Immediate and delayed reactions to cosmetic ingredients.

The purpose of this study was to investigate the incidence and etiology of cutaneous reactions caused by cosmetics, with an emphasis on perfume sensitivity. 19 control subjects and 31 patch test clinic patients (16 with a history of adverse cosmetic reactions) were examined for sensitivity by history, open and patch testing using the North American Contact Dermatitis Group (NACDG) fragrance screening series and 11 other common allergens found in cosmetics. Contact urticaria was very frequent to certain chemicals; however, patients with a history of cosmetic sensitivity were not found to have a significant increase in positive reactions when compared to controls or patients with eczematous skin. 12 subjects had positive patch test reactions, most of which were not clinically relevant. 3 patients with a history of cosmetic sensitivity had positive reactions, only 1 of which was in the fragrance screening series (cinnamic alcohol). There were 6 reactions in patients with eczematous skin, 4 of which were to preservatives. 3 controls had positive reactions, each to thimerosal. A history of cosmetic sensitivity was not confirmed by open and closed skin testing in our subjects.