What is ivp dye allergy
Lipsticks and other lip care products such as lipliners, lip balms/salves, lip gloss, lip plumpers and sunscreens can cause:
Cheilitis is the medical term for inflamed lips.
A basic lipstick is composed of the stick, emollient, solvent for the dyes, preservatives/anti-oxidants, perfumes/flavourings and colours. Further chemical agents may be added for gloss, water-resistance, sealant, cushioning, texture and richness.
Irritant contact cheilitis due to lip cosmetics
Irritant contact cheilitis is a diagnosis of exclusion, made when investigations for an allergic cause own been negative, the patient is not atopic and lip-licking (perlèche) has not been observed.
Manufacturers avoid well-known irritants, but mild irritants may still be present.
Some components of lip care products can be both irritant and allergenic. Examples of such irritants include olive oil, citral, shellac and cinnamon.
As with allergic contact cheilitis, there should be an improvement when the source of irritation is avoided. Lip licking in response to the dryness may continue an irritant dermatitis despite avoiding the original irritant.
What are the features of contact reactions to lip care products?
Lipsticks and other lip care products are the major causes of allergic contact cheilitis of the vermilion margin, where the skin and red lip meet.
Sometimes the reaction extends onto adjacentperioral skin, with or without the involvement of the angles of the mouth.
The reaction may present in either acute or more persistent chronic forms.
Acute allergic contact cheilitis may mimic contact urticaria, with swelling and little blisters within minutes of contact with the allergen.
The reaction may spread to the face and neck.
The chronic form, however, presents with redness, scaling or dryness, and itch. This may be associated with mild swelling. Typically it begins within hours of contact and may persist for days, weeks or months, if exposure to the allergen continues.
Pigmented allergic contact cheilitis has also been reported due to lipsticks.
How is allergic cheilitis to lip cosmetics diagnosed?
Patch testing is the investigation for contact allergy due to Type IV (delayed) hypersensitivity. Patch testing should include the baseline series and an extended series such as perfumes/flavourings and other components found in lip care products.
It is significant to also test the patient’s own products as in a significant number of cases the patient only reacts to these.
Many cosmetic companies are willing to co-operate with dermatologists to discover the specific allergen in their product. They will generally supply de-identified samples which can be used for patch testing and will then identify the chemical that gives a positive patch test. This means the patient knows what to avoid in future and provides the cosmetic company with feedback about a possible problem with their product.
It is not unusual for a patient to react to more than one allergen in lip care products.
Avoidance of the allergen generally results in resolution of the inflammation. Sometimes however there is more than one contributing factor to thecheilitis and it is, therefore, significant to be re-assessed if the cheilitis persists despite not using the identified product.
Allergens reported in lip care products
Eosin, or a contaminant of it, was the commonest allergen identified in lipsticks up until 1960.
Since then eosin has been used less often in lipstick formulations and is also more highly purified, so is rarely a problem now.
Ricinoleic acid, the main constituent of castor oil, has been identified in several large case series as the commonest current cause of allergic cheilitis due to lip cosmetics.
Some other allergens identified in lipsticks and lip care products as causing allergic cheilitis reactions:
- Perfumes and flavourings — perfume mix; Myroxylon pereirae (balsam of Peru); citral; cinnamaldehyde; peppermint oil; vanilla; geraniol;
- Solvent for dyes — castor oil
- Emollients — lanolin; castor oil; olive oil; almond oil; coconut oil; branched chain fatty acid esters such as glyceryl diisostearate, diisostearyl malate, glyceryl monoisostearate monomyristate; propylene glycol; oleyl alcohol; 12-hydroxystearic acid (major fatty acid in hydrogenated castor oil); isopalmityl diglyceryl sebacate (DGS) was synthesised as a replacement for castor oil in Japan and exported to other Asian countries, but not to Europe.
It is already being withdrawn from lipsticks and lip gloss.
- Nickel — from the metal casing
- Colours — D&C Yellow #11; D&C Red #7, 17, 21 (eosin), 36; Lithol Rubine BCA; quinazoline yellow
- Preservatives/anti-oxidants – propyl gallate.
Additional components may include:
- Gloss — colophonium and its derivative ester gum (main allergen believed to be glyceryl-1-mono abietate); propolis (and other propolis-related substances including cera alba, propolis cerus, beeswax acid, synthetic beeswax) is also used as an emulsifier and thickening agent in cosmetics
- ‘Anti-irritant agent’ — bisabolol (the main athletic ingredient in chamomile)
- Sealant — shellac
- Water-resistant film — polyvinylpyrrolidone/hexadecene copolymer (also used to improve stick integrity, give a wealthy feel and disperse the pigment)
- Cushioning/texture — di-isostearyl malate (fatty ester)
- Sunscreens — benzophenone-3
- Vitamin E
Allergic contact cheilitis due to lip cosmetics
Who gets allergic contact cheilitis due to lip cosmetics?
Lipsticks and lip care products are the commonest cause of allergic contact cheilitis in women.
And as the majority of patients presenting with cheilitis are women, this makes these products the most common overall source of allergens. Toy make-up may contain high levels of fragrances and metals, above those recommended for cosmetics, and may frolic a role in sensitization. Lipsticks are regarded as moderate-risk cosmetics for the development of allergic reactions.
Contact urticaria due to lip plumpers
Lip plumpers are cosmetics used to increase the apparent volume of the lips either by vasodilation or hydration. Vasodilation may be achieved by one of three mechanisms:
- Nonimmunological contact urticaria is the most frequent immediate contact reaction and is due to cinnamon and cayenne pepper affecting prostaglandin metabolism.
It may resemble irritant contact cheilitis clinically.
- Irritant contact cheilitis is the most common reaction to spices such as cinnamon and cayenne pepper which act on receptors that release substance P.
- Direct vasodilation effect from benzyl nicotinate, L-arginine.
Lip swelling is the desired effect following use of lip plumper. However, a kiss soon after application of the product may result in an unintended transfer of the reaction.
If your doctor has ordered you to own a medical imaging exam, you may own a test that uses contrast dye. Contrast dye (also called medical imaging contrast, or contrast agent) is a substance radiologists use that acts love a dye.
But receiving contrast dye isn’t love going to the hairstylist—it won’t change the color of your organs and bones!
Contrast Dye – What It Does and Why You Need It
Contrast dye—sometimes referred to as medical imaging contrast, contrast materials or contrast agent—is a substance that radiologistsuse to see your organs and tissues more clearly in your medical images. It’s helpful of love a dye in the way that it temporarily changes how your insides appear on a medical image, but it won’t change the color of anything and it won’t hurt you.
You might need contrast when you are having an X-ray, CT, MRI, or ultrasound exam.
It can be an iodine-based material, barium-sulfate, gadolinium, or saline and air mixture that can be swallowed or injected intravenously.
Contrast distinguishes, or “contrasts,” between organs, tissues, bones, or blood vessels during your imaging exam. It doesn’t change any of these things, but it changes how your X-ray, CT, or MRI scan sees them.
Contrast is significant because it helps radiologists distinguish between normal and abnormal conditions.
This helps them to see what’s going on inside of you better.
In turn, this allows them to make a more precise diagnosis, and recommend the best treatment for your specific case. In cases where it is needed, contrast ultimately leads to better care.