Contact allergy to the 26 specific fragrance ingredients to be declared on cosmetic products in accordance with the EU cosmetics directive

Cinnamic acid promotes elongation of hair peg-like sprouting in hair follicle organoids via oxytocin receptor activation

Considerable global demand exists for the development of novel drugs for the treatment of alopecia. A recent report demonstrated that oxytocin promotes hair growth activity in human dermal papilla (DP) cells; however, its application in drugs or cosmetic products is challenging because rapid degradation and relatively large molecular weight prevent long-term topical administration on the scalp. Here, we examined cinnamic acid, a small molecule activator for oxytocin receptor (OXTR) expression. Treatment with cinnamic acid led to upregulation of OXTR and trichogenic gene expression in human DP cells. Furthermore, inhibition of OXTR with an antagonist, L-371,257, suppressed hair growth-related gene expression in DP cells. These findings suggest that cinnamic acid enhances the hair growth ability of DP cells via oxytocin signaling. Additionally, we tested the hair growth-promoting effects of cinnamic acid using hair follicle organoids in vitro and observed that cinnamic acid significantly promoted the growth of hair peg-like sprouting. These promising results may be useful for developing hair growth-promoting products targeting oxytocin.

Prioritization of chemicals in personal care products based on persistent, bioaccumulative and toxic (PBT) potential: An Indian perspective

Numerous organic ingredients present in Personal care products (PCPs) are being detected in sewage which has a high potential to impact the environment. These compounds are called as Emerging contaminants (ECs) or Contaminants of emerging concern. However, the information on the source and occurrence of ECs present in PCPs is very minimal. Specifically, information on the persistence (P), bioaccumulation (B) and toxicity (T) is very scarce. The determination of PBT properties is a complex task given the magnitude of chemicals, thus it is necessary to have a tool to quickly screen and prioritize the most important compounds. Estimation Program Interface (EPI) Suite™ is one such tool authorized by United States Environmental Protection Agency (US EPA) for screening purposes. In the present study, several organic compounds present in the PCPs viz. body lotion, sunscreens, moisturizers, hair dyes, and some hair care products were identified and their PBT property was estimated. The results from the study indicate that the order of increasing occurrence of PBT chemicals is sunscreens > moisturizers > body lotion > hair care products > hair dyes. The prioritized compounds were given rank 1 (maximum concern) to rank 4 (minimum concern). From the results, the compounds octocrylene in sunscreens and butylphenyl methylpropional in body lotions were prioritized as Rank 1.

Decoding Cosmetic Complexities: A Comprehensive Guide to Matrix Composition and Pretreatment Technology

Despite advancements in analytical technologies, the complex nature of cosmetic matrices, coupled with the presence of diverse and trace unauthorized additives, hinders the application of these technologies in cosmetics analysis. This not only impedes effective regulation of cosmetics but also leads to the continual infiltration of illegal products into the market, posing serious health risks to consumers. The establishment of cosmetic regulations is often based on extensive scientific experiments, resulting in a certain degree of latency. Therefore, timely advancement in laboratory research is crucial to ensure the timely update and adaptability of regulations. A comprehensive understanding of the composition of cosmetic matrices and their pretreatment technologies is vital for enhancing the efficiency and accuracy of cosmetic detection. Drawing upon the China National Medical Products Administration's 2021 Cosmetic Classification Rules and Classification Catalogue, we streamline the wide array of cosmetics into four principal categories based on the following compositions: emulsified, liquid, powdered, and wax-based cosmetics. In this review, the characteristics, compositional elements, and physicochemical properties inherent to each category, as well as an extensive overview of the evolution of pretreatment methods for different categories, will be explored. Our objective is to provide a clear and comprehensive guide, equipping researchers with profound insights into the core compositions and pretreatment methods of cosmetics, which will in turn advance cosmetic analysis and improve detection and regulatory approaches in the industry.

A Catastrophic Biodiversity Loss in the Environment Is Being Replicated on the Skin Microbiome: Is This a Major Contributor to the Chronic Disease Epidemic?

There has been a catastrophic loss of biodiversity in ecosystems across the world. A similar crisis has been observed in the human gut microbiome, which has been linked to "all human diseases affecting westernized countries". This is of great importance because chronic diseases are the leading cause of death worldwide and make up 90% of America's healthcare costs. Disease development is complex and multifactorial, but there is one part of the body's interlinked ecosystem that is often overlooked in discussions about whole-body health, and that is the skin microbiome. This is despite it being a crucial part of the immune, endocrine, and nervous systems and being continuously exposed to environmental stressors. Here we show that a parallel biodiversity loss of 30-84% has occurred on the skin of people in the developed world compared to our ancestors. Research has shown that dysbiosis of the skin microbiome has been linked to many common skin diseases and, more recently, that it could even play an active role in the development of a growing number of whole-body health problems, such as food allergies, asthma, cardiovascular diseases, and Parkinson's, traditionally thought unrelated to the skin. Damaged skin is now known to induce systemic inflammation, which is involved in many chronic diseases. We highlight that biodiversity loss is not only a common finding in dysbiotic ecosystems but also a type of dysbiosis. As a result, we make the case that biodiversity loss in the skin microbiome is a major contributor to the chronic disease epidemic. The link between biodiversity loss and dysbiosis forms the basis of this paper's focus on the subject. The key to understanding why biodiversity loss creates an unhealthy system could be highlighted by complex physics. We introduce entropy to help understand why biodiversity has been linked with ecosystem health and stability. Meanwhile, we also introduce ecosystems as being governed by "non-linear physics" principles-including chaos theory-which suggests that every individual part of any system is intrinsically linked and implies any disruption to a small part of the system (skin) could have a significant and unknown effect on overall system health (whole-body health). Recognizing the link between ecosystem health and human health allows us to understand how crucial it could be to maintain biodiversity across systems everywhere, from the macro-environment we inhabit right down to our body's microbiome. Further, in-depth research is needed so we can aid in the treatment of chronic diseases and potentially change how we think about our health. With millions of people currently suffering, research to help mitigate the crisis is of vital importance.

Toxicological investigation of lilial

Lilial (also called lysmeral) is a fragrance ingredient presented in many everyday cosmetics and household products. The concentrations of lilial in the final products is rather low. Its maximum concentration in cosmetics was limited and recently, its use in cosmetics products was prohibited in the EU due to the classification as reproductive toxicant. Additionally, according to the European Chemicals Agency, it was under assessment as one of the potential endocrine disruptors, i.e. a substance that may alter the function of the endocrine system and, as a result, cause health problems. Its ability to act as an androgen receptor agonist and the estrogenic and androgenic activity of its metabolites, to the best of our knowledge, have not yet been tested. The aim of this work was to determine the intestinal absorption, cytotoxicity, nephrotoxicity, mutagenicity, activation of cellular stress-related signal pathways and, most importantly, to test the ability to disrupt the endocrine system of lilial and its Phase I metabolites. This was tested using set of in vitro assays including resazurin assay, the CHO/HPRT mutation assay, γH2AX biomarker-based genotoxicity assay, qPCR and in vitro reporter assays based on luminescence of luciferase for estrogen, androgen, NF-κB and NRF2 signalling pathway. It was determined that neither lilial nor its metabolites have a negative effect on cell viability in the concentration range from 1 nM to 100 µM. Using human cell lines HeLa9903 and MDA-kb2, it was verified that this substance did not have agonistic activity towards estrogen or androgen receptor, respectively. Lilial metabolites, generated by incubation with the rat liver S9 fraction, did not show the ability to bind to estrogen or androgen receptors. Neither lilial nor its metabolites showed a nephrotoxic effect on human renal tubular cells (RPTEC/TERT1 line) and at the same time they were unable to activate the NF-κB and NRF2 signalling pathway at a concentration of 50 µM (HEK 293/pGL4.32 or pGL4.37). Neither lilial nor its metabolites showed mutagenic activity in the HPRT gene mutation test in CHO-K1 cells, nor were they able to cause double-strand breaks in DNA (γH2AX biomarker) in CHO-K1 and HeLa cells. In our study, no negative effects of lilial or its in vitro metabolites were observed up to 100 µM using different in vitro tests.

Artificial Intelligence That Predicts Sensitizing Potential of Cosmetic Ingredients with Accuracy Comparable to Animal and In Vitro Tests-How Does the Infotechnomics Compare to Other "Omics" in the Cosmetics Safety Assessment?

The aim of the current study was to develop an in silico model to predict the sensitizing potential of cosmetic ingredients based on their physicochemical characteristics and to compare the predictions with historical animal data and results from "omics"-based in vitro studies. An in silico model was developed with the use of WEKA machine learning software fed with physicochemical and structural descriptors of haptens and trained with data from published epidemiological studies compiled into estimated odds ratio (eOR) and estimated attributable risk (eAR) indices. The outcome classification was compared to the results of animal studies and in vitro tests. Of all the models tested, the best results were obtained for the Naive Bayes classifier trained with 24 physicochemical descriptors and eAR, which yielded an accuracy of 86%, sensitivity of 80%, and specificity of 90%. This model was subsequently used to predict the sensitizing potential of 15 emerging and less-studied haptens, of which 7 were classified as sensitizers: cyclamen aldehyde, N,N-dimethylacrylamide, dimethylthiocarbamyl benzothiazole sulphide, geraniol hydroperoxide, isobornyl acrylate, neral, and prenyl caffeate. The best-performing model (NaiveBayes eAR, 24 parameters), along with an alternative model based on eOR (Random Comittee eOR, 17 parameters), are available for further tests by interested readers. In conclusion, the proposed infotechnomics approach allows for a prediction of the sensitizing potential of cosmetic ingredients (and possibly also other haptens) with accuracy comparable to historical animal tests and in vitro tests used nowadays. In silico models consume little resources, are free of ethical concerns, and can provide results for multiple chemicals almost instantly; therefore, the proposed approach seems useful in the safety assessment of cosmetics.

Influence of vegetation on the composition of essential oil from (Melissa officinalis L.)

Lemon balm (Melissa officinalis L.) is a perennial plant of the family Lamiaceae, which is used in folk medicine and the food industry, as well as being processed to obtain essential oil. The aim of the special work is to monitor the influence of vegetation on the composition of the essential oil. The chemical composition of essential oils, obtained by steam distillation from lemon balm cultivated in North-eastern Bulgaria, has been determined. The plants were harvested in two periods of vegetation - the first at the end of June and second - at the end of August 2020. The main components in the oil from the first cut are geranial (26.41%), neral (19.55%), (E)-β-caryophyllene (17.46%), germacrene D (7.86%) and β-citronellal (3.24%). In the oil from the second cut, the main components are geranial (37.26%), neral (28.46%), (E)-β- caryophyllene (6.65%), geraniol (4.72%), and β-citronellal (3.04%). The oil from the second harvest has a high content of the main components of geranial, neral and geraniol and a lower content of (E)-β- caryophyllene and germacrene D. Variations in the amounts are also present in other compounds.

The immediate patch test reaction to fragrance in patients with allergic contact dermatitis to fragrance: A prospective study

BACKGROUND

Fragrance is one of the common causes of immediate contact reaction. Knowing the prevalence of a reaction in a given population enables prioritization of allergy screening.

OBJECTIVE

The purpose of this study was to determine the prevalence of an immediate patch test reaction to fragrance in patients with fragrance allergic contact dermatitis.

METHODS

This prospective study enrolled 291 patients who were given standard patch tests for allergic contact dermatitis. Those with positive reactions were then asked to undergo additional patch tests to assess both immediate and delayed reactions to 28 different fragrance substances.

RESULTS

Cinnamic aldehyde and cinnamic alcohol were the most frequently encountered substances in positive immediate reactions and standard (delayed) patch test reactions. Immediate patch reactions to benzyl alcohol, sorbic acid, and coumarin were more frequently observed than standard patch test reactions.

LIMITATIONS

Because of the small sample size of patients who agreed to continue further patch testing evaluation, a statistical association between patient characteristics and fragrance-positive patch test reactions was difficult to establish.

CONCLUSIONS

In this population, cinnamic aldehyde and cinnamic alcohol were the most common fragrance allergens causing both immediate and delayed reactions, whereas reactions to benzyl alcohol, sorbic acid, and coumarin were frequently observed in immediate patch tests.

What is the added value of patch testing with 30 fragrance allergens in addition to the European baseline series?

Background

Patch testing with the fragrance allergy markers in the European baseline series (EBS) does not identify all patients with fragrance allergy. Hydroperoxides of linalool and limonene have been shown to be useful allergens in detecting fragrance sensitization.

Objectives

To evaluate the added value of testing with 30 fragrance allergens in addition to the EBS.

Methods

All patients with suspected fragrance allergy who underwent patch testing at the Amsterdam University Medical Centers between November 2019 and January 2021 to the EBS and fragrance series were included.

Results

Of 323 patients tested, 162 (50.2%) were found to be fragrance sensitized. The most sensitizing single allergens were the hydroperoxides of linalool (1.0 and 0.5% pet.) and limonene (0.3 and 0.2% pet.). Testing with the hydroperoxides of linalool and limonene identified 62 fragrance‐sensitized patients (38.3%) who could not be detected by the common fragrance markers. Of all fragrance‐sensitized patients, 21 (13.0%) would have been missed when not testing with the fragrance series.

Conclusions

Patch testing with the fragrance series in addition to the EBS is valuable. To reduce the risk of false‐negative reactions, it is advisable to test the hydroperoxides of linalool and limonene.

Highlights

Of the 323 patients with suspected fragrance allergy, 162 (50.2%) were found to be fragrance sensitized.

Testing with the hydroperoxides of linalool and limonene identified 62 fragrance‐sensitized patients (38.3%) who could not be detected by the European baseline series (EBS) fragrance markers. When not tested with the fragrance series, 21 (13.0%) of the sensitized patients would have been missed.

Routinely performing patch testing with the fragrance series in addition to linalool and limonene hydroperoxide as part of the EBS is recommended.

Epicutaneous Patch Testing in Type IV Allergy Diagnostics: State of the Art and Best Practice Recommendations

This chapter summarises all relevant aspects of patch testing, closely following recommendations outlined in a recent European, and a German S3 guideline on diagnostic patch testing with contact allergens and medicinal products (drugs). Patch testing is indicated in patients suspected of suffering, or having been suffering, from delayed-type hypersensitivity leading to allergic contact dermatitis or other skin and mucosal diseases. Sections of this chapter include detailed indications, reasons for possibly postponing the test, considerations on choosing haptens (contact allergens) to test, various aspects of the application of patch test allergen preparations (storage, dosing) and of testing with individual materials provided by the patients. Special aspects of patch testing in cutaneous adverse drug reactions, children, or occupational contact dermatitis are outlined. Supplemental test methods, notably the repeated open application test, are briefly described. Finally, the final evaluation in terms of assessment of clinical relevance of reactions and patient counselling are outlined.

Could Modifying the Skin Microbiome, Diet, and Lifestyle Help with the Adverse Skin Effects after Stopping Long-Term Topical Steroid Use?

We set up this preliminary study to begin to evaluate one main question: could strengthening the microbiome have potential benefits for the skin condition of patients suffering with adverse effects after stopping long-term topical steroid use? We aim to turn it into a much larger study if the results show the interventions might help. After commonly being prescribed for eczema, cessation of topical steroid use, especially after long periods of inappropriate use, can leave lasting adverse effects on the body and skin, known by some as topical steroid withdrawal (TSW). This preliminary study involved seven human participants suffering with skin problems associated with TSW who approached Dr. Anja Gijsberts-Veens of their own volition because they were interested in more natural recovery methods. Five completed the study in full. Progress in skin condition was tracked by self-assessed symptom severity questionnaires filled out at the beginning and end of the five-month study. The skin microbiome was addressed by using a 100% natural product shown in previous work to significantly increase skin microbiome biodiversity. Three participants implemented dietary changes and supplementation in response to guidance after fecal sample analysis, with the aim of improving gut microbiome health. The average improvement in skin symptoms for all participants was 40%, and average symptom improvement ranged from 14% for Patient 5 to 92% for Patient 1. On average, the participants saw an improvement in 85% of their symptoms and stagnation or regression in 11% and 4%, respectively. Our results suggest that the interventions used might improve the skin condition of TSW patients, but the small sample size and the lack of a control group mean that more definitive conclusions should be reserved for our follow-up work, which addresses these issues. We also aim to swab the skin of participants to assess the effect on the skin microbiome from skin and gut treatments, as well as including a more in-depth analysis of skin and gut microbiomes.

Contact allergy to fragrance mix I and its components in individuals with photocontact allergy to ketoprofen

BACKGROUND

Contact allergy to fragrance mix I (FM I) is over-represented in patients photoallergic to ketoprofen. The prevalence of contact allergy to two components of FM I, cinnamal and cinnamyl alcohol, in ketoprofen-photoallergic patients is higher than in dermatitis patients.

OBJECTIVE

To explore the prevalence of contact allergy to FM I and its individual components in patients with photocontact allergy to ketoprofen, and to compare with a dermatitis and the general population.

METHODS

Data on patch and photopatch tests performed between 2009-2018 were collected. Ketoprofen-photoallergic patients were compared with dermatitis patients and published data on the general population regarding the prevalence and the distribution of contact allergy to FM I and its components.

RESULTS

A higher prevalence of contact allergy to cinnamyl alcohol compared with cinnamal (23.3% vs 10.0%), and eugenol compared with isoeugenol (23.3% vs 6.7%), was observed in ketoprofen-photoallergic patients, while the relationship was the opposite in the dermatitis group (0.7% vs 1.05%; 0.4% vs 0.9%). The overall prevalence of contact allergy to several components of FM I was significantly higher in ketoprofen-photoallergic patients.

CONCLUSIONS

Contact allergy to FM I and many of its components is over-represented in patients photoallergic to ketoprofen compared with dermatitis patients and the general population.

Patch Test Clinic Start-up: From Basics to Pearls

Allergic contact dermatitis is a prevalent burdensome condition affecting millions of Americans. Patch testing, the criterion-standard allergic contact dermatitis diagnostic tool, is underused by US dermatologists. Incorporating patch testing into modern dermatology practices is achievable with utilization of accurate resources and sustainable support. This review focuses on the basics of patch testing and provides practical pearls to assist novice providers in establishing a contact dermatitis specialty practice.

Myroxylon pereirae (balsam of Peru): Still worth testing?

Background

Because Myroxylon pereirae (MP), or balsam of Peru, is nowadays almost not used “as such,” and fragrance mix 1 (FM1) apparently is more sensitive in detecting fragrance allergy, the usefulness of testing MP in baseline series was recently questioned.

Objectives

Identification of the number of clinically relevant patch test reactions to MP not detected by FM1.

Methods

Retrospective analysis of 12 030 patients patch tested with MP and FM1 for contact dermatitis between January 2018 and December 2019 in 13 Italian dermatology clinics.

Results

Four hundred thirty‐nine patients (3.6%) had a positive patch test reaction to MP; 437 (3.6%) had a positive patch test reaction to FM1. Positive reactions to both MP and FM1 were observed in 119 subjects (1.0%), 310 (2.6%) reacted to MP only, 304 (2.5%) to FM1 only, 5 to MP and sorbitan sesquioleate (SSO), 9 to FM1 and SSO, and 5 to MP, FM1, and SSO. Single sensitizations were clinically relevant in 75.2% of cases for MP (62.9% current, 12.3% past) and 76.3% for FM1 (70.1% current, 6.2% past).

Conclusions

Based on our results, MP appears to be still worth testing along with FM1 in baseline series, because it allows detection of a remarkable number of fragrance allergies, often relevant, which would be otherwise missed.

Allergic contact dermatitis: a significant environmental and occupational skin disease

This review article seeks to provide an overview of allergic contact dermatitis (ACD) as a significant environmental and occupational skin disease, the phases of ACD, its causes from the occupational and environmental perspectives, its detection, the effects of ACD with respect to the social, psychological, occupational, and financial perspectives, and its cure and/or prevention. Human skin is very sensitive and as the largest organ in the body, it is highly prone to direct and indirect contact with the substances from its environment. The skin reacts to these substances (xenobiotics) differently depending on the individual's tolerance level or threshold. Allergic contact dermatitis is a significant environmental and occupational skin disease that should not be ignored in our society because it can affect the quality of life of an affected individual. There are multiple causes of ACD, and these causes of ACD have been discussed from two perspectives: environmental and occupational. The effects of ACD can be psychological, social, financial, and occupational. There is need for more public enlightenment on the effects of ACD as well as a precise understanding that it is not a contagious disease so as to significantly reduce the psychological and social effects of ACD on these patients.

A negative breakdown test in a fragrance mix I-positive patient does not rule out contact allergy to its fragrance constituents

BACKGROUND

In about half of the patients reacting positive to fragrance mix I (FM I), breakdown testing remains negative. This raises the question of whether the reaction to FM I is false-positive, or the breakdown test is false-negative.

OBJECTIVES

To identify characteristics and sensitization patterns of patients positive to FM I, but not to its fragrance constituents.

PATIENTS AND METHODS

Retrospective analysis of data from the Information Network of Departments of Dermatology (IVDK) between 2005 and 2019. Three patient groups were defined according to their reaction pattern: Group I, FM I positive and ≥1 single fragrance positive in the breakdown test (n = 1912); Group II, FM I positive and breakdown test negative (n = 1318); Group III, FM I negative (n = 19 790).

RESULTS

Regarding the pattern of concomitant reactions to other fragrances, Group II had an intermediate position between Group I and Group III. In other respects (age and sex distribution, frequency of sensitization to non-fragrance baseline series allergens), Group II rather resembled Group I.

CONCLUSIONS

Not every positive reaction to FM I in patients with negative breakdown tests is false-positive. There may be false-negative reactions to the single fragrance components when patch tested at 1% pet. Raising patch concentrations of some single fragrances is recommended.

Frequency of sensitization to the individual fragrances of fragrance mix I and II according to the factors included in the MOAHLFA index

BACKGROUND

Fragrances constitute the second most frequent cause of allergic contact dermatitis in Spain.

OBJECTIVES

To determine the rate of sensitization to the individual fragrances of fragrance mix (FM) I and FM II for each of the demographic and clinical factors included in the MOAHLFA (male, occupational dermatitis, atopic dermatitis, hand dermatitis, leg dermatitis, facial dermatitis, age) index.

METHODS

We conducted a 5-year retrospective study in 23 Spanish centres. We identified the patients who had undergone patch testing with a specific fragrance series after reacting positively to fragrance markers in a baseline series. We obtained the MOAHLFA index items in this population, then calculated for each demographic and clinical factor the frequencies of sensitization to the individual fragrances of FM I and FM II.

RESULTS

A specific fragrance series was patch tested in 1013 patients. The most frequent allergens in men, women, children, and retired people were Evernia prunastri (16%), geraniol (16.6%), isoeugenol (17.9%), and geraniol (22.4%), respectively. Citral (20.5%) and hydroxyisohexyl 3-cyclohexene carboxaldehyde (HICC) (14.5%) were the most common allergens in occupational eczemas and were also associated with a large proportion of hand and facial dermatitis.

CONCLUSIONS

Frequency of sensitization to the individual fragrances of FM I and FM II varies with age, sex, affected body region, and history of occupational or atopic dermatitis.

Validation of Qualitative Broth Volatilization Checkerboard Method for Testing of Essential Oils: Dual-Column GC–FID/MS Analysis and In Vitro Combinatory Antimicrobial Effect of Origanum vulgare and Thymus vulgaris against Staphylococcus aureus in Liquid and Vapor Phases

Combinatory action of antimicrobial agents such as essential oils (EOs) show to be an effective strategy to overcome the problem with increasing antibiotic resistance of microorganisms, including Staphylococcus aureus. The objective of this study was to evaluate in vitro antimicrobial interactions between Origanum vulgare and Thymus vulgaris EOs against various S.aureus strains in both liquid and vapor phases using the broth volatilization checkerboard method. Fractional inhibitory concentrations (FICs) were determined for both liquid and vapor phases, and the composition of EOs was analyzed by gas chromatography-mass spectrometry using dual-column/dual-detector gas chromatograph. Results of oregano and thyme EOs combination showed additive effects against all S. aureus strains in both phases. In several cases, sums of FICs were lower than 0.6, which can be considered a strong additive interaction. The lowest FICs obtained were 0.53 in the liquid phase and 0.59 in the gaseous phase. Chemical analysis showed that both EOs were composed of many compounds, including carvacrol, thymol, γ-terpinene, and p-cymene. This is the first report on oregano and thyme EOs interactions against S. aureus in the vapor phase. It also confirms the accuracy of the broth volatilization checkerboard method for the evaluation of combinatory antimicrobial effects of EOs in the vapor phase.

Ubiquity, Hazardous Effects, and Risk Assessment of Fragrances in Consumer Products

Purpose of review

The main aims of fragrances are to create pleasing scents or to mask unpleasant odors. We hereby review their main exposure sources, presumed benefits, and unwanted effects, with special attention to allergic contact dermatitis (prevalence, regulatory environment, risk assessment methodology, and preventive measures).

Recent findings

Fragrances elicit positive emotions and presumably have therapeutic benefits related to stress reduction and memory enhancement. However, they also cause detrimental health or environmental effects including contact dermatitis (irritant and/or allergic), non-eczematous contact reactions, photosensitivity, photo-allergy, and immediate contact reactions, which can negatively impact the quality of life. Fragrances are the most frequent chemicals causing contact dermatitis. Their main sources are cosmetics, household products, industrial substances, food flavorings, oral hygiene products, and topical medications. It is difficult for sensitized patients to avoid contact with fragrances, due to their ubiquity and because manufacturers are not willing to volunteer information regarding fragrance ingredients.

Summary

The treatment of contact dermatitis relies on allergens avoidance which does not “cure” the disease (sensitization persists for life) but prevents disabling illness. The patient should understand that avoiding perfume means to avoid all scented goods and not just perfumes.

Labeling fragrances is key in primary prevention (by giving the healthy individual the chance to make an informed choice to avoid risky substances), diagnosis (by helping the practitioner to plan and interpret patch tests), secondary prevention, and prognosis (by allowing the sensitized patient to follow the avoidance instructions). However, only 26 fragrances are mandatory to be declared in cosmetics. The vague labeling of other fragrance ingredients as “perfume” or “fragrance” hampers the diagnostic and preventive approaches. Therefore, in our opinion, declaration should be mandatory for all fragrance ingredients as well as straightforward so most consumers can understand it. Moreover, legislation should be improved to prevent inappropriately high exposures by forbidding stronger allergens, restricting maximum concentrations in the finished product or fields of application, delivering information regarding the risks to the general public, and controlling the compliance of manufacturers with the regulations. Besides, manufacturers should share information regarding the composition in the final products and provide physicians with samples of all fragrance chemicals whenever needed for patch test investigations.

Prevalence, concomitant reactions, and factors associated with fragrance allergy in Thailand

BACKGROUND

Fragrances are the most common cause of cosmetic contact allergy. Up-to-date information on contact allergy frequencies and relevance aids primary and secondary preventive measures.

OBJECTIVES

To determine the prevalence, associated factors, and concomitant reactions in fragrance allergy among Thais.

METHODS

This retrospective study collected data from 2012 to 2019. The patient characteristics of fragrance and nonfragrance allergy groups were compared. Concurrent positive reactions to fragrance allergens (fragrance mix [FM] I, FM II, Myroxylon pereirae resin and hydroxyisohexyl 3-cyclohexene carboxaldehyde) and other baseline-series allergens were analysed.

RESULTS

Of 1032 patients, 175 (17.0%) had fragrance allergy, with 57.7% of clinical relevance. FM I showed the highest prevalence (9.4%). The associated factors were being elderly, lesions on the extremities, metal allergy history, and long dermatitis duration. Contact allergies to epoxy resin and Compositae plants were significantly associated with fragrance allergy with an odds ratio of 5.95 (95% confidence interval [CI]: 5.21-6.80) and an odds ratio of 4.42 (95% CI: 1.58-12.36), respectively. No significant associations between colophonium (previously proposed as a fragrance marker) and fragrance allergens were found.

CONCLUSIONS

The prevalence of fragrance contact allergy remains high and should be considered in old patients presenting with long-standing eczema on the extremities. Unlike reports from other countries, varied, significant, concomitant reactions were observed.

Patch testing with purified and oxidized citronellol

BACKGROUND

Citronellol is a commonly used fragrance terpene included in fragrance mix II. As with many other fragrance terpenes, citronellol is susceptible to autoxidation. Citronellol hydroperoxides are formed in large amounts and are the only oxidation products identified as sensitizers in oxidized citronellol.

AIM

To compare frequencies of contact allergy to purified and oxidized citronellol and to investigate the pattern of concomitant reactions to fragrance markers of the baseline series, oxidized linalool, and oxidized limonene.

METHODS

A total of 658 dermatitis patients were patch tested with purified and oxidized citronellol at 2.0%, 4.0%, 6.0%, and 1.0%, 2.0%, 4.0%, 6.0% petrolatum, respectively. The irritant properties of purified and oxidized citronellol were studied before patch testing.

RESULTS

Few irritant reactions were observed in the pretest. Purified citronellol detected positive reactions in 0.15%-0.31% of patients, while oxidized citronellol detected positive reactions in 0.61%-4.5%. Among patients reacting to oxidized citronellol, 34%-50% showed concomitant reactions to fragrance markers of the baseline series and 75%-91% to oxidized linalool or oxidized limonene.

CONCLUSION

Oxidized citronellol detects more cases of contact allergy than purified citronellol, and these cases are not all detected using fragrance mix II. Patch testing with oxidized citronellol will add to the tools in the diagnosis of fragrance allergy.

Effects of Fermented Oils on Alpha-Biodiversity and Relative Abundance of Cheek Resident Skin Microbiota

The skin microbiome is in a very close mutualistic relationship with skin cells, influencing their physiology and immunology and participating in many dermatological conditions. Today, there is much interest in cosmetic ingredients that may promote a healthy microbiome, especially postbiotics, mainly derived from fermented products. In the present work, we studied the effects on skin microbiota of new patented natural oils obtained by unique fermentation technology in vivo. Three fermented oils were evaluated: F-Shiunko (FS), F-Artemisia® (FA) and F-Glycyrrhiza® (FG). The active components were included as single active component or in combination (FSAG) in an emulsion system. A total of 20 healthy women were recruited, and skin microbiota from cheek were analyzed by mean of swab sampling at T0 and T1 (after 4 weeks of a one-day treatment). 16S sequencing revealed that the treatment with fermented oils improved microbiome composition and alpha-diversity. It was shown that higher biodiversity reflects in a healthier microbial ecosystem since microbial diversity decreases in the presence of a disease or due to aging. The treatment also resulted in a more “beneficial” and “younger” microbial community since a significant decrease in Proteobacteria and the increase in Staphylococcus were reported after the treatment with fermented oils.

Fragrant and sticky allergens from the pinewood: Cohabiting and coreacting

BACKGROUND

Tree moss (Pseudevernia furfuracea [L.] Zopf.), a lichen growing on conifers, is a frequent fragrance sensitizer. Previous studies have shown two subgroups of tree moss-allergic patients: a group sensitized to common allergens of tree and oak moss (Evernia prunastri), and another group sensitized to colophonium-derived allergens, which may contaminate tree moss extract.

OBJECTIVES

To report the results of including tree moss extract in the baseline series and discuss the clinical implications.

METHODS

Tree moss extract was included in the baseline series and sensitized patients were assessed for concomitant allergy to colophonium and oak moss, and the relevance of these reactions was analyzed.

RESULTS

Altogether, 22 of 632 patients (3.5%) had positive reactions to tree moss. Eight patients were sensitized to tree moss only (among fragrance allergens) and 75% had relevant reactions to colophonium. Fourteen patients were sensitized to other fragrance allergens as well and 28.5% had relevant colophonium reactions.

CONCLUSIONS

The prevalence of positive tree moss reactions is high enough to justify its inclusion in the baseline series. If tree moss is not included, patients with positive colophonium reactions should be informed of possible (false) cross-reactivity to tree moss to avoid this labeled fragrance allergen.

Sensitization to Fragrance mix-1 in Patients with Contact Dermatitis in Nord-East of Italy: 1996–2016 Time Trend and Gender Effect

(1) Background: Fragrance sensitization is common in Italy and their constituents are used in many cosmetics and detergents. The objective of the study was to analyze the temporal trend of sensitivity to fragrance mix-1 in northeastern Italy and to evaluate gender differences; (2) Methods: From 1996 to 2016, 27,381 consecutive patients with suspected allergic contact dermatitis were patch tested. Individual characteristics were collected through a standardized questionnaire in six departments of dermatology or occupational medicine; (3) Results: The overall prevalence of sensitization to fragrance mix-1 was 7.3%; the prevalence was significantly higher in women (7.7%) than in men (6.3%). From 1996 to 2016, we observed an increase of this sensitization, ranging from 6.2% to 7.7% in males and from 7.2% to 9.1% in females; (4) Conclusions: Our study showed that contact allergy to fragrance mix-1 is important in both sexes and prevalence is increasing over time, despite the introduction of new fragrances with lower sensitization potential. There is the need to reduce the use of fragrances mix-1 to stop the increase of sensitization in exposed subjects.

Potential Health Risks of Chemicals in Car Colorant Products

Public concern regarding the use of products with chemicals has increased in Korea, following reports indicating that hazardous chemicals in products, such as disinfectants, can cause fatal lung disease. Despite the widespread use of car colorant products, little is known regarding their potential health risks. The purpose of this study was to determine the potential health risks of substances that exist in car colorant products. Thirteen car colorant products were purchased from the Korean market and 15 commonly used chemicals were analyzed. Exposure and risk assessments were conducted in two assessment stages (screening and refined). The analysis showed that all of the examined products contained toluene, ethylbenzene, and xylene. The maximum concentration of toluene was 52.5%, with a median concentration of 10.8%. Tier 1 (screening) assessment showed that four chemicals (toluene, ethylbenzene, xylene, and 2-butoxyethanol) may pose health risks, but tier 2 (refined) assessment showed that these chemicals do not pose any risk. However, these chemicals were present in all of the examined products, and government regulations did not control their concentrations in these products. Therefore, we suggest that levels of toluene, ethylbenzene, and xylene in car colorant products should be regulated to protect public health.

The Role of Every-Day Cosmetics in Altering the Skin Microbiome: A Study Using Biodiversity

As described in previous work, the use of synthetic chemical ingredients in modern cosmetics is postulated to be a cause of damage to the skin microbiome. The discovery that biodiversity on the human skin is currently the only reliable indicator of skin health, meant that for the first time, a mechanism to test for healthy skin was possible. Using this mechanism and in collaboration with The Medical University of Graz, who carried out the independent study, this work aimed to help answer whether modern day synthetic cosmetics are a main cause of long-term damage to the skin microbiome. Thirty-two human participants tested three different face washes for their effect on the skin’s microbial diversity, along with skin pH, moisture and TEWL (trans-epidermal water loss), washing twice-a-day for four weeks. The upper volar forearm of the volunteers was swabbed at the beginning, two weeks in and at the end of the four weeks. 16S rRNA sequencing was used. One leading ‘natural’ brand full of synthetic ingredients, a leading synthetic brand and a 100% natural face wash were used. Results give the first indications of a link between synthetic ingredients in a cosmetics product and its effect on skin microbiome biodiversity. It paves the way for future studies on the topic with a larger sample group, longer test period and standardised methodology to create a universal standard for testing the health of skin using benchmark diversity values. This can be used in the future to test the effectiveness of cosmetics or ingredients on skin health, leading to the restriction in cosmetics of products proven to harm the skin’s natural environment.

Fragrances and PAHs in snow and seawater of Ny-Ålesund (Svalbard): Local and long-range contamination

Polar regions are fragile ecosystems threatened by both long-range pollution and local human contamination. In this context, the environmental distribution of the Personal Care Products (PCPs) represent a major knowledge gap. Following preliminary Antarctic studies, Fragrance Materials (FMs) were analyzed in the seawater and snow collected in the area of Ny-Ålesund, Svalbard, to investigate local and long-range contamination. Polycyclic Aromatic Hydrocarbons (PAHs), including Retene, were determined in parallel to help the identification of the governing processes. Concentrations of FMs up to 72 ng L^-1 were detected in the surface snow near the settlement and at increasing distances, in relation to the prevailing winds. PAHs follow a similar scheme, with levels of Retene up to 1.8 μg L^-1, likely deriving from the occurrence of this compound in the coal dust due to the previous mining activities in the area. The snow seasonal deposition of FMs and PAHs was estimated in a snowpit dug at the top of the Austre Brøggerbreen glacier, indicating the long-range atmospheric transport (LRAT) of these compounds.

Contact sensitization to hydroperoxides of limonene and linalool: Results of consecutive patch testing and clinical relevance

Background

Hydroperoxides of limonene and linalool are potent sensitizers.

Objectives

To investigate the prevalence of contact allergy to both hydroperoxides of limonene and hydroperoxides of linalool, to report clinical relevance, and to investigate patient demographics.

Methods

A total of 821 patients (35.6% male, mean age 42.4 years ± 17.8 years) were consecutively patch tested with our departmental baseline series and our fragrance series, including hydroperoxides of limonene 0.3% pet. and hydroperoxides of linalool 1.0% pet. The clinical relevance was assessed for all positive reactions.

Results

Positive patch test reactions to hydroperoxides of limonene and to hydroperoxides of linalool were observed in 77 patients (9.4%, 95% confidence interval [CI]: 7.4%‐11.4%) and in 96 patients (11.7%, 95%CI: 9.5%‐13.9%), respectively; 38 of these patients (4.6%, 95%CI: 3.2%‐6.0%) reacted to both. Most reactions were considered to be possibly or probably clinically relevant (66.3% and 68.8%, respectively), and a small proportion were deemed to be of certain clinical relevance (18.2% and 19.8%, respectively).

Conclusion

As compared with previous studies, high numbers of positive reactions to both hydroperoxides of limonene and hydroperoxides of linalool were observed, the majority of which were clinically relevant, supporting their inclusion in the European baseline series.

Distribution of fragrances and PAHs in the surface seawater of the Sicily Channel, Central Mediterranean

The Mediterranean Sea is highly influenced by several anthropic pressures, including different kinds of organic pollutants. Fragrance Materials (FMs) and Polycyclic Aromatic Hydrocarbons (PAHs) were investigated in the surface seawater of the Sicily Channel in offshore and coastal areas. Total concentrations of FMs and PAHs resulted respectively up to 112ngL^-1 and 43ngL^-1, with similar distributions of both classes of analytes. Low values were detected in some coastal samples, due to the upwelling of deep and unpolluted waters, while the presence of gyres probably accumulates contaminants in offshore areas. Confirming previous works, the allergenic and oestrogenic Salicylates generally resulted the most abundant FMs and diagnostic ratios indicated combustion processes as the sources of PAHs. The coupling of the well-known PAHs with a new class of Personal Care Products (PCPs) helped the identification of the major environmental drivers: the results highlighted the role of mesoscale hydrodynamics and suggested long-range atmospheric transport as key factors. The first detection of the selected FMs in open sea areas supports the hypothesis of their environmental persistence.

Cinnamic acid derivatives in cosmetics: current use and future prospects

Cinnamic acid derivatives are widely used in cosmetics and possess various functions. This group of compounds includes both naturally occurring and synthetic substances. On the basis of the Cosmetic Ingredient Database (CosIng) and available literature, this review summarizes their functions in cosmetics, including their physicochemical and biological properties as well as reported adverse effects. A perfuming function is typical of many derivatives of cinnamaldehyde, cinnamyl alcohol, dihydrocinnamyl alcohol and cinnamic acid itself; these substances are commonly used in cosmetics all over the world. Some of them show allergic and photoallergic potential, resulting in restrictions in maximum concentrations and/or a requirement to indicate the presence of some substances in the list of ingredients when their concentrations exceed certain fixed values in a cosmetic product. Another important function of cinnamic acid derivatives in cosmetics is UV protection. Ester derivatives such as ethylhexyl methoxycinnamate (octinoxate), isoamyl p-methoxycinnamte (amiloxiate), octocrylene and cinoxate are used in cosmetics all over the world as UV filters. However, their maximum concentrations in cosmetic products are restricted due to their adverse effects, which include contact and a photocontact allergies, phototoxic contact dermatitis, contact dermatitis, estrogenic modulation and generation of reactive oxygen species. Other rarely utilized functions of cinnamic acid derivatives are as an antioxidant, in skin conditioning, hair conditioning, as a tonic and in antimicrobial activities. Moreover, some currently investigated natural and synthetic derivatives of cinnamic acid have shown skin lightening and anti-ageing properties. Some of them may become new cosmetic ingredients in the future. In particular, 4-hydroxycinnamic acid, which is currently indexed as a skin-conditioning cosmetics ingredient, has been widely tested in vitro and in vivo as a new drug candidate for the treatment of hyperpigmentation.

Can the epoxides of cinnamyl alcohol and cinnamal show new cases of contact allergy?

BACKGROUND

Cinnamyl alcohol is considered to be a prohapten and prehapten with cinnamal as the main metabolite. However, many individuals who are allergic to cinnamyl alcohol do not react to cinnamal. Sensitizing epoxides of cinnamyl alcohol and cinnamal have been identified as metabolites and autoxidation products of cinnamyl alcohol.

OBJECTIVE

To investigate the clinical relevance of contact allergy to epoxycinnamyl alcohol and epoxycinnamal.

METHODS

Irritative effects of the epoxides were investigated in 12 dermatitis patients. Epoxycinnamyl alcohol and epoxycinnamal were patch tested in 393 and 390 consecutive patients, respectively. In parallel, cinnamyl alcohol and cinnamal were patch tested in 607 and 616 patients, respectively.

RESULTS

Both epoxides were irritants, but no more positive reactions were detected than when testing was performed with cinnamyl alcohol and cinnamal. Late allergic reactions to epoxycinnamyl alcohol were observed. In general, patients with late reactions showed doubtful or positive reactions to cinnamal and fragrance mix I at regular patch testing.

CONCLUSION

The investigated epoxides are not important haptens in contact allergy to cinnamon fragrance. The high frequency of fragrance allergy among patients included in the irritancy study showed the difficulty of suspecting fragrance allergy on the basis of history; patch testing broadly with fragrance compounds is therefore important.

A validated UPLC-MS/MS method for biomonitoring the exposure to the fragrance 7-hydroxycitronellal

7-Hydroxycitronellal is a synthetic fragrance (CAS No. 107-75-5) which is used commonly in cosmetics, washing- and cleaning agents and as flavoring in foods. Due to its broad application in various fields, 7-hydroxycitronellal was selected for the development of a biomonitoring method for the quantitative exposure assessment within the frame of the cooperation project of the German Federal Ministry for the Environment, Nature Conservation, Building and Nuclear Safety (BMUB) and the German Chemical Industry Association (VCI). For this purpose, an ultra performance liquid chromatography combined with tandem mass spectrometry (UPLC-MS/MS) based method was developed for the determination of potential biomarkers of 7-hydroxycitronellal (7-HC) in human urine samples. 7-Hydroxycitronellylic acid (7-HCA) turned out to be the quantitatively most important metabolite of 7-HC in human urine, occurring in 1000 times higher amounts than 7-hydroxycitronellol (7-HCO) or other potential metabolites. Therefore, an analytical method for 7-HCA was developed using stable isotope-labeled 7-HCA as internal standard (IS). The method includes a cleavage step of possible metabolite conjugates with an enzyme mix of ß-glucuronidase and arylsulfatase. Subsequent sample cleanup was performed by liquid-liquid extraction (LLE) with dichloromethane. The method was calibrated by calculating the linear regression between the analyte/IS ratio and the nominal 7-HCA concentrations in water. The method was validated according to approved standard guidelines and proved to be robust, reliable and sensitive for the human biomonitoring of 7-HC. The method was applied to urine samples of 40 adult volunteers from the general population. 7-HCA was quantifiable in urine of all subjects. Thus the developed method proved to be suitable for assessing the background exposure to 7-HC in the general population.

Non-mix fragrances are top sensitizers in consecutive dermatitis patients - a cross-sectional study of the 26 EU-labelled fragrance allergens

BACKGROUND

For cosmetics, it is mandatory to label 26 fragrance substances, including all constituents of fragrance mix I (FM I) and fragrance mix II (FM II). Earlier reports have not included oxidized R-limonene [hydroperoxides of R-limonene (Lim-OOH)] and oxidized linalool [hydroperoxides of linalool (Lin-OOH)], and breakdown testing of FM I and FM II has mainly been performed in selected, mix-positive patients.

OBJECTIVES

To report the prevalence of sensitization to the 26 fragrances, and to assess concomitant reactivity to FM I and/or FM II.

METHODS

A cross-sectional study on consecutive dermatitis patients patch tested with the 26 fragrances and the European baseline series from 2010 to 2015 at a single university clinic was performed.

RESULTS

Of 6004 patients, 940 (15.7%, 95%CI: 14.7-16.6%) were fragrance-sensitized. Regarding the single fragrances, most patients were sensitized to Lin-OOH (3.9%), Evernia furfuracea (3.0%), Lim-OOH (2.5%), and hydroxyisohexyl 3-cyclohexene carboxaldehyde (2.1%). Significantly fewer patients were 'FM I-positive and constituent-positive' than 'FM II-positive and constituent-positive' (32.7% versus 57.0%, p < 0.0001). Additionally, significantly more patients were 'FM II-negative but constituent-positive' than 'FM I-negative but constituent-positive' (12.4% versus 3.2%, p = 0.0008).

CONCLUSIONS

Non-mix fragrances are the most important single fragrance allergens among consecutive patients. The test concentration of the single FM I constituents should be increased when possible.

Fragrance contact allergens in 5588 cosmetic products identified through a novel smartphone application

BACKGROUND

More than 25% of the adult European population suffers from contact allergy, with fragrance substances recognized as one of the main causes. Since 2005, 26 fragrance contact allergens have been mandatory to label in cosmetic products within the EU if present at 10 ppm or above in leave-on and 100 ppm or above in wash-off cosmetics.

OBJECTIVE

To examine exposure, based on ingredient labelling, to the 26 fragrances in a sample of 5588 fragranced cosmetic products.

METHODS

The investigated products were identified through a novel, non-profit smartphone application (app), designed to provide information to consumers about chemical substances in cosmetic products. Products registered through the app between December 2015 and October 2016 were label checked according to International Nomenclature of Cosmetic Ingredients (INCI) for the presence of the 26 fragrance substances or the wording 'fragrance/parfum/aroma'.

RESULTS

The largest product categories investigated were 'cream, lotion and oil' (n = 1192), 'shampoo and conditioner' (n = 968) and 'deodorants' (n = 632). Among cosmetic products labelled to contain at least one of the 26 fragrances, 85.5% and 73.9% contained at least two and at least three of the 26 fragrances, respectively. Linalool (49.5%) and limonene (48.5%) were labelled most often among all investigated products. Hydroxyisohexyl 3-cyclohexene carboxaldehyde (HICC/Lyral^® ) was found in 13.5% of deodorants. Six of the 26 fragrance substances were labelled on less than one per cent of all products, including the natural extracts Evernia furfuracea (tree moss) and Evernia prunastri (oak moss). A total of 329 (5.9%) products had one or more of the 26 fragrance substances labelled but did not have 'parfum/fragrance/aroma' listed on the label.

CONCLUSIONS

Consumers are widely exposed to, often multiple, well-established fragrance contact allergens through various cosmetic products intended for daily use. Several fragrance substances that are common causes of contact allergy were rarely labelled in this large sample of cosmetic products.

Fragrances in the seawater of Terra Nova Bay, Antarctica

Personal Care Products are emerging pollutants whose distribution in the Antarctic and remote environments is still largely unknown. Among PCPs, long-lasting and stable Fragrance Materials were selected to perform a first pilot study on their occurrence in the coastal surface seawater of Terra Nova Bay in the Ross Sea, Antarctica. Ambrofix, Amyl Salicylate, Benzyl Salicylate, Hexyl Salicylate, Lemonile and Okoumal were detected for the first time in Antarctic natural seawater, and reached total concentrations up to 100ngL^-1. Treated discharges from the Italian research station Mario Zucchelli (MZS) contain FMs, however concentrations in nearby Tethys Bay increase during the seasonal melt of the sea ice and its snow cover: variability in emissions and distribution, as well as a contribution from atmospheric (long or short-range) transport were hypothesized.