Synonyms for Quaternium-15
Chloroallyl methenamine chloride
cis-1-(3-chloroally) 3,5,7-triaza-1-azoniaadamantane chloride
N-(3-Chloroallyl) hexaminium chloride
Dowicil 75, 100, 200
Preventol D 1
Quaternium-15 is one of the most widely used preservatives (Rietschel & Fowler, 2008). It is not surprising that it is also the most common preservative that causes ACD (Marks et al., 2002; Zug et al., 2009). It affected 10.3% of patients that were patch tested in 2005–2006 (Zug et al., 2009). Quaternium-15 is the top allergen in hand ACD (Warshaw et al., 2007). It is the sixth most common allergen to cause eyelid dermatitis (Rietschel et al., 2007). This is a broad-spectrum preservative that is effective against bacteria, fungi, molds, Pseudomonas aeruginosa, and P. cepacia (Maier et al., 2009; Marks et al., 2002).
Quaternium-15 releases the highest amount of free formaldehyde when compared to other FRPs (Maier et al., 2009). Quaternium-15 0.1% concentration (1,000 ppm) releases 100 ppm of free formaldehyde; this amount is enough to induce dermatitis in a patient with formaldehyde sensitivity (Frosch et al., 2006). Accordingly, when a patient has a positive reaction to quaternium-15 during patch testing, the patient may be sensitive to the formaldehyde that quaternium-15 releases, the actual quaternium-15 molecule, or both the quaternium-15 and formaldehyde (Sasseville, 2004). Approximately 50% of patients with quaternium-15 sensitivity also react to formaldehyde (Frosch et al., 2006).
Certain occupations are affected by ACD caused by quaternium-15 more than others. Hair stylists, machinists, food preparation, health care, housekeepers, and janitors are among the high-risk groups (Maier et al., 2009; Rietschel & Fowler, 2008). However, occupational cases of quaternium-15 are not common (Frosch et al., 2006).
Allergic reactions to quaternium-15 during patch testing are usually relevant (Frosch et al., 2006). Almost 80% of patients were exposed to quaternium-15 through a moisturizer. Hair care products, not including coloring products, were also common sources as they exposed approximately 33% of patients. Makeup accounted for 12% of patients (Rietschel & Fowler, 2008). It is important to mention other quaternium preservatives do not release formaldehyde and, therefore, do not cross-react with quaternium-15 (Maier et al., 2009).
Sources of Quaternium-15 (Maier et al., 2009; Marks et al., 2002).
Shampoos, hair conditioners, liquid soaps, and shaving products.
Moisturizing creams and lotions, cosmetics, shaving products, and sunscreens.
Cleansers, disinfectants, and laundry soaps.
Metalworking fluids and cutting fluids.
Latex paints, glues, and adhesives.
Food packaging: paper, paperboard, and polyurethane resins.
Dermatology Nursing © 2010 Jannetti Publications, Inc.
Cite this: Allergic Contact Dermatitis: Topical Preservatives, Part I - Medscape - Mar 01, 2010.