Allergic Risk of Moisturising Cosmetic Products: A Study on the Composition of 300 Products Commercialised in Tunisia

BACKGROUND: Moisturising cosmetic products (MCP) formulations may contain ingredients known to trigger allergic contact dermatitis. Claims such as 'hypoallergenic' or 'fragrance-free' are commonly used in marketing, yet these terms are not consistently regulated, potentially posing a risk for patients with allergic contact dermatitis. OBJECTIVES: To assess the allergenic potential of moisturisers by analysing their ingredients and determining the prevalence of contact allergens. METHODS: A survey conducted between April and June 2023. MCPs were collected from supermarkets and pharmacies. Data analysis focused on allergen prevalence and product origin. All products were systematically screened for seven targeted allergenic components by reviewing their ingredient labels (INCI): isothiazolinones, phenoxyethanol, formaldehyde and its releasers, lanolin, fragrances, parabens and propylene glycol. All allergens included in our study were systematically searched for all relevant synonyms in both English and French. RESULTS: Three hundred products were analysed, including 153 items (51%) from supermarkets and 147 (49%) from pharmacies. Fragrances were the most frequently identified allergens, present in 84.7% of formulations. Only 15.3% of products were free from fragrances and plant extracts. Among those labelled 'fragrance-free', 86.8% (46 of 53) were truly free of fragrances. Isothiazolinones were found in 7% of products, predominantly in leave-on formulations and locally manufactured brands. Formaldehyde-releasing agents were detected in 10.3% of products, with higher prevalence in supermarkets and leave-on items. Parabens were present in 10.7%, including two products with hydroxybenzoate. Propylene glycol was identified in 28% of products; still, 24.3% (18 of 74) of hypoallergenic-labelled products contained it. Phenoxyethanol appeared in 37.7% of formulations and was more common in supermarket-sold products. Lanolin was found in 2.7% of the products. CONCLUSION: The study highlights a high prevalence of contact allergens in MCPs, including those marketed as hypoallergenic.