Tag Archive for: contact dermatitis

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Petrolatum Facts—150 years to today.

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Petrolatum was discovered in 1859 inadvertently by the oil rig drillers in Titusville, Pennsylvania. The thick “rod wax” caused the rigs to malfunction and had to scraped off, however the workers found it to help soothe and heal their skin cuts. Robert Chesebrough, a chemist, refined, distilled, patented, and named it Vaseline—from the German wasser (water) and the Greek elaion (olive oil).

Purified petrolatum is a highly useful moisturizer and skin protectant as it prevents up to 98% of transepidermal water loss, is triple-purified and devoid of any allergens. It is recommended by the National Eczema Association as safe treatment option. There have not been any evidence-based reports directly linking purified petrolatum to cancer.

However, unrefined, low grade petrolatum does contain carcinogens called polycyclic aromatic hydrocarbons. Although the US does not regulate petrolatum use in cosmetics, labels stating “white petrolatum” or “Petrolatum, USP” can be sure they are buying a purified high grade product.

Petrolatum itself has never been reported to cause allergic contact dermatitis. Some petrolatum-based products, however, may not use a purified form of petroleum and often have additional ingredients such as Lanolin or fragrances and should be carefully evaluated for their ingredients by patients with known sensitizations.  

The Dermatologist – Features Regional Atlas on Contact Dermatitis

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“The Dermatologist is a print and digital brand that circulates to more than 14,798 dermatologists, dermatology residents, dermatology nurse practitioners, physician assistants and nurses, as well as other healthcare professionals. The Dermatologist is collaborating with numerous associations, including the National Psoriasis Foundation, the world’s leading patient advocacy organization dedicated to the 7.5 million Americans with psoriasis and psoriatic arthritis, to educate dermatologists on the latest research related to psoriasis through The Dermatologist print and digital brand. Others include The National Eczema Association, The National Rosacea Society, and The Skin Cancer Foundation.

The editorial mission of The Dermatologist  focuses on providing practical and clinical insight, industry news and peer perspectives into today’s general dermatology issues. This award-winning publication offers dermatologists reader-friendly, timely and informative articles that highlight clinical advances for treatment of cutaneous pathologies such as skin cancer, acne and psoriasis, as well as information on how to incorporate cosmetic procedures, such as Botox and laser skin resurfacing, into a dermatology practice. Practice management topics, such as managed care, Medicare regulations and marketing techniques that can easily be translated into current practice settings, are also featured.”

Check out the Regional Atlas of Contact Dermatitis!

The Dermatologist (formerly Skin and Aging) has had a column dedicated to allergic contact dermatitis (allergen focus) since January 2005!

Test Your BOP Savvy – Which of these items might contain BOP?

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Preservative allergy alert!

Update on isothiazolinone (preservative) contact dermatitis

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New! Off the Press today! An update on the impact of isothiazolinone (preservative) contact dermatitis allergy .

“Allergic contact dermatitis (ACD) is a socially and economically significant condition. ‘We are in the midst of an outbreak of allergy to a preservative [methylisothiazolinone] which we have not seen before in terms of scale in our lifetime…. I would ask the cosmetic industry not to wait for legislation but to…address the problem before the situation gets worse,” stated John McFadden, FRCP, consultant dermatologist at St. John’s Institution of Dermatology in London, in a 2013 article in The Telegraph. Because MCI was believed to be a more potent allergen than MI, MI was approved for use as an individual pre- servative in industrial products in 2000 and in cosmetics in 2005. Comparing pooled prevalence rates… In the 1980s, in response to the newly recognized isothiazolinone allergens, expert panels from the United States and European Union recommended more strict concentrations in cosmetic products. The Scientific Committee on Consumer Safety (SCCS) recommended to the Cosmetic Directive of the European Union to limit. ‘”

Read more: UPDATE ON ISOTHIAZOLINONES.   Isothiazolinones, including (methylisothiazolinone, methylchloroisothiazolinone, and benzisothiazolinone, are common synthetic biocides/preservatives found in many skin and hair products as well as industrial products.

By MICHAEL LIPP, DO, MISHA BERTOLINO, MA, ALINA GOLDENBERG, MD, MAS, AND SHARON E. JACOB, MD in The Dermatologist™.  Please click the ‘prevent’ button on Break the Isothiazolinone Cycle on the Dermatitis Academy Isothiazolinone allergen (hapten) page.

Goblin's Copper Nickel Policy

Time for Nickel Policy

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Goblin’s Copper –The Time For a Nickel-Directed US Health Policy is Here. In THE DERMATOLOGIST, Vol 23 – Issue 3 – March 2015, pg 18-21

By Sharon E. Jacob, MD, Alina Goldenberg, MAS, Nanette Silverberg, MD, Luz Fonacier, MD, Bruce Brod, MD, Richard Usatine, MD, Robert Sidbury, MD, MPH, James Young, DO, Anthony Fransway, MD, Jonathan Silverberg, MD, PhD, MPH, Albert Yan, MD, and Janice L. Pelletier, MD, FAAP

Review by Chandler Rundle, BS. MSI, Loma Linda University

For years, nickel sensitization has plagued individuals of all ages. Nickel allergy can present as a localized or diffuse reaction, leading the reaction to often be confused with other conditions such as atopic dermatitis. Cases of nickel allergy are increasing, but there is minimal legislation on nickel restriction. The Jacob et al. article reviews/highlights that:

*International initiatives that regulated the allowable amount of nickel release from items inserted in piercings limited to <0.2 μg/cm2/week has led to decreased sensitization rates and a cost savings of $2 billion US dollars over a twenty year period.*A significant percentage of the clinical cases are unpublished – hence underrepresented.
* Half of the subjects sensitized to nickel have never consulted a doctor because of their nickel dermatitis
*Rates of nickel dermatitis have risen significantly. While awareness of nickel dermatitis has heightened as a public health issue.
* United States legislation has yet to formulate regulation of nickel in products – as Europe did in the 1990’s.

Amanda’s Allergic Contact Dermatitis Story – My ACD story

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Amandasstory

“My MI/MCI story by Amanda B.

In April of 2013, I began struggling with sleep. Friends suggested I go on Hormone Replacement Therapy, and my doctor, who knew nothing about hormones, suggested I visit a gynecologist for HRT. She also offered me sleeping pills. Not wanting either alternative, I chose to hope for the best and tough it out. But months and months later, I still wasn’t sleeping, and my thoughts and feelings began to become affected. The day before Thanksgiving, my only surviving family member and sibling was admitted into the hospital 2,000 miles away. She passed away on December 11 and I was unable to attend her funeral.  My college-aged children were home and I pressured myself into preparing elaborate holiday feasts. My business, which is in full swing during the holidays, was demanding my attention. I say all of this so you can understand that I was on overload, to say the least. I fully believe that my sensitization to MI/MCI was due in large part to stress, the fact that I wasn’t handling my stress well, and my use of denial (“it will all get better”).

That Christmastime, I began experiencing itchy rashes on the back of my hands. I was at a loss as to what was causing it. I booked a January appointment with a dermatologist and they kind of shrugged, gave me a preliminary diagnosis of dyshidrotic eczema (although the presentation of my rashes was irregular for that diagnosis), gave me some very strong ointment, and sent me on my way. I read the package insert of the medication and was alarmed at how they stated it could interfere with the adrenals. I used it sparingly, and it worked.

I kept having these sorts of breakouts on my hands, but then later in 2014, I began breaking out on my face, chest and arms. These blisters were horrible. As the rash on my face was in a butterfly shape, the dermatologist tested me for Lupus, which was negative. No indication on their part as to what could be causing the rashes. More corticosteroids.

Finally in early 2015, after a facial caused my lips to flare, I insisted we get to the bottom of the problem. The dermatologist suggested a patch test to determine if I had contact allergies. She administered the TRUE test and I reacted quite strongly, and only to isothiazolinone. Not one person in the office could pronounce it, and not one person talked with me about Allergic Contact Dermatitis (ACD). They handed me a printout from the TRUE test and said, “this is what the problem is.” I immediately talked with the aesthetician who had given me the facial. She began looking on her phone right away. The first site she went to was Wikipedia, and then she went to Facebook. She found the MI group and I immediately began following. To date, these MI support groups have provided me with nearly 100% of my education on ACD.

Like everyone else with ACD, the allergy ruled my life at first (and it still does, for the most part, but I have a safe home now, and I know how to live with the diagnosis). I spent a great deal of time focusing on how to keep out of a flare. I am a jewelry artist and am exposed to chemicals on a regular basis, but it was cleaning out my basement this past winter that caused a huge flare that I couldn’t seem to heal. Although I have prescriptions for various corticosteroids, I try to use them sparingly, even to wean myself off of them, because they are known for thinning the skin, and the ingredients are absorbed into the bloodstream. So during this particular flare, I began using natural salves that were absolutely lovely (in my opinion). But something wasn’t right. I would use corticosteroids one night, the natural salves another night, and I kept flaring. There was no MI/MCI in any of the products I was using. So back to the dermatologist. She had mentioned that there was a specialist about an hour and a half away who could patch test me on a larger scale if I needed it, so I said, “it’s time”. Fortunately, I have medical insurance that would pay for it.

In April of 2016, I had my appointment and was given 129 patches on my back. The results were that I had developed sensitivities to some of the ingredients in the natural salves I had been using. My new allergens include Fragrance II, Propolis, the botanicals neroli and lemongrass, as well as ethylhexylglycerin and dodecyl gallate. I was told to avoid all fragrances, all botanical oils and beeswax, in addition to MI/MCI.

Now I use very little on my skin, as I fear that I will become sensitized to more allergens. Something that I feel has been missing in all of this is patient education about how to heal a flare once you get one. And that education for the medical community in this arena is sorely lacking. I know that doctors become highly specialized and it may be impossible for them all to know about ACD, but it seems to me that dermatologists ought to be able to patch test a patient sooner than later.   I think that most of us ACD sufferers are out there floundering with no idea of diagnosis and treatment. I am grateful that Dermatitis Academy exists now to help us all through this maze!”

My Allergic Contact Dermatitis (ACD) Story is a portion of the Dermatitis Academy Blog that highlights real life, user submitted, allergic contact dermatitis journeys in an attempt to provide awareness and encouragement regarding this crippling disease.

Infographic by Peter Gust