Allergic Contact Dermatitis: Topical Preservatives, Part I

J. Desiree Douglas


Dermatology Nursing 

In This Article


Approximately half of all patients with formaldehyde sensitivity react to one or more of the formaldehyde-releasing preservatives. A common cross-reaction involves formaldehyde and quaternium-15. DMDM hydantoin can cross-react with formaldehyde. In addition, diazolidinyl urea can cross-react with imidazolidinyl urea (Sasseville, 2004).

However, some argue if a patient was patch tested against all formaldehyde and FRPs, he/she needs only to avoid the allergens he/she reacted to and does not need to avoid the entire family (Herbert & Rietschel, 2004). This is a complicated issue because different FRPs can release varying levels of formaldehyde. A person may tolerate lower levels of formaldehyde from a product with one FRP, but not others. Therefore, many authors suggest patients with formaldehyde sensitivity avoid all of the formaldehyde-releasing preservatives including:

  • Quaternium-15

  • Diazolidinyl urea

  • Imidazolidinyl urea

  • DMDM hydantoin

  • Bronopol (2-bromo-2-nitropropane-1,3-diol)