The Validated Hypoallergenic Cosmetics Rating System: Its 30-year Evolution and Effect on the Prevalence of Cosmetic Reactions

Its 30-Year Evolution and Effect on the Prevalence of Cosmetic Reactions

Vermén M. Verallo-Rowell


Dermatitis. 2011;22(2):80-97. 

In This Article

Contact Dermatitis Prevalence

Contact dermatitis prevalence among users of cosmetics in general has risen in tandem with cosmetic industry reports of global growth by developed countries and emerging markets.[50]

In the 1980s, studies in the United States among the general population reported rates of less than 1%.[51,52,53] Likewise, in Europe from 1989 to 1994, the Swedish Medical Products Agency evaluated only 191 reports concerning adverse effects of 253 cosmetics and toiletries.[54] Later studies in Europe in the 1980s began to show rising prevalence,[55,56,57,58,59] and a study by Nielsen and colleagues showed a doubling of rates among patients in Denmark tested in 1990 and 1998.[60]

In the twenty-first century, prevalence rates of patch test–proven CCD continue to rise worldwide,[61,62,63,64] ranging from 2.4 to 36.3%, most studies reporting between 4% and 9%.[65] Even higher was the rate reported by the latest NACDG analysis for the study periods from 2001 to 2004, which found that 24% of females (vs 18% of males) who were patch-tested were allergic to 20 of the 65 cosmetic allergens tested.[66] Users of facial cosmetics and users of eye makeup (color cosmetics) had 11% and 4% CCD rates, respectively.[67] These studies show that the occurrence of cosmetic allergy varies with time and geographic location[68] and is associated with increased consumer use of cosmetics, use of more allergenic ingredients, and enhanced accessibility of allergens for patch testing.[69]

Almost all of these patch-test studies postulate that the actual prevalence of cosmetic reactions is higher. Milder allergic and irritant reactions usually result in discontinued use of the cosmetic product, forestalling the need for medical attention or reporting to the cosmetic manufacturer. In 50% of cases, neither the patient nor the physician suspected a cosmetic product as a cause of the dermatitis.[70]