim of the present study was to map the eliciting contact allergens in 401 patients with periocular dermatitis (PD) by patch testing with environmental and ophthalmic contact allergens.

Methods Following the methodics of international requirements, 401 patients were tested with contact allergens of the standard environmental series, 133 of 401 patients with the Brial ophthalmic basic and supplementary series as well.

Results Contact hypersensitivity was detected in 34.4% of the patients. Highest prevalence was seen in cases of PD without other symptoms (51.18%), in patients of PD associated with ophthalmic complaints (OC; 30.4%), and PD associated with atopic dermatitis (AD; 27.9%). In the subgroup of PD associated with seborrhoea (S) and rosacea (R), contact hypersensitivity was confirmed in 17.6%. Most frequent sensitisers were nickel sulphate (in 8.9% of the tested 401 patients), fragrance mix I (4.5%), balsam of Peru (4.0%), paraphenylendiamine (PPD) (3.7%), and thiomersal (3.5%). By testing ophthalmic allergens, contact hypersensitivity was observed in nine patients (6.7% of the tested 133 patients). The most common confirmed ophthalmic allergens were cocamidopropyl betaine, idoxuridine, phenylephrine hydrochloride, Na chromoglycinate, and papaine. Limitations Patients with symptoms of PD were tested from 1996 to 2006.

Conclusions The occurence of contact hypersensitivity in PD patients was in present study 34.4%. A relatively high occurence was seen in cases of PD without other symptoms, in PD + OC and in PD + AD patients. The predominance of environmental contact allergens was remarkable: most frequent sensitizers were nickel sulphate, fragrance mix I, balsam of Peru, thiomersal, and PPD. The prevalence of contact hypersensitivity to ophthalmic allergens did not exceed l.5%.

[calcan]

This is interesting. I was wondering, how does nickel sulphate get near the eyes? Where is this found?

[Scout]

http://www.aaaskindoctor.com/nickel.html
Nickel allergy (aka allergic contact dermatitis) is a common reaction to minute amounts of nickel particles coming into direct contact with the skin and may include jewelry, watches, zippers, snaps and even eyeglasses. Certain occupations result in habitual nickel exposure, which increases the risk of developing a nickel allergy. These include metal factory workers, hairdressers, tailors and restaurant workers.


http://dermnetnz.org/dermatitis/thiomersal-allergy.html
Thiomersal is an organic compound containing mercury and thiosalicylate. It is commonly used as a preservative in topical pharmaceutical preparations, cosmetics, and biological products such as vaccines. It is an antiseptic with both bactericidal and fungicidal action.
Products commonly containing thiomersal preservative
Cosmetics Pharmaceutical/self-hygiene products Biological products
* Make-up removers
* Eye moisturizers
* Eye shadows
* Mascaras
* Soap-free cleansers
* Eye, ear and nose drops/ointments
* Antiseptic sprays
* Topical medications
* First-aid product (tincture of Merthiolate)
* Vaccines, particularly multi-dose vials
* Antitoxins
* Immune globulin preparations
* Skin prick test antigens

http://dermnetnz.org/dermatitis/fragrance-allergy.html
Fragrance mix is a mixture of 8 individual fragrances that is used to screen for fragrance allergy. The 8 listed are the most common allergy-causing fragrances that are used across many products for their fragrant and flavouring properties.
Components of Fragrance Mix
Fragrance Used/found in

Cinnamic alcohol
* Odour of hyacinth
* Ester in natural fragrances such as Balsam of Peru, storax, cinnamon leaves, hyacinth oil and propolis
* Fragrance in perfumes, cosmetics, deodorants, paper, laundry detergent products, toilet soap, personal hygiene products
* Flavouring in beverages (cola, bitters, Vermouth), chewing gums, toothpaste and mouthwash

Cinnamic aldehyde
* Warm spicy odour with a taste of cinnamon
* Constituent of cinnamon oil

Eugenol
* Powerful spicy odour of clove with a pungent taste
* Found in oils of clove and cinnamon leaf
* Also found in roses, carnations, hyacinths and violets
* Fragrance in perfume, cosmetics, colognes, toilet waters, hair cosmetics, aftershave, personal hygiene products
* Flavouring in toothpaste, mouthwash and food flavourings
* Used in dental cement and packing agents thus giving the characteristic odour of dental surgeries
* Inherent insecticidal and fungicidal properties — used to preserve meats and other foods
* Pharmaceutical creams and lotions for its antiseptic properties

Isoeugenol
* Odour of clove weaker than that of eugenol
* Constituent of nutmeg oil and ylang ylang oil
* Isomerization of eugenol

Geraniol
* Sweet floral odour of rose
* Constitutes a large portion of rose and palmarose oil, geranium oil, lavender oil, jasmine oil and citronella oil
* Present in over 250 essential oils
* Most widely used fragrance in perfumes, colognes, facial make-up and skin care products

Alpha amyl cinnamic alcohol
* Intense odour of jasmine
* Synthetic essential oil
* Found in perfumes, soaps, cosmetics and toothpaste

Hydroxycitronellal
* Sweet fresh odour of lily of the valley
* Synthetic floral fragrance
* Found in perfumes, soaps, cosmetics, eye cream, aftershaves
* Also used in insecticides and antiseptics

Oak moss absolute
* Earthy, woody, masculine odour
* Essential oil produced by solvent extraction of tree lichen
* Commonly used in colognes, aftershaves and scented products for men

Fragrances may also be found in the workplace. Paints, cutting fluids and metal working fluids may contain fragrances to mask offending odours. Fragrances may also be circulated through air conditioning.

http://dermnetnz.org/dermatitis/para...e-allergy.html
Paraphenylenediamine (PPD) is a chemical substance that is widely used as a permanent hair dye. It may also been found in textile or fur dyes, dark coloured cosmetics, temporary tattoos, photographic developer and lithography plates, photocopying and printing inks, black rubber, oils, greases and gasoline.

[calcan]

Thank you. I will check all my lotions and make-up removers.

[eva b]

thanks for all this very detailed information - most interesting.

One major ingredient that no-one has spotted, though, is cocamidopropyl betaine - derived from coconut - which is a major component of a huge number of "natural" shampoos....its well known to be a skin irritant, and yet it appears in nearly all brands you can get in health shops. Most frustrating.

I've done quite a lotof research on shampoos and conditioners (obviously because there's a chance of some of it getting in your eyes) and it's impossible to find one that doesn't contain at lease one of the harmful ingredients

and as for the so called "baby" shampoos...don't even get me started...full of sodium lauryl sulfate...not to mention parabens

[sazy123]

http://www.ncbi.nlm.nih.gov/pubmed/1...ubmed_RVDocSum

Journal of the European Academy of Dermatology and Venereology . 2008 Aug 29. [Epub ahead of print]

Periocular dermatitis: a report of 401 patients.

Temesvári E, Pónyai G, Németh I, Hidvégi B, Sas A, Kárpáti S.

Faculty of Medicine, Department of Dermatology, Venerology and Dermatooncology, Semmelweis University, Budapest, Hungary.

Background Periocular contact dermatitis may appear as contact conjunctivitis, contact allergic and/or irritative eyelid and periorbital dermatitis, or a combination of these symptoms. The clinical symptoms may be induced by several environmental and therapeutic contact allergens.

Objectives The aim of the present study was to map the eliciting contact allergens in 401 patients with periocular dermatitis (PD) by patch testing with environmental and ophthalmic contact allergens.

Methods Following the methodics of international requirements, 401 patients were tested with contact allergens of the standard environmental series, 133 of 401 patients with the Brial ophthalmic basic and supplementary series as well.

Results Contact hypersensitivity was detected in 34.4% of the patients. Highest prevalence was seen in cases of PD without other symptoms (51.18%), in patients of PD associated with ophthalmic complaints (OC; 30.4%), and PD associated with atopic dermatitis (AD; 27.9%). In the subgroup of PD associated with seborrhoea (S) and rosacea (R), contact hypersensitivity was confirmed in 17.6%. Most frequent sensitisers were nickel sulphate (in 8.9% of the tested 401 patients), fragrance mix I (4.5%), balsam of Peru (4.0%), paraphenylendiamine (PPD) (3.7%), and thiomersal (3.5%). By testing ophthalmic allergens, contact hypersensitivity was observed in nine patients (6.7% of the tested 133 patients). The most common confirmed ophthalmic allergens were cocamidopropyl betaine, idoxuridine, phenylephrine hydrochloride, Na chromoglycinate, and papaine. Limitations Patients with symptoms of PD were tested from 1996 to 2006.

Conclusions The occurence of contact hypersensitivity in PD patients was in present study 34.4%. A relatively high occurence was seen in cases of PD without other symptoms, in PD + OC and in PD + AD patients. The predominance of environmental contact allergens was remarkable: most frequent sensitizers were nickel sulphate, fragrance mix I, balsam of Peru, thiomersal, and PPD. The prevalence of contact hypersensitivity to ophthalmic allergens did not exceed l.5%.

Scout is there any indication of eye allergies occurring from systematic exposure to nickel- rather than direct contact with the allergen? I have a brace above top teeth- which am always in contact with.

I do not have issues when in contact with nickle to my skin- i.e watches, rings etc. I do wear glasses but are rimless and i dont see how i could be allergic since not touching the eye?

I have had kinesology with an allergist who said i have high sensitivity to nickel, but im wary, i dont want to have brace taken out based on only this information.

Thanks

[skygoddess]

Just looking at your pic, I suspect cocamidopropyl betaine, may be your culprit, its mine.
It is in pretty much all hair care products, by one name or another
Your bangs hit right where mine do.

[skygoddess]

Eva,
You are so right, it is almost impossible to find shampoo without cocamidopropyl betaine, by one name or another.
But since you live in the UK, you can buy Eucerin Urea %5 .
It does not contain any. We can't get it in the States.
Now I only wish I could find a conditioner.
I bought some jojoba oil today. It will have to do.
If you find a cream rinse please let me know.


My eyes are almost completely normal since I got rid of all the cocamidopropyl betaine in my world.
I also have allergies to benzyl alcohol, fragrance mix, and acrylates.
But I think the cocamidopropyl was giving me the most problem.

[sazy123]

Just looking at your pic, I suspect cocamidopropyl betaine, may be your culprit, its mine.
It is in pretty much all hair care products, by one name or another
Your bangs hit right where mine do.

Hi skygoddess,
How long after not using the conditioner did you notice an improvement? what about if you clipped your hair away from your eyes?

I dont think this is my problem, ive now been on an organic tea tree oil shampo for a couple of weeks, i did use organic conditioner for a few days but ran out, and i put it on, i dont get it anywhere near face or eyes and wash it out quickly, also i always only wash my hair every 3 days because it doesnt need more. So it doesnt really make sense. still gonna im willing to try anything.

[alisonW]

skygodess...

What shampoo have you found that doesn't contain cocamidopropyl betaine?

[skygoddess]

Organic shampoos have it also.
I noticed a difference as soon as I stopped using the shampoo and conditioners.
I did not notice the connection right away, I think it was because I also do not wash my hair every day, so some days were better than others

I needed a few days to get the reaction under control, with steroid drops, or azasite clears it up for me also, but as long as I stay away from the allergens I am doing well.

The only one I found without cocamidopropyl betaine is Eucerin Urea %5. Problem is you can only get it in Europe.
Ther are about two dozen names for it, so it slips in unnoticed.
My Dr gave me a list of shampoos with few allergens, and Neutrogena T-Sal was on it, I don't know for sure if it contains cocamidopropyl betaine, but it seemed to be OK. I found it at Rite Aid.

[alisonW]

Thanks so much...

I actually have some Neutrogena T-Sal and will check out its ingredients.

[sazy123]

can you tell me if these ingredients are is cocamidopropyl betaine

Its teatree oil shampoo

shikakai, reetha extract, arnica, nettle, calendula, chlorophyll

[magoo]

Organic shampoos have it also.
I noticed a difference as soon as I stopped using the shampoo and conditioners.
I did not notice the connection right away, I think it was because I also do not wash my hair every day, so some days were better than others

I needed a few days to get the reaction under control, with steroid drops, or azasite clears it up for me also, but as long as I stay away from the allergens I am doing well.

The only one I found without cocamidopropyl betaine is Eucerin Urea %5. Problem is you can only get it in Europe.
Ther are about two dozen names for it, so it slips in unnoticed.
My Dr gave me a list of shampoos with few allergens, and Neutrogena T-Sal was on it, I don't know for sure if it contains cocamidopropyl betaine, but it seemed to be OK. I found it at Rite Aid.

I looked up the ingredients in T-Sal shampoo:
Active Ingredients: Salicylic Acid (3%)

Inactive Ingredients: Water, Cocamidopropyl Betaine, Sodium C14 16 Olefin Sulfonate, Linoleamidopropyl PG Dimonium Chloride Phosphate, Sodium Lauroyl Sarcosinate, Polyquaternium 22, Hexylene Glycol, Sodium Citrate

Not surprised to see cocamidopropyl betaine, it seems to be in almost everything!

[skygoddess]

Sazy,
I do not think so. But I remember reading that Tea Tree oil is becoming know as a allergen , more people are reporting reacting to it,
probably because it is getting more widespread use.

Yesterday I found a good website,
http://www.scheman.com/aboutus.asp
If you click on brochures, you get a comprehensive ( 47 page) product listing of allergens in common products.
There, I read about Magiick Botanicals conditioner, available from Whole Foods, so I ran out and bought some today.
Sure hope it is a keeper