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Meta-Analysis
. 2022 Jun 21;19(13):7588.
doi: 10.3390/ijerph19137588.

Skin Toxicity of Selected Hair Cosmetic Ingredients: A Review Focusing on Hairdressers

Cara Symanzik  1 , Patricia Weinert  1 , Željka Babić  2 , Sarah Hallmann  3 , Martin Stibius Havmose  4 , Jeanne Duus Johansen  4 , Sanja Kezic  5 , Marija Macan  2 , Jelena Macan  2 , Julia Strahwald  3 , Rajka Turk  2 , Henk F van der Molen  5 , Swen Malte John  1 , Wolfgang Uter  3
Affiliations
Meta-Analysis

Skin Toxicity of Selected Hair Cosmetic Ingredients: A Review Focusing on Hairdressers

Cara Symanzik et al. Int J Environ Res Public Health. .

Abstract

The safety assessment of cosmetics considers the exposure of a 'common consumer', not the occupational exposure of hairdressers. This review aims to compile and appraise evidence regarding the skin toxicity of cysteamine hydrochloride (cysteamine HCl; CAS no. 156-57-0), polyvinylpyrrolidone (PVP; CAS no. 9003-39-8), PVP copolymers (CAS no. 28211-18-9), sodium laureth sulfate (SLES; CAS no. 9004-82-4), cocamide diethanolamine (cocamide DEA; CAS no. 68603-42-9), and cocamidopropyl betaine (CAPB; CAS no. 61789-40-0). A total of 298 articles were identified, of which 70 were included. Meta-analysis revealed that hairdressers have a 1.7-fold increased risk of developing a contact allergy to CAPB compared to controls who are not hairdressers. Hairdressers might have a higher risk of acquiring quantum sensitization against cysteamine HCl compared to a consumer because of their job responsibilities. Regarding cocamide DEA, the irritant potential of this surfactant should not be overlooked. Original articles for PVP, PVP copolymers, and SLES are lacking. This systematic review indicates that the current standards do not effectively address the occupational risks associated with hairdressers' usage of hair cosmetics. The considerable irritant and/or allergenic potential of substances used in hair cosmetics should prompt a reassessment of current risk assessment practices.

Keywords: cocamide diethanolamine; cocamidopropyl betaine; cosmetics; cysteamine hydrochloride; hairdresser; hairdressing; hand eczema; polyvinylpyrrolidone; polyvinylpyrrolidone copolymers; sodium laureth sulfate.

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Conflict of interest statement

W.U. has received an honorarium for a lecture on contact allergy from mixed dermatopharmaceutical sponsors (GEIDAC, Toledo, September 2018) and travel reimbursement for participation in study meetings of the IDEA project (IFRA). W.U. is external expert for the SCCS. Other authors: None to declare.

Figures

Figure 1
Figure 1
Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020, flow diagram of literature search according to Page et al. [38].
Figure 2
Figure 2
Forest plot quantifying the risk of cocamidopropyl betaine (CAPB) contact allergy diagnosed by patch testing associated with being a hairdresser vs. other (non-specified) occupation/exposure. De Groot et al. restricted “positive” reactions to “clinically relevant positive” reactions [26]; Armstrong et al. compared hairdressers to consecutively patch-tested patients [25]; and the three Uter et al. studies compared female hairdressers to female patients with suspected contact dermatitis to hair cosmetics—mostly dyes, bleaches, and waving products [22,23,24].
Figure 3
Figure 3
Forest plot depicting the prevalence of cocamidopropyl betaine (CAPB) contact allergy diagnosed by patch testing in hairdressers [6,48,50,56,62].
Figure 4
Figure 4
Forest plot depicting the prevalence of cocamidopropyl betaine (CAPB) contact allergy diagnosed by patch testing in patients other than hairdressers or with non-specified occupation/exposure [39,40,41,42,43,44,46,49,51,52,54,55,57,58,59,60,61,63,64,65,66,67,68].
See this image and copyright information in PMC

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