Contact dermatitis to cosmetics, fragrances, and botanicals

Cosmetics, fragrances, and botanicals are important causes of allergic contact dermatitis. Identifying and avoiding the causative allergens can pose a challenge to both the patient and the dermatologist. The site of involvement can give the investigator clues to the cause of the eruption in many cases. Fragrances and preservatives are the two most clinically relevant allergens in cosmetics. Botanicals are being added to cosmetics because of consumer demand and are now being recognized as sources of allergy as well. Patch testing allows for the detection of allergens that are potentially relevant in the genesis of the patient's eczema. Common skin-care product allergens, including fragrances and botanicals as well as those found in sunscreen, nail, and hair-care products, are reviewed. Practical methods of allergen avoidance are also discussed.