Contact Allergy to Propolis: Update 2013-2025

Area of Science:

• Dermatology
• Allergology
• Cosmetic Science

Background:

• Propolis allergy reviews are essential for understanding contact dermatitis.
• Previous reviews highlighted propolis as a contact allergen.
• Updated literature is needed due to new propolis sources and testing methods.

Purpose of the Study:

• To provide an updated review of propolis contact allergy literature from March 2013 to May 2025.
• To analyze the emergence of Brazilian propolis as a significant patch test allergen.
• To investigate the causes of frequent positive reactions to Brazilian propolis and assess its role in cosmetic allergy.

Main Methods:

• Comprehensive literature search on propolis contact allergy.
• Analysis of patch test results from consecutive and selected patient groups.
• Review of case reports and series, including co-reactivity studies.
• Examination of propolis component analyses and cosmetic usage data.

Main Results:

• Brazilian propolis (Allergeaze) has emerged as a surprising and frequent patch test allergen.
• High rates of positive reactions to Brazilian propolis may be linked to fragrance cross- or pseudo-cross-reactions.
• Propolis is infrequently used in cosmetics and is a rare cause of sensitization.
• Distinguishing between Chinese and Brazilian propolis in testing is crucial.

Conclusions:

• The high prevalence of positive patch tests to Brazilian propolis warrants further investigation into its allergenic potential and cross-reactivity.
• Fragrance sensitization is a more probable cause for many positive propolis patch tests than true propolis allergy.
• Clear identification of propolis source material in studies is critical for accurate interpretation of contact allergy data.