Fulton J E, Pay S R, Fulton J E
J Am Acad Dermatol. 1984 Jan;10(1):96-105. doi: 10.1016/s0190-9622(84)80050-x.
Cosmetics continue to be used by acne-prone individuals. Often as more acne develops, more cosmetics are applied. In order to protect against this natural tendency, physicians should provide more patient information on the currently available products and ingredients. This presentation is designed to help in that effort. The data presented were gleaned from the rabbit ear assay, which is not an ideal animal model but is the best we have. If an ingredient is negative in the rabbit ear assay, we feel it is safe on the acne-prone skin. A strong, positive ingredient or cosmetic should be avoided. Ingredient offenders include isopropyl myristate and its analogs, such as isopropyl palmitate, isopropyl isostearate, butyl stearate, isostearyl neopentanoate, myristyl myristate, decyl oleate, octyl stearate, octyl palmitate or isocetyl stearate, and new introductions by the cosmetic industry, such as propylene glycol-2 (PPG-2) myristyl propionate. Lanolins continue to be a problem, especially derivatives such as acetylated or ethoxylated lanolins. Our most troublesome recent finding is the comedogenic potential of the D & C Red dyes. They are universally used in the cosmetic industry, especially in blushers. This may explain the predominance of cosmetic acne in the cheekbone area. All of these D & C Red dyes tested to date, the xanthenes, monoazoanilines, fluorans, and indigoids, are comedogenic. Actually, this is not surprising as they are coal tar derivatives. The natural red pigment, carmine, is noncomedogenic and can serve as a substitute for D & C dyes in blushers. Many finished products are comedogenic. Most troublesome to the dermatologists are the therapeutic tools that we use, such as Liquimat, Retin-A cream, Hytone, Staticin, Sulfoxl, Desquam-X, and Persadox HP cream. These should be reformulated. We have been unable to confirm that precipitated sulfur (U.S.P.) is a potent comedogen in the rabbit ear assay. Clinically, we still find sulfur quite effective as an adjuvant to the benzoyl peroxide therapy for the treatment of acne vulgaris. We would suggest that the bias against sulfur be reconsidered.
易长痤疮的人群仍在使用化妆品。通常随着痤疮越来越严重，使用的化妆品也越来越多。为了防止这种自然倾向，医生应向患者提供更多关于现有产品和成分的信息。本次报告旨在助力这一工作。所展示的数据来自兔耳试验，该试验并非理想的动物模型，但却是我们现有的最佳模型。如果一种成分在兔耳试验中呈阴性，我们认为它对易长痤疮的皮肤是安全的。应避免使用具有强烈阳性反应的成分或化妆品。有问题的成分包括肉豆蔻酸异丙酯及其类似物，如棕榈酸异丙酯、异壬酸异丙酯、硬脂酸丁酯、新戊酸异硬脂醇酯、十四烷酸十四烷基酯、油酸癸酯、硬脂酸辛酯、棕榈酸辛酯或异鲸蜡硬脂酸酯，以及化妆品行业新推出的产品，如丙二醇 -2（PPG -2）肉豆蔻酸丙酯。羊毛脂仍然是个问题，尤其是乙酰化或乙氧基化羊毛脂等衍生物。我们最近最棘手的发现是D&C红色染料具有致粉刺潜力。它们在化妆品行业中被广泛使用，尤其是在腮红中。这可能解释了颧骨区域化妆品性痤疮的高发。迄今为止测试的所有这些D&C红色染料，包括呫吨类、单偶氮苯胺类、荧烷类和靛类，都有致粉刺性。实际上，这并不奇怪，因为它们是煤焦油衍生物。天然红色素胭脂红不具有致粉刺性，可作为腮红中D&C染料的替代品。许多成品都有致粉刺性。对皮肤科医生来说最麻烦的是我们使用的治疗工具，如Liquimat、维甲酸乳膏、氢化可的松乳膏、Staticin、Sulfoxl、Desquam -X和Persadox HP乳膏。这些产品应重新配方。我们无法在兔耳试验中证实沉淀硫磺（美国药典级）是一种强效致粉刺物。临床上，我们仍然发现硫磺作为辅助药物与过氧化苯甲酰联合治疗寻常痤疮非常有效。我们建议重新考虑对硫磺的偏见。
