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Contact Sensitivity to Preservatives in Singapore: Frequency of Sensitization to 11 Common Preservatives 2006–2011

Cheng, Suzanne MBBS; Leow, Yung Hian MBBS; Goh, Chee Leok MD; MBBS; Goon, Anthony MBBS

doi: 10.1097/DER.0000000000000031

Background: Preservatives are indispensable agents used to prevent bacterial and fungal contamination of cosmetics, personal care products, domestic preparations, and industrial products.

Objective: We evaluated patch-test data at the National Skin Centre, Singapore, from 2006 to 2011 to identify the trends in preservative contact allergies.

Methods: All patients with suspected contact dermatitis were patch tested to 4 preservatives within the modified European standard series. Patients were also tested with 7 preservatives from our special series if clinically indicated.

Results: Three thousand one hundred seventy-seven patients were tested to preservatives in the standard series. Sensitization frequencies were all greater than 1%: parabens (2.58%), methylchloroisothiazolinone/methylisothiazolinone (1.75%), quaternium 15 (1.43%), and methyldibromoglutaronitrile (1.2%). There was no change in trends in sensitization frequencies from 2006 to 2011, with no increase in sensitization frequency to methylchloroisothiazolinone/methylisothiazolinone. The sensitization frequencies for methyldibromoglutaronitrile/phenoxyethanol and diazolidinylurea were 2.03% and 1.37%, respectively, and remained less than 1% for bronopol, imidazolidinyl urea, and 2-phenoxyethanol. A rate of 0% was seen for 1,3-dimethylol-5,5-dimethyl hydantoin and formaldehyde; 9.4% of positive patch-test results became positive only at day 7.

Conclusions: Preservatives are common causes of allergic contact dermatitis. This should be considered when introducing new preservatives into the market. Day 7 readings are important to detect late reactions.

From the National Skin Centre, Singapore.

Address reprint requests to Suzanne Cheng, MBBS, National Skin Centre, 1 Mandalay Rd, Singapore 308205. E-mail:

The authors have no funding or conflicts of interest to declare.

© 2014 American Contact Dermatitis Society
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