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Dermatitis : Contact, Atopic,... 2023Lanolin is a complex mixture of high molecular weight esters, aliphatic alcohols, sterols, fatty acids, and hydrocarbons that has been widely used for centuries for its...
Lanolin is a complex mixture of high molecular weight esters, aliphatic alcohols, sterols, fatty acids, and hydrocarbons that has been widely used for centuries for its emollient properties. The purification of crude lanolin into lanolin wax and the processing of this wax into various derivatives began in 1882 and continue to this day with newer highly purified anhydrous lanolins. Controversy as to lanolin's allergenicity began in the 1920s and remains an issue. The most appropriate patch test preparation(s) for detecting allergy remain disputed. Detection of lanolin-induced contact dermatitis in diseased skin by patch testing on normal skin may lead to false negative results. Patients with a positive patch test to lanolin may tolerate use of lanolin on normal skin. Although lanolin is a weak sensitizer and the frequency of contact allergy to it in the European population reportedly is 0.4%, there are high-risk concomitant conditions: stasis dermatitis, leg ulcers, perianal/genital dermatitis, and atopic dermatitis (AD). Children and the elderly are also at greater risk of developing contact allergy to lanolin, partly because of comorbidities (AD and stasis dermatitis/leg ulcers, respectively). Finally, in the United States, non-Hispanic white patients are more likely than their non-Hispanic black counterparts to be lanolin allergic.
Topics: Child; Humans; Aged; Lanolin; Dermatitis, Allergic Contact; Allergens; Dermatitis, Atopic; Patch Tests; Leg Ulcer
PubMed: 36917502
DOI: 10.1089/derm.2022.0002 -
Dermatology (Basel, Switzerland) 1996Several puzzling aspects of the use of lanolin are discussed as "lanolin paradoxes', in analogy with the 'paraben paradoxes'. Lanolin in topical therapeutic agents... (Review)
Review
Several puzzling aspects of the use of lanolin are discussed as "lanolin paradoxes', in analogy with the 'paraben paradoxes'. Lanolin in topical therapeutic agents sensitizes a high proportion of patients, whereas the same lanolin is 'safe' in cosmetics so widely used by millions of individuals. Patients with an allergic contact dermatitis to lanolin in a medication applied to a stasis ulcer can nevertheless use lanolin-containing cosmetics and not experience a reaction. Lanolin-sensitive individuals often show false-negative patch test reactions to unaltered lanolin. Patch testing with 30% wool wax alcohols used in the standard patch test tray cannot be considered a reliable method for detecting and confirming lanolin allergies. There are too many false-positive and false-negative results using the standard patch test tray.
Topics: Cosmetics; Humans; Hypersensitivity; Lanolin; Patch Tests
PubMed: 8726630
DOI: 10.1159/000246365 -
Buffalo Medical and Surgical Journal Apr 1886
PubMed: 36665790
DOI: No ID Found -
The Hospital Aug 1890
PubMed: 29826956
DOI: No ID Found -
Contact Dermatitis Sep 1998Lanolin has the reputation of being an important contact sensitizer. The market place abounds with products that are labeled "lanolin free". In fact, lanolin is at most... (Review)
Review
Lanolin has the reputation of being an important contact sensitizer. The market place abounds with products that are labeled "lanolin free". In fact, lanolin is at most a weak contact allergen. The supposed hazards of sensitization to lanolin products are a resultant of faulty science and failure to appreciate the limitations of patch testing. Lanolin allergy is a myth created mainly by overzealous professional patch testers. No one has succeeded in sensitizing animals or humans to lanolin or wool wax alcohols. Most of the case reports are false positives, in association with the angry back syndrome.
Topics: Dermatitis, Allergic Contact; False Positive Reactions; Humans; Lanolin; Ointment Bases; Patch Tests
PubMed: 9771981
DOI: 10.1111/j.1600-0536.1998.tb05856.x -
Dermatitis : Contact, Atopic,... 2008Allergy to lanolin has been recognized by dermatologists for decades. This review summarizes the history, epidemiology, and allergenicity of lanolin and its derivatives.... (Review)
Review
Allergy to lanolin has been recognized by dermatologists for decades. This review summarizes the history, epidemiology, and allergenicity of lanolin and its derivatives. "The lanolin paradox" and the safety of pharmaceutical-grade lanolin products are also discussed.
Topics: Allergens; Animals; Dermatitis, Allergic Contact; Dermatologic Agents; History, 19th Century; History, 20th Century; History, Ancient; Humans; Lanolin; Patch Tests; Reproducibility of Results; Risk Factors; Wool
PubMed: 18413106
DOI: No ID Found -
British Medical Journal Nov 1896
PubMed: 20756567
DOI: 10.1136/bmj.2.1871.1376 -
Hall's Journal of Health Oct 1886
PubMed: 36491596
DOI: No ID Found -
Dermatitis : Contact, Atopic,...Lanolin is an important cause of allergic contact dermatitis.
BACKGROUND
Lanolin is an important cause of allergic contact dermatitis.
OBJECTIVES
The aims of this study were to describe the epidemiology of lanolin allergy and to assess trends in patch test reactions to lanolin over time.
METHODS
This study used a retrospective analysis of patients patch tested with lanolin alcohol 30% or Amerchol L-101 50% in petrolatum by the North American Contact Dermatitis Group between 2001 and 2018 (n = 43,691).
RESULTS
Overall, 1431 (3.3%) had a positive reaction, and 1238 (2.8%) were currently relevant. Prevalence of lanolin allergy was 4.63% between 2011 and 2018 (P < 0.0001). Most lanolin-allergic patients had + (52%) reactions; 18%, and 6% had ++ and +++ reactions, respectively. Common primary anatomic sites of dermatitis were the hands (20.7%), scattered/generalized distribution (19.6%), and face (17.0%). Allergic reactions to lanolin were more common in children (4.5%) than in adults (3.2%, P = 0.0018). Compared with nonallergic patients, lanolin-allergic patients were more likely to have history of eczema or hay fever, male sex, older than 40 years, or Black race (P < 0.05). Common lanolin sources were personal care products and drugs/medications. Only 2.24% of the positive reactions were linked to occupation.
CONCLUSIONS
Lanolin sensitivity was common. Reactions were often clinically relevant and linked to personal care products and medications.
Topics: Adult; Allergens; Child; Cosmetics; Dermatitis, Allergic Contact; Humans; Lanolin; Male; North America; Patch Tests; Retrospective Studies
PubMed: 35481824
DOI: 10.1097/DER.0000000000000871