SKIN REACTIONS TO COSMETIC PREPARATIONS 27 Brittle nails These may be the result of ill health, excessive housework or exposure to alkali and detergents, and excessive use of nail varnish and varnish solvents. 7 g gelatin daily by mouth improves the nails (37), as do local applications of glycerine. Paronychia A pyococcal invasion and infection of the nail folds, due to damage to the cuticles, either by manicuring, hard work or fibreglass, etc. Nearly all of the patients seen are females, so probably the first is the most important. Dystrophy of the nail plate is secondary to the paronychia. Discolouration Resorcin used in scalp lotions may react with the nitrocellulose lacquer producing an yellow-orange discolouration. •ercury locally, or by mouth, sometimes produces discolouration of the nails especially with coexistent dermatoses, and this is aggravated by exposure to light (38). Antibiotics, e.g. dimethylchlorotetracycline have produced photosensitivity of the skin with shedding of the nails, thought to be a phototoxic reaction. The nail plate offers poor protection against actinic radiation, and indeed may concentrate it, damaging the nail-forming part of the nail bed (30). Chlorotetracycline given to a pregnant woman produced yellow dis- ½olouration of the teeth and bones of the foetus (40). }V[ISCELLANEOUS COSMETIC PREPARATIONS Oral preparations Toothpastes and mouth washes sometimes cause soreness of the tongue and angular stomatiffs, more rarely dermatitis of the perioral skin or even the hand, often due to dichlorophene (preservative). •uch the same picture is seen from acrylic dentures. Likely sensitizing agents include flavour/rig and essentiM oils, e.g. pepper- mint, cinnamon, sassafras, clove, caraway, citrus oils, eugenol, aniseed, nutmeg and thyme. Peppermint lozenges can produce oral leuco-keratoses if sucked habitually in the same area over the years. The leuco-keratosis like that produced by cigars on the gums, is precancerous. Bath preparations Generalized skin irritation is sometimes seen from bath salts or antiseptics (Dettol), and from detergents in bath water. These contain perfume, colourants, Glauber or Epsom salts, sodium sesquicarbonate, borax and water-softening agents. Bubble effects are achieved by synthetic surface active detergents, and foaming agents in powder or liquid (5%).

28 JOURNAL OF THE SOCIETY OF COSMETIC CHEMISTS Dermatitis due to rubber sponges These are sometimes used for applying cosmetics. Dermatitis may be seen in any area according to the use made of the sponge, and is called constitutional or seborrhoeic. The agent is usually the rubber, and this can be confirmed by patch testing. Ch!oasma like pigmentation has also been described (41). Dermatitis due to silica hair curlers Sore fingertips in hairdressers, due to the penetration of the epidermis by silica fragments has been reported. Facial cleansing tissues impregnated with urea-formaldehyde have caused dermatitis. TREATMENT In cosmetic dermatitis, diagnosis is the important factor. Once the agent responsible for the reaction has been determined and eliminated, the dermatitis usually clears rapidly. Local applications of hydrocortisone or triamcinalone preparations, diminish irritation and by stopping scratching and rubbing, accelerate healing. If secondary infection is present, a com- bined steroid and antibiotic application is desirable. Systemic steroids are rarely necessary unless the dermatitis is severe and widespread such as that sometimes seen from pphenylene diamine hair dyes. Systemic antibiotics are rarely required. (Received.' $Oth August 1963) (1) (2) (3) (4) (5) (6) (7) (s) (9) (lO) (11) (12) (13) (14) (15) (16) (17) (18) REFERENCES A. Voidanova Ceshoslav. dermatol. 32 40 (1957) A. Rostenberg and M. B. Sulzberger .4. M..4. Arch. Dermatol. 76 330 (1957) N.J. Hjorth J. Soc. Cosmetic Chemists 10 96 (1959) E. J. Masters N.Y. State J. Med. 60 1934 (1960) C. D. Calnan Brit. Med. J. 226 (1956) F. Reiss Dermatologica 116 419 (1958) E. Sidi and J. Arouete Presse med. 67 2067 (1959) N.J. Hjorth Acta Dermato-Venereol. 41 46 (1961) S. Fregert and H. Rorsman Acta Dermato-Venereol. 40 206 (1960) G. Hodgson Practitioner 189 667 (1962) H. T. I-I. Wilson Brit. J. Dermatol. 67 291 (1955) D.C. G. Bert and C. D. Calnan Trans. St. John's Hospital Dermatol. Soc. 39 20 (1957) I. Sarkany Brit. J. Dermatol. 72 345 (1960) R. L. Baer Modern Trends in Dermatology 232 (1954) (Butterworths, London) S. M. Peck and E.G. Klarmann Practitioner 173 159 (1954) C. D. Calnan and I. Sarkany Trans. St. John's Hospital Dermatol. Soc. 39 28 (1957) I. Sarkany, R. I-I. Meara and J. Everall Trans. St. John's Hospital Dermatol. Soc. 45 39 (1961) C. D. Calnan Praxis 46 782 (1957)