Preservative, Surfactant Allergens Frequently Found in Infant Skincare Products

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Allergens associated with risk of allergic contact dermatitis may be often present in the ingredients of the US’ highest-selling skincare products marketed toward infants, according to new data.¹

A poster presentation at the American Academy of Dermatology (AAD) 2024 Annual Meeting in San Diego, CA, this week showed that in particular baby product moisturizers and preservatives may include sensitizing ingredients such as phenoxyethanol and tocopherol that which may induce risk of allergic contact dermatitis.

Led by Maria Karim, MD, of the Icahn School of Medicine at Mount Sinai Morningside West, the New York- and New Jersey-based investigators sought to analyze the composition of potential allergens in the most popular skincare products marketed for infants in the US.

“The prevalence of allergic contact dermatitis in the United States pediatric population is about 16.5%,” the team wrote. “With a market cap of $1.7 billion annually, the skincare industry for infants and children continues to expand, providing consumers with a plethora of often confusing choices.”

The team conducted a cross-sectional analysis by matching the 10 most popular baby skincare products from the 10 largest US-based retailers with allergens reported in the Core Allergen Series, a published report of the most common allergens per patch testing published by the American Contact Dermatitis Society and North American Contact Dermatitis Group.² They then categorized allergens by subgroup: botanicals; emollients preservatives; surfactants; and other. Retailers were excluded from analysis if inventory was not applicable, and duplicate products were removed as well.¹

Karim and colleagues surveyed 38 unique infant skincare products: 13 moisturizers; 10 bathing products; 8 diaper creams; 5 sunscreens; and 2 powders. They identified 82 total allergens from those products. Only 3 observed products contained no allergens.

The most common sensitizers observed in the 35 products included the following:

• Phenoxyethanol (n = 15)
• Tocopherol (n = 13)
• Ethylhexylglycerin (n = 10)
• Sodium benzoate (n = 9)
• Cocamidopropyl betaine (n = 7)

Categorically, preservative (n = 38) and surfactant (n = 14) allergens comprised a majority of all observed in the 35 products, followed by emollients (n = 12) and botanicals (n = 5). Another 13 allergens were categorized as “other.”

Investigators concluded their findings may help elucidate the prevalence and risk of allergen exposure through infant skincare products; they advised parents and practitioners use this information to communicate on and inform decisions around selecting over-the-counter topicals and other skincare products for infants.

“Consumers and dermatologists alike should be aware of the sensitizing potential of popular baby products and ingredients, namely moisturizers and preservatives,” investigators wrote. “Notice should be taken with certain ingredients, such as cocamidopropyl betaine and lanolin, as they have been shown to be significant pediatric allergens in the United States through positive patch test reaction rates."

References

1. ^{Karim M, Chou M, Itzkowitz T, Shin H. Potentially Allergenic Ingredients in Best-selling Skin Care Products for Infants. Paper presented at: American Academy of Dermatology (AAD) 2024 Annual Meeting. March 8 – 12, 2024. San Diego, CA.}
2. ^{Schalock PC, Dunnick CA, Nedorost S, Brod B, Warshaw E, Mowad C, Scheman A; American Contact Dermatitis Society Core Allergen Series Committee. American Contact Dermatitis Society Core Allergen Series: 2020 Update. Dermatitis. 2020 Sep-Oct;31(5):279-282. doi: 10.1097/DER.0000000000000621. PMID: 32947457.}