Interpersonal Hormone Transfer and Cosmetic Contact Allergens

Mar 1, 2012 | Contact Author | By: Howard I. Maibach, MD, University of California School of Medicine; and Kristine B. Zitelli, MD, Kettering Medical Center.
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Title: Interpersonal Hormone Transfer and Cosmetic Contact Allergens
transdermal hormone transferx contact allergensx percutaneous penetrationx
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In clinical medicine, percutaneous penetration has become a diagnostic reality, with evidence of the unintentional transfer of active gender hormones, i.e., estrogen and testosterone, from dosed to unknowing individuals occurring in clinical trials via interpersonal contact.1–4 Transfer depends on many factors, such as type of exposure, amount of transdermal hormone applied, number of exposures, applied area, transfer area, timing and frequency of contact.5 This unintentional transdermal hormone transfer may cause a clinically significant hormone imbalance and side effects such as cardiovascular events or masculinization in adults and precocious puberty or virilization in children.5–10

It is also possible that the transdermal transfer of applied hormones is of clinical relevance to personal care products. An estimated 1–3% of the population is allergic to a cosmetic product or ingredient contained therein.10 These allergies are mainly to fragrance chemicals such as hydroxy-isohexyl-3-cyclohexene carboxaldehyde and preservatives such as methyldibromo glutaronitrile, but also include emerging allergens such as UV filters and nail acrylates.11 Clinically significant reactions may range from mild sensory irritation to a clear allergy resulting in a positive patch test.11 Similar to transdermal hormone transfer, allergic dermatitis from a cosmetic product depends on many factors including composition of the product, concentration and purity of the ingredients, condition and site of application, contact duration and application frequency.11 The present overview examines the evidence validating transdermal hormone transfer and explores the potential for percutaneous penetration of cosmetic ingredients to cause dermatologic disease not only in the dosed individuals, but also in their interpersonal contacts.

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Table 1. Cases of connubial contact dermatitis from cosmetic ingredients

Table 1. Cases of connubial contact dermatitis from cosmetic ingredients

 Researcher  Dosed Individual  Recipient Physical Exam  Cosmetic Product  Ingredients  Resolution 
 Caro18  Wife  Male, 30 years  Pruritic erythematous eruption ocalized to right neck and right axillary fold  Topical acne medication  Benzoyl peroxide  Discontinued use
 Dooms-Goossens et al19  Husband  Woman, 29 years  Acute, pruritic, ethythematous popular dermatitis in both ears, neck and eyelids  Hair lotion Procaine   Discontinued use
 Leroy and Dompmartin20  Partner  Male, 63 years  Pruritic, eczematous eruption of the face  Toilet water  Musk ambrette Discontinued use 
 Nijhawan and Jacob21  Mother  Infant, 11 months  Widely dispersed eczematous plaques with facial predominance  Mother’s perfume  Balsam of Peru, amlcinnamal dehyde, fragrance mix 1, fragrance list 2, lyral  Switched to fragrance-free cosmetics
 Swinyer22  Wife  Male, 25 years  Unilateral right facial eczematous eruption  Perfumes   Balsam of Peru, cinnamic alcohol, tincture of benzoin Data not included

 

 

a-c

a Estrasorb is a estradiol emulsion manufactured by Graceway Pharmaceuticals LLC, Brisol, Tenn., USA, which was recently acquired by Medicis Pharmaceutical Corp.

b Androgel is a testosterone gel manufactured by Abbott Laboratories, Abbott Park, Ill., USA.

c Testim is a testosterone gel manufactured by Auxilium Pharmaceuticals Inc., Malvern, Pa., USA.

Biography: Howard I. Maibach, MD, University of California, San Francisco

Howard I. Maibach, MD, is a professor of derma­tology at the University of California School of Medicine, San Francisco. His labor­atory has been interested in and has published exten­sively on derm­ato­pharma­cology and dermatotoxicology.

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