Allergens in corticosteroid vehicles.

Area of Science:

• Dermatology
• Contact Allergy
• Pharmacology

Background:

• Allergies to topical steroid vehicle ingredients are known but under-documented.
• Specific common vehicle ingredients and their association with active molecules are not well-characterized.

Purpose of the Study:

• To identify and describe the use of common allergenic vehicle ingredients in prescription topical corticosteroids.
• To provide data on ingredient profiles of widely used topical steroids.

Main Methods:

• Systematic review of package inserts for all U.S. prescription topical corticosteroids.
• Generation of comprehensive ingredient lists for each product.

Main Results:

• Seven common allergens found in topical corticosteroid vehicles: propylene glycol, sorbitan sesquioleate, formaldehyde-releasers, parabens, methylisothiazolinones, lanolin, and fragrance.
• 128 out of 166 (77%) topical corticosteroids, including all creams, contained at least one common allergen.
• Generic formulations were less likely to contain allergens than branded ones; solutions and ointments were least allergenic.

Conclusions:

• The majority of prescription topical corticosteroids contain ingredients that can cause allergic contact dermatitis.
• Dermatologists should consider the potential for vehicle-induced allergic reactions and prescribe allergen-free alternatives when necessary.