Botanicals Botanicals and Contact plant extracts Allergy essential oils increasingly popular additives cosmetics Christen M. Mowad MD cosmeceuticals Geisinger Medical Center personal care products aromatherapy Danville, PA 17821 massage therapy [email protected] medicinal/healing properties fragrances
Botanicals Botanicals - composition
push to naturals highly variable consumers dependent on plant part “If natural has to be OK” leaf fewer side effects root industry has added botanicals everywhere fruit cosmetics stem shampoos flower soaps bath gels
Botanicals - composition Botanicals and Adverse Events
highly variable patients increasingly using them concentration, antigeniticy can differ felt to be Natural and therefore harmless timing of harvest patients may neglect to mention usage Where the plant was grown need to ask processing of plant
1 Botanicals and Adverse Events Botanicals and Phototoxicity
Irritant contact dermatitis Balsam of Peru Allergic contact dermatitis Carotene Photocontact dermatitis Cinnamic aldehyde Contact urticaria Essential oils Pigmentation abnormalities Furocoumarins Acneiform eruptions Oak moss
Seminars in Derm 15(2):78-82,1996.
Botanicals and Contact Urticaria Botanicals and Pigmentation
Balsam of Peru Red discoloration by terpenes Benzoic acid Lemon, lime, orange, juniper Camphor Postinflammatory depigmentation Cinnamic alcohol Capsicum Postinflammatory hyperpigmentation Caraway oil Benzyl alcohol Cinnamic acid, alcohol, aldehyde Benzyl salicylate Coumarin Cananga oil Henna Cinnamic alcohol Ethyl vanilla Geraniol Eugenol Seminars in Derm 15(2):78-82,1996.
Botanicals and Acneiform Eruptions Botanical Allergy Location
Cocoa butter Frequency Coconut oil Location Simpson Thomson Corn oil Axilla 14.3% 10% Linseed oil Extremities 50% 21% Face/Neck 21.4% 41% Olive oil Trunk 21.4% 10% Peanut oil Genitalia 14.3% Pine tar Generalized 7% Sesame oil Exposed 14% Hand 14% Seminars in Derm 15(2):78-82,1996.
2 Tea Tree oil Botanicals and Contact Allergy extracted oil from Melaleuca alternifolia shrub in Australia increasing popularity, increased ACD antimicrobial - bacteria, virus, fungi anti-inflammatory effects most allergenic botanical extract
Tea Tree Oil- increasing usage Tea Tree Oil- adverse effects
cosmetic products allergic contact dermatitis household products occupational contact dermatitis massage oils irritant contact dermatitis aromatherapy products systemic contact dermatitis mouthwashes erythema multiforme- like reaction moisturizing creams
Tea Tree oil Propolis
occupational allergen in beekeepers Allergens “bee glue” d-limonene collected by bees from poplar and conifer buds alpha-terpinene used in cosmetics and medicinal products terpinen-4-ol not the same as beeswax Terpinolene secreted by bees 1,8 cineole antiseptic, anti-inflammatory, anesthetic wound healing, ulcer care
3 Propolis Propolis as Allergen
composition varies 1.2 – 6.6 % of dermatitis patients allergic 180-300 components patch test at 10 % pet main allergens linear increase in annual frequency of allergy LB-1 (3isomeric pentenyl caffeates) increased usage 3-methyl-2-butenyl caffeate Phenylethyl caffeate Benzyl salicylate Contact Dermatitis 26: 34-44, 1992. Benzyl cinnamate Contact Dermatitis 45: 269-272, 2001.
Lichens Lichens
Plantlike organisms Lichen acid mix 17,000 species Usnic acid Atranorin lichen acid pickers Everinic acid woodworkers Usnic acid cosmetic products antimicrobial properties axillary dermatitis- deodorants anti-inflammatory properties Analgesic activity Increased usage in personal care products
Feverfew Aloe
Tanacetum parthenium used for soothing properties original use- fever, headache, migraines thousands of individual chemicals allergens- exact allergen unknown sesquiterpene lactones ACD in literature parthenolides contact urticaria contact dermatitis contact stomatitis uncommon sensitizer
4 Gingko biloba Curcumin- tumeric
anti-inflammatory effects Curcuma longa no allergic contact dermatitis reported used to prevent degradation of products fruit pulp contains the allergen anti-inflammatory effects extracts usually don’t use fruit pulp antimicrobial effects known irritant known contactant
Arnica Chamomile
Arnica Montana member of Compositae family sprains, bruises, wounds several species of plant cosmetic products Anthemis nobilis- Roman Chamomile Matricaria chamomilla - German chamomile allergic contact dermatitis reported anti-inflammatory effects often Compositae positive bacteriostatic effects can be missed with sesquiterpene lactone sesquiterpene lactones as allergen allergic contact dermatitis contact urticaria
Peppermint Rosemary
Mentha piperita Rosmarinus officinalis Lamiaceae or mint family evergreen shrub Flavoring agent antioxidant properties toothpaste, gum, mouth wash anti-cancer activity Several adverse events anti-photoaging activity ACD stomatitis allergic contact dermatitis burning mouth syndrome carnosol, carnosic acid, caffeic acid oral ulceration uncommon allergen chronic cheilitis
5 Potential Botanical Screening Allergens Patch Testing and Botanicals
Positive in Pt with no good screening allergen Screening Allergen Botanical Allergy large numbers of botanicals Fragrance Mix 33.3% test to Balsam of Peru 30.0% botanical series- most relevant allergens Compositae 20.0% fragrances patient’s products Sesquiterpene lactone 6.7%
Dermatitis 15(2): 67-72, 2004
Proposed Botanical Screening Tray Botanical Allergy Education
Tea tree oil Lavender avoid all botanicals Lichen acid mix Sandalwood oil avoid all fragrances Geranium oil Cananga oil read labels Spearmint oil Rose oil CARD Dandelion Ylang-ylang oil Neroli oil Compositae
Dermatitis 15(2);67-72,2004.
Botanicals
increase in usage increase in allergy need to ask about usage difficult to screen for test to larger screen test to personal care products
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