Can we make cosmetic contact allergy history?

Abstract

Chemical allergy is of considerable importance to the toxicologist, who, amongst other things, has the responsibility of identifying and characterizing the skin (and respiratory) sensitizing potential of chemicals, and estimating the risk they pose to human health. Allergic contact dermatitis (ACD) is to a large extent a preventable disease. Although quantitative risk assessment (QRA) for contact allergy can be performed, it is reasonable to ask why the burden of the skin disease ACD appears to remain stubbornly high, and in particular, that the general level of ACD to sensitizing ingredients found in cosmetics has not fallen noticeably over recent decades; some could argue that it has increased. In this review, this conundrum is addressed, considering whether and to what extent the prevalence of cosmetic allergy is truly unchanged, whether the predicted test methods and potency estimations are sufficiently precise and how proposed changes to the QRA process (i.e., cumulative exposure) may ameliorate the situation. Improved and more widespread use of risk assessment, better education of risk assessors, better post-marketing surveillance and monitoring of dermatology clinic feedback to improve QRA, all together could help to "make contact allergy history".