Is benzyl alcohol a significant contact sensitizer?

J Eur Acad Dermatol Venereol. 2022 Jun;36(6):866-872. doi: 10.1111/jdv.17968. Epub 2022 Feb 25.

Abstract

Background: Benzyl alcohol is a widely used preservative, solvent and fragrance material. According to published data, it is a rare sensitizer in humans.

Objectives: To identify characteristics and sensitization patterns of patients with positive patch test reactions to benzyl alcohol and to check the reliability of the patch test preparation benzyl alcohol 1% pet.

Patients and methods: Retrospective analysis of data from the Information Network of Departments of Dermatology (IVDK), 2010-2019.

Results: Of 70 867 patients patch tested with benzyl alcohol 1% pet., 146 (0.21%) showed a positive reaction, most of them (89%) only weakly positive. The number of doubtful and irritant reactions significantly exceeded the number of positive reactions. Reproducibility of positive test reactions was low. Among benzyl alcohol-positive patients, compared to benzyl alcohol-negative patients, there were significantly more patients with leg dermatitis (17.8% vs. 8.6%), more patients aged 40 years or more (81.5% vs. 70.5%) and more patients who were tested because of a suspected intolerance reaction to topical medications (34.9% vs. 16.6%). Concomitant positive reactions were mainly seen to fragrances, preservatives and ointment bases.

Conclusions: Sensitization to benzyl alcohol occurs very rarely, mainly in patients with stasis dermatitis. In view of our results, benzyl alcohol cannot be regarded as a significant contact allergen, and therefore marking it as skin sensitizer 1B and labelling it with H 317 is not helpful.

MeSH terms

  • Allergens / adverse effects
  • Benzyl Alcohol / adverse effects
  • Dermatitis, Allergic Contact* / epidemiology
  • Dermatitis, Allergic Contact* / etiology
  • Humans
  • Patch Tests / methods
  • Perfume* / adverse effects
  • Preservatives, Pharmaceutical / adverse effects
  • Reproducibility of Results
  • Retrospective Studies

Substances

  • Allergens
  • Perfume
  • Preservatives, Pharmaceutical
  • Benzyl Alcohol