Baby wipes and allergic contact dermatitis

A preservative used in disposable baby wipes and other products is causing an increasing number of cases of allergic contact dermatitis.

Methylisothiazolinone (MI) has been used in a range of cosmetic and personal products, including disposable wet wipes, shampoos, conditioners, body washes, moisturisers, sunscreens and deodorants, as well as in paints, cooling tower water and cutting oils since the early 2000s.

Dr Jennifer Cahill, a dermatologist with the Skin and Cancer Foundation inc, and her team, have included MI in their baseline patch test series for allergies since 2011, after European reports of increased numbers of cases of MI contact allergy.

“Our current rate of positive test reactions to MI to November 2013 is 11.3% (40 patients who had relevant reactions of a total 353), compared with a rate of 3.5% (15/428) in 2011 and 8.4% (38/454) in 2012”, Dr Cahill wrote.

“MI is now the most common cause of allergic contact dermatitis in our patient population.”

Preservatives like MI are needed in moist wipes and other water-based products to prevent bacterial contamination.

“Interestingly it is parents using baby wipes on their children who are presenting with hand dermatitis, although it is likely that allergic contact dermatitis involving the groin in children may not be diagnosed accurately”, Dr Cahill wrote.

“Medical practitioners and consumers should be aware of the potential for allergic contact dermatitis to develop to MI from wipes, in particular causing persistent hand dermatitis.”

People with unexplained rashes should check the label of ingredients and see if it contains MI, said co-author Associate Professor Rosemary Nixon. They should then try an alternative product which does not contain MI. If their rash persists, they should see their GP.

Common Questions

WHAT ARE THE SYMPTOMS?

Allergic contact dermatitis (ACD) commonly presents as an itchy red rash on the hands.

IS IT CAUSING NAPPY RASH?

It is possibly contributing to nappy rash, but there are many factors which contribute to nappy rash (for example, contact with urine, faeces, sweating, thrush). However, it is the parents of the babies who are being referred by their dermatologists for specialised allergy testing (patch testing) to determine the cause of their hand dermatitis, not the babies.

WHAT PRODUCTS CURRENTLY USE MI?

MI is a preservative used in water-based products. While wet wipes are our most common source of MI, it is also found in other wipes, such as those used for make-up removal, some deodorants, moisturising lotions, cosmetics, shampoos, conditioners, body washes, work skin cleansers and  sunscreens.

ALL BABY WIPES OR SPECIFIC BRANDS?

Not all baby wipes use MI as the preservative. Manufacturers are now starting to move away from using MI because of the problems that it is causing.

SHOULD MI BE REMOVED FROM THESE PRODUCTS?

Yes, that is our recommendation. There are a range of alternative preservatives that can be used instead. In December 2013, the Scientific Committee for Consumer Safety  of DG Sanco, European Commission, recommended that MI should not be used in leave-on cosmetic products and restricted to 15ppm in rinse-off products.

CAN PARENTS LOOK FOR ALTERNATIVES? ARE THERE MI FREE BABY WIPES?

Yes there are.

WHAT ARE THE KEY RECOMMENDATIONS FROM THE STUDY?

This is a report of our findings published in the medical journal, which is an observational study.

WHAT IS RECOMMENDED TO REPLACE MI?

There are a range of alternative preservatives that can replace MI, including parabens.

HAVE YOU RAISED THIS WITH THE AUTHORITIES?

Yes. We have spoken to the ACCC addressing it as a consumer safety matter. We have also alerted NICNAS (National Industrial Chemicals Notification and Assessment Scheme).

 HAVE YOU BEEN IN TOUCH WITH THE MANUFACTURERS OR THE RETAILERS?

Yes, and many of them are taking steps to make the changes and remove MI from their products.

 WHO HAS NOT?

That’s a question best addressed with the retailers or the ACCC. We are medical researchers and this question is really one for the regulators or the retailers.