Benzisothiazolinone Is an Emerging Important Preservative Allergen
abstract
This abstract is available on the publisher's site.
Access this abstract nowBACKGROUND
Preservatives are used widely in cosmetic, household, and industrial products to prevent microbial growth and spoiling of the products. There has been a recent epidemic of contact allergy to methylisothiazolinone (MI).
OBJECTIVES
To establish emerging trends in preservative contact allergy as MI is replaced.
METHODS
We performed a retrospective study on consecutively patch-tested patients at our center from January 2011 to December 2019.
RESULTS
A total of 7846 consecutively patch-tested patients were included who were patch tested between January 2011 and December 2019. The prevalence of allergy to MI fell from a peak of 9.39% in 2013 to 1.98% in 2019. MI/methylchloroisothiazolinone (MCI) followed a similar trend, with a peak prevalence of 7.85% in 2014 and falling to 1.39% in 2018. The prevalence of contact allergy to benzisothiazolinone (BIT) has increased steadily increased in 2014 from 0.26% (confidence interval [CI] 0.03-0.93) to 3.42% (CI 2.43-4.66) in 2019.
CONCLUSIONS
Our data show a significant increase in the prevalence of contact allergy to BIT over the last 6 years, probably as a consequence of increased use in household products. It is essential to continue to look for emerging trends in contact allergy to enable prompt preventative measures to be taken.
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Additional Info
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Trends in preservative allergy: Benzisothiazolinone emerges from the pack
Contact Derm 2021 Sep 05;[EPub Ahead of Print], N King, F Latheef, M WilkinsonFrom MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.
Preservatives are used in personal care products and household and industrial products to prolong shelf life and prevent spoilage or microbial overgrowth. Numerous preservatives are available on the market. Over the years there have been many preservatives that have caused spikes in allergic contact dermatitis (ACD) such as quaternium-15, methylchloroisothiazolinone/methylisothiazolinone (MCI/MI), and methylisothiazolinone (MI). These reported spikes in allergic contact dermatitis often result in adjustments in preservative usage by companies.
The authors of this study wanted to observe for changes in preservative usage patterns in the United Kingdom and to see if there is a new preservative replacing MI and MI/MCI, the most recent preservatives to cause a spike in allergic contact dermatitis. The authors observed that ACD to benzisothiazolinone (BIT) has increased over the study period of 6 years (2011–2019) and that reactions to MCI/MI and MI have decreased from their peaks of 7.85% and 9.39% to 1.39% and 1.98%, respectively. One must remember that usage patterns and positivity rates vary with geography, in part due to regulations of usage and changes in preservative usage.
Although the United Kingdom has seen significant decreases in allergy to MCI/MI and MI, the most recent North American Contact Dermatitis group data still report high rates of MI positivity (15.3%) and MCI/MI (11%) in the 2017–2018 data.1 BIT did rise to a top-ten allergen in these data, with a reaction rate of 7.3%, suggesting that this may be a new allergen source to watch.
This study highlights changes in preservative usage that typically follow reported high rates of allergy and also points out regional differences in reported allergy prevalence.
Reference