Eyelid allergic contact dermatitis to black iron oxide

Eye cosmetics are a common cause of eyelid dermatitis. These products contain pigments, fragrances, resins, preservatives and vehicles. Mascara might cause either irritant or allergic contact dermatitis (ACD) of the eyelids. We present the case of a 44-year-old woman with a 10-month history of periorbital and eyelid dermatitis. Epicutaneous patch testing using the TRUE Test, cosmetic series, steroid series, and her personal products yielded a strong reaction to her mascara. Subsequent patch testing to the mascara components provided by the manufacturer revealed a severe reaction only to 5% black iron oxide. This black iron oxide was further tested in 10 normal controls with no reactions produced. There is only one previous report of eyelid ACD secondary to iron oxide that represents a rare cause of eyelid ACD.