Allergic patch test reactions associated with cosmetics: Retrospective analysis of cross-sectional data from the North American Contact Dermatitis Group, 2001-2004

Background: Allergy to cosmetics is common. Objectives: We sought to characterize patients with positive patch test reactions associated with a cosmetic source, to identify common allergens; and to explore gender and occupational associations. Methods: We performed a retrospective, cross-sectional analysis. Results. Of 6621 female and 3440 male patients, 1582 female (23.8%) and 611 of male (17.8%) patients liad at least one allergic patch test reaction associated with a cosmetic source. Of allergic patients (>1 allergic reaction, n = 6815), females were 1.21 times more likely to have an allergic reaction associated with a cosmetic source than were male patients (p < .0001, 95% confidence interval [CI] 1.12-1-31). Within the cosmetic allergic group (n = 2243), head and neck involvement was significantly higher in female than in male patients (49.3% vs 23.7%, p < .0001). One hundred twenty-five patients liad occupationally related allergic reactions associated with a cosmetic. Limitations: This study is limited by its cross-sectional, retrospective design. Conclusion: Of all patients studied, 21.8% had an allergic reaction associated with a cosmetic. Site of dermatitis, cosmetic categories, and specific allergens differed somewhat by gender. (J Am Acad Dermatol 2009-160:23-38.)