Cosmetics are in principle safe to use. In some cases, however, cosmetic products may lead to undesirable reactions, such as itching and erythema. In 2009, the RIVM set up a monitoring system in which participating dermatologists can register undesirable and allergic reactions caused by cosmetics: Consumer Exposure Skin Effects and Surveillance (CESES). In the period under consideration, as in previous years, undesirable and allergic reactions mainly occurred on the face and hands after using skin/facial care and hair products. Most patients were diagnosed with contact allergy. Again as in previous years, isothiazolinones (preservatives) and fragrances were the ingredients causing most of the allergic reactions.
This report provides an overview of the 90 notifications received within CESES in the period October 2015-October 2017. Dermatologists carry out patch tests and, where necessary, tests on specific ingredients of the associated cosmetic products.
Isothiazolinones are widely recognised as an important cause of contact dermatitis. For this reason, the use of the potent allergen methylchloroisothiazolinone/methylisothiazolinone (MCI/MI) was prohibited in leave-on products in 2015. In rinse-off products it may be used in a concentration up to 0.0015%. The same limitations will start to apply to methylisothiazolinone (MI) in 2018. Only one notified case could be attributed to MCI/MI in the last two years. It is expected that in the course of 2018 the incidence of notifications caused by MI in cosmetics will decline. It is not yet clear what preservative(s) will replace MI, and developments will be closely followed.
Three cases of allergic reactions to (meth)acrylates in nail products were reported. As this is an increase over previous years, this development will be monitored.
To encourage the notification of cases within CESES, support was provided to one of the participating clinics to fill in the questionnaire. Considering the success of this experiment, we will investigate the options to continue this support and extending it to the other clinics. An update of the questionnaire in August 2017 enabled dermatologists to notify reactions to tattoos and tattoo aftercare products. Although these are not cosmetic products, they sometimes contain sensitizing substances and reactions to these products are not yet monitored.