Risk factors and common contact allergens in facial allergic contact dermatitis patients

BACKGROUND: Facial dermatitis is commonly encountered in dermatologic practice. It is sometimes difficult to manage because its causative factors may be multiple and difficult to diagnose. OBJECTIVES: This study was designed to identify the characteristics, patch test results, and final diagnoses of facial dermatitis patients who were referred to a contact dermatitis clinic and to identify factors associated with facial allergic contact dermatitis (ACD). METHODS: We retrospectively reviewed case records of facial dermatitis patients who underwent patch testing at the clinic during the period from July 2006 to June 2011. RESULTS: Of the 891 patients patch-tested, 244 (27.4%) had facial dermatitis. Female patients were 9.1 times more predominant than male patients. The mean ± standard deviation age of patients was 37.3 ± 14.8 years. A total of 199 (81.6%) patients demonstrated at least one positive reaction to a patch test, 66.7% of which were clinically relevant. Allergic contact dermatitis was diagnosed in 45.5% of patients. Independent factors predisposing towards facial dermatitis were female sex, having a previous history of cosmetic allergy, a positive patch test reaction to hairdressing product-related allergens, and a positive allergic reaction to preservative allergens. CONCLUSIONS: The prevalence of facial dermatitis was 27.4%. Almost half of all patients with facial dermatitis demonstrated ACD. Factors associated with facial ACD were female gender, a history of cosmetic allergy, and positive patch test reactions to hairdressing product-related allergens and preservatives.