Propylene glycol: an often unrecognised cause of allergic contact dermatitis in patients using topical corticosteroids

Propylene glycol (PG) is used in many personal care products and pharmaceutical preparations: a colourless, viscous, nearly odourless liquid that is used as an intermediate for the synthesis of other chemicals. It is commonly found in topical corticosteroids, which are used to treat various inflammatory skin disorders. Skin reactions to PG are mostly irritant, but allergic contact dermatitis can also be caused by PG.

There is a difficulty in determining whether someone may be allergic to PG, because of finding the ideal concentration of PG for patch testing which would be non-irritating but elicit an allergic reaction. Allergic contact dermatitis (ACD) should be suspected if the dermatitis worsens or does not improve during treatment.

An investigation by the North American Contact Dermatitis Group (NACDG)* found that topical corticosteroids were responsible for 18% of the positive patch test reactions to PG, and another study** found PG to be the most common allergen in topical corticosteroids.

*Warshaw EM, Botto NC, Maibach HI, et al. Positive patch-test reactions to propylene glycol: a retrospective cross-sectional analysis from the North American Contact Dermatitis Group, 1996 to 2006. Dermatitis 20(1):14-20 (2009 Jan-Feb).
** Coloe J, Zirwas MJ. Allergens in corticosteroid vehicles. Dermatitis 19(1):38-42 (2008 Jan-Feb).

Source: Skin Therapy Letter

May 2011

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