Yesterday, a simple email landed in my inbox, propelling me into the possible link between deodorants and vitiligo. The core question at hand: "Could our everyday deodorant swipe influence vitiligo?"

We rely on deodorants to combat body odor. They promise to keep us fresh and smelling good, by halting the bacteria that break down sweat in our armpits. Deodorants contain antibacterial agents, such as triclosan and aluminum salts, which certainly do their job. They don't mess with the natural and helpful bacteria on our skin, but some links have been drawn between these agents and the onset of various diseases, including Alzheimer.

But let’s zoom on vitiligo, particularly in the context of allergic contact dermatitis. Vitiligo involves skin depigmentation, and 'contact vitiligo' specifically refers to depigmentation resulting from repeated chemical exposure, primarily phenolic and catecholic derivatives. There's a distinction to be made between 'contact leukoderma' and 'contact vitiligo.' Contact leucoderma is a type of localized depigmentation stemming from prolonged chemical exposure, possibly accompanied by allergic contact dermatitis; it generally resolves once the chemical agent is avoided. In contrast, contact vitiligo arises from recurrent chemical exposure and results in persistent skin depigmentation. 

The scientific community first documented a case of this nature in 1939, attributing it to monobenzyl ether of hydroquinone in rubber gloves. Various other chemicals, including phenols, catechol derivatives, hydroquinone, and even metals, have since been identified as potential triggers for vitiligo onset.

A noteworthy allergen is nickel, recognized as one of leading causes of contact allergies. From jewelry to eyeglasses to even the paint on our walls, this silent disrupter is everywhere. The typical allergic response, known as allergic contact dermatitis, manifests as eczematous dermatitis at the contact site. However, other manifestations like vitiligo-like lesions or systemic contact dermatitis can also occur. Sensitivity to nickel is a tricky business, diagnosed typically through patch testing. Yet, the cure is simple: avoid and look for alternatives.

With the backdrop of this understanding, the question arises: could deodorants influence vitiligo via the allergic contact dermatitis mechanism? There's a whisper in the medical community about this, but not enough solid evidence. 

Most contact allergies from deodorants come from the fragrances and preservatives they contain.  

According to the so-called "26 allergens rule" (Article 1 (10) of Directive 2003/15/EC), twenty six supposedly allergenic fragrances must be listed on the containers of cosmetics products if they are present above certain mass percentages in the product. A recent study in Germany found that a staggering 80% of deodorants listed at least one of these allergens on its label. However in markets like India, unspecified “fragrances" finds its way into nearly three out of every four cosmetic products without explicit acknowledgment. 

To put it plainly: deodorants, with their mix of chemicals, can potentially trigger allergic reactions, which could influence or worsen vitiligo. 

Choose wisely, and always stay informed. Your body, your responsibility.

Yan Valle

 

P.S. In case you wonder, here is the full list of 26 substances that have to be identified on products, their usage and limit are regulated by IFRA:

1. Alpha isomethylionone
2. Amyl cinnamal (Jasmonal A)
3. Amyl cinnamyl alcohol
4. Anisyl alcohol
5. Benzyl alcohol
6. Benzyl benzoate
7. Benzyl cinnamate
8. Benzyl salicylate
9. Butylphenyl methylpropional (Lilial)
10. Cinnamal
11. Cinnamyl alcohol
12. Citral
13. Citronellol
14. Coumarin
15. Eugenol
16. Farnesol
17. Geraniol
18. Hexyl cinnamal (Jasmonal h)
19. Hydroxycitronellal
20. Hydroxyisohexyl 3-cyclohexene carboxaldehyde (Lyral)
21. Isoeugenol
22. Limonene
23. Linalool
24. Methyl 2-octynoate
25. Evernia furfuracea (Treemoss) extract
26. Evernia prunastri (Oakmoss) extract
     

Unsurprisingly, 1-3% of Europeans show allergic reactions to common fragrance ingredients. In 2012, the Scientific Committee on Consumer Safety (SCCS) released its scientific opinion on fragrance allergens. Annex II of the regulation states that over 1300 different substances are prohibited in cosmetic goods, including Lyral, atranol, and chloroatranol. Of all these substances, the ban of Lyral caused a stir, as many fragrances contain this chemical. Products with these substances should have been taken off the EU market before 23 August, 2021 but may be occasionally found in the stores today.