CD17 A survey of cosmetic product use and contact skin reactions in children: a decade later

Abstract

The prevalence of allergic contact dermatitis in children is increasing. It is assumed that this is due to increasing usage of cosmetic products, although evidence for this is limited. This survey aims to compare current usage trend of various products and the incidence of contact skin reactions in children outside the patch test clinic, to data from 10 years ago. The survey was distributed to patients and parents attending paediatric clinics between December 2024 and January 2025. In total, 64 responses were collected, capturing demographic details, atopic and patch testing history, product use and contact skin reactions. Products used for daily personal care, such as shower gels, were considered typical, while cosmetic products such as hair dye were considered atypical. Contact skin reactions were reported in 21 patients (33%), with 13 of these (62%) reacting to multiple products. Although these are similar to previous rates, the number of implicated products causing reaction has nearly doubled. Atopy was reported in 62% of patients with contact reactions compared with 30.4% previously. Most have not been patch tested. The top three products causing reactions were sunblock (12%), shower gel (12%) and baby wipes (8%), compared with shower gels (39%), prescribed creams (26%) and baby wipes (17%) previously. As expected, atypical product usage is higher in the older children from the current survey compared with 10 years ago. The current data are age 0–4 years (4 of 28, 14%), 4–8 years (six of eight, 75%), 8–12 years (six of nine, 67%) and 12–16 years (13 of 19, 68%). The data 10 years ago were age 0–4 years (4 of 10, 40%), 4–8 years (4 of 14, 29%), 8–12 years (10 of 16, 63%) and 12–16 years (22 of 28, 78.6%). Although usage is now lower in the group aged 0–4 years, it has increased in the groups aged 4–8 and 8–12 years. Although atypical product use is higher in girls in the present survey, as expected, exposure is also high in boys both now (female 19 of 31, 61% vs. male 15 of 34, 44.1%) and 10 years ago (female 24 of 32, 75% vs. male 21 of 36, 58%). The proportion of boys using atypical products has also increased in the groups aged 4–8 years (three of seven, 43% vs. three of eight, 38%) and 12–16 years (three of three, 100% vs. 11 of 15; 73.3%) compared with 10 years ago. The proportion of patients using atypical products from more deprived areas (deprivation scores < 2000) has also increased slightly from 21% (11 of 53) 10 years ago to 22% (11 of 49). The survey showed that children continue to be exposed to atypical products even in the younger age groups. Many factors could contribute to this, such as earlier exposure to social media and deprivation, although further and larger studies will be required to prove this. Therefore, it is important to enquire in detail when patch testing to avoid potentially missing allergies.