A preservative causing an epidemic of skin allergy is to remain in a range of cosmetic products, despite a widespread call for it to be banned, it has emerged today.

According to a decision made by the EU Commission, Methylisothiazolinone (MI) will be removed from products left on the skin, except for those used on the hair and scalp. However it will not be banned from products that are rinsed off the skin, and nor will its permitted concentration in these products be reduced.

It has been a year since dermatologists first warned the public about a contact allergy epidemic in the UK, largely stemming from the use of MI as a chemical preservative in cosmetic products. In addition to this latest EU ruling, new research is being presented from tomorrow at the British Association of Dermatologists’ Annual Meeting in Glasgow tomorrow, warning about the use of the chemical in other products, such as paints and detergents, as well as in the workplace, as the epidemic shows no sign of abating.

This decision not to ban the chemical outright in cosmetic products will further inflame the problem.

MI is widely used, either on its own or in combination with methylchloroisothiazolinone (MCI), as a preservative in personal care products such as moist tissue wipes, cleansers, shower gels, deodorants and shaving foam. However, it can also be found in everyday professional and household products such as detergents, paints and glues.

Since last July, when the British Association of Dermatologists first raised the issue, several new studies have been conducted.   At the time, a team at the Leeds Centre for Dermatology showed a sharp rise (up to 6.2 per cent sensitivity) in contact allergy to MCI/MI and MI over the previous three years. This, combined with other studies released by the British Association of Dermatologists, prompted a public outcry about the continued use of the chemical.

In December 2013, in response to pressure from dermatologists, Cosmetics Europe, the European cosmetics trade association, recommended to all its members that MI should be immediately removed from all leave-on skin products and personal care products, including cosmetic wet wipes, without waiting for action from regulators.

In practice, however, many leading household name cosmetic products containing MI have remained on the shelves during the last six months and are now likely to do so for the foreseeable future. MI continues to feature in a wide range of household and industrial products, often without sufficient labelling.

Prior to 2005, MI had to be mixed with MCI and was generally found in concentrations of around four parts per million (ppm) in personal care products. However, from 2005 MI was permitted for use on its own in far higher concentrations – up to 100 ppm – which is a 25-fold increase on the previous levels of the preservative and widely thought to be responsible for the disease increase.

The Scientific Committee on Consumer Safety of the European Union recommends limiting the concentrations of MI in rinse-off products, such as shower gels, to 15 parts per million (ppm). This has not been upheld in the decision by EU Commission’s decision.

MI Research presented at the BAD Annual Conference, 30th June to the 3rd July 2014

MI in paint causing acute facial dermatitis and difficulty breathing:

Dermatologists from University Hospital Lewisham and St John’s Institute of Dermatology have identified MI in paint as a serious potential public health concern. Exposure to paints with MI can trigger reactions in those already sensitised to the allergen, as well as causing those with no history of allergy to MI to be reactive.

To illustrate the problem, the researchers used the case of a 52-year-old woman who presented with severe facial eczema and difficulty breathing, caused when she repainted her living room. She had no past medical history of asthma or other respiratory conditions. The symptoms started with an itchy rash over the cheeks, which progressed to involve the entire face, eyelids, upper chest and dominant hand.

After initial treatment, the patient then suffered a further flare-up of her symptoms when she tried to continue painting her living room, not knowing this was the trigger for her reaction, and her breathing difficulties became so serious that she required emergency treatment. The use of MI in the paint was eventually identified as the cause of the reaction; however, the patient had to avoid her living room for the next two months.

Dermatologist Dr Wisam Alwan, one of the authors of the study, said: “Lack of necessary regulation regarding the use of MI in paint means there is no current maximum permitted concentration and no requirement to label MI as an ingredient.

“As with its use in cosmetics, urgent action is required to assess and manage the risk of including MI in paints and other non-cosmetic products. At the very least, MI should immediately be classified as an allergen with the potential to cause serious harm to human health and it needs to be regulated. It also needs to be identified in all product labelling. Given the serious reactions seen with MI exposure from paints, its use should be restricted and alternative, safer preservatives should be considered.”

MI an occupational health hazard:

Scientists from the Leeds Centre for Dermatology and the Faculty of Medical and Human Sciences at the University of Manchester are presenting research identifying MI and MCI as an occupational health risk. This research is backed-up by a case presented by dermatologists from The Royal United Hospital, Bath, of two workers from the same furniture factory who presented with allergic contact dermatitis (eczema) caused by MI in glue.

In the Leeds study, an analysis of the data from 1996 to 2012 regarding occupational skin disease caused by MCI and MI, across a range of professions, showed a 4.1% annual increase in the number of cases. This included a 3.8% increase in workers exposed to personal care products, with the greatest increases in healthcare workers (8.1%) and beauty workers (6.6%). There was also a 6.3% increase among manufacturing workers.

In the second study, two men, working at the same furniture factory under identical conditions, both suffered for almost two years from severe allergic contact dermatitis due to MI in the glue they used to assemble the furniture.

Dr Rachel Urwin, of the Leeds Centre for Dermatology and one of the authors of the first study, said: “This research shows that a review of regulations in an industrial setting is needed. There is currently little guidance and an improvement in labelling would allow workers to protect themselves against contact allergy from MI.”

Dr Deirdre Buckley, Consultant Dermatologist at The Royal United Hospital, Bath, said: “These cases add to the evidence that MI can be a significant occupational allergen, and suggest that limitation of the exposure concentration in industrial products may be advisable. It is reasonable for workers to expect to work in conditions which are not detrimental to their health.”

Speaking of the latest EU ruling, Dr David Orton of the British Association of Dermatologists said: “I am extremely disappointed at this decision and remain concerned for all UK consumers, both adults and children. The ban on the use of MI in leave on cosmetics was requested over a year ago and even industry’s own representative body, Cosmetics Europe, suggested this six months ago. Yet these products remain on the shelves even today. There is no argument that these sorts of products sensitise people, so every day more people will be sensitised and have the capacity to react to MI. Dermatologists unequivocally know such sensitised people will react to MI at concentrations of only 50 parts per million (ppm) so it is not joined-up thinking to continue to allow rinse-off products to be sold at concentrations of 100 ppm. It allows continued severe allergic reactions to highstreet cosmetics to occur.

The data supplied by the cosmetics industry lobby to the European Parliament is a predictive tool which is not uniformly accepted  and it is being used in a retrospective fashion. UK and European citizens continue to be industry’s guinea pigs. I urge them to put the health of their consumers first.”

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The conference will be held at SECC in Glasgow from July 1^st to 3^rd 2014, and is attended by approximately 1,300 UK and worldwide dermatologists and dermatology nurses.

For more information please contact: Matt Gass, Communications Officer, on 020 7391 6084 or atmatthew.gass@bad.org.uk