Contact Dermatitis Associated with Skin Cleansers: Retrospective Analysis of North American Contact Dermatitis Group Data 2000-2014

Erin M. Warshaw, Molly C. Goodier, Joel G. Dekoven, Howard I. Maibach, James S. Taylor, Denis Sasseville, Donald V. Belsito, Joseph F. Fowler, Anthony F. Fransway, Vincent A. Deleo, James G. Marks, Melanie D. Pratt, Toby Mathias, Matthew J. Zirwas, Kathryn A. Zug

Research output: Contribution to journalArticlepeer-review

18 Scopus citations


Background There is limited information regarding contact dermatitis (CD) associated with skin cleansers (SCs). Objective The aim of the study was to evaluate the prevalence of allergic patch test (APT) reactions and irritant CD (ICD) associated with SCs. Methods A retrospective cross-sectional analysis was performed using North American Contact Dermatitis Group data, 2000-2014. Results Of 32,945 tested patients, 1069 (3.24%) had either APT reaction or ICD associated with SCs. Of these, 692 (64.7%) had APT reaction only, 350 (32.7%) had ICD only, and 27 (2.5%) had both. Individuals with APT reaction and/or ICD were more likely to have occupationally related skin disease (relative risk [RR] = 3.8 [95% confidence interval {CI} = 3.3-4.5] for APT reaction and 10.0 [95% CI = 8.2-12.2] for ICD, respectively, P < 0.0001). As compared with those without APT reaction to SC, individuals with APT reaction had significantly higher frequencies of hand (RR = 2.4 [95% CI = 2.1-2.7]) and arm dermatitis (RR = 1.3 [95% CI = 1.1-1.6], P ≤ 0.001). Irritant CD was strongly associated with hand dermatitis (RR = 6.2 [95% CI = 5.2-7.3], P < 0.0001). More than 50 allergens were associated with SCs including quaternium-15 (11.2%), cocamidopropyl betaine (9.5%), methylchloroisothiazolinone/methylisothiazolinone (8.4%), coconut diethanolamide (7.9%), fragrance mix I (7.7%), Myroxylon pereirae (5.9%), 4-chloro-3,5-xylenol (5.8%), amidoamine (5.5%), and formaldehyde (4.4%). Conclusions Many allergens, especially preservatives and surfactants, were associated with SCs. Most cases involved the hands and were occupationally related.

Original languageEnglish (US)
Pages (from-to)32-42
Number of pages11
Issue number1
StatePublished - Jan 1 2018

All Science Journal Classification (ASJC) codes

  • Immunology and Allergy
  • Dermatology


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