484 JOURNAL OF THE SOCIETY OF COSMETIC CHEMISTS of the sensitizer in the soap may be very low. I am inclined to add "it is therefore necessary to test the ingredients separately in appropriate non-toxic, but higher concentrations". What is your opinion about this? THE LECTURER: I am inclined to agree with you about inserting such a sentence. One of the reasons I did not do so was that there are so many ingredients in many of these cosmetics that it does become quite a labour. Also the exact composition of many of them is, as you know, not precisely known, but in general I would agree with this principle. MR. N.J. VA• ABBg: Do you accept the view expressed by Professor Kligman that there are all grades of "irritancy" between that of a definite primary irritant and of a true sensitizer? Would you also support his scheme of testing for sensitization whereby the skin is initially pre-disposed to react by treatment with a known irritant? Tn• L•-CTUR•R: I agree entirely that there is no distinction between an irritant and a sensitizer and, in fact, while some may be only irritants and some may be only sensitizers, there are many which are both. I disagree most profoundly that there is no difference between the body reaction to an irritant and the body response to a sensitizer. In fact, the differentiation is based on the body response rather than on the chemical concerned. I do not quite know how to take this idea of irritating the skin beforehand there is evidence that if you produce irritation beforehand, at the right time thereafter you can get an enhanced response but at a certain time. you can get a diminished response. In this respect you can also get a potent sensitizer masking the effect of a less potent one. DR. T. J. E•.•.•OTT: In the last year or two there has emerged a number of ranges of so-called hypoallergenic (or non-allergic) cosmetics, and I am wondering whether the incidence of either real or imagined allergy is more widespread than comes to the attention of the dermatologist. In other words, do women only go to the derma- tologist when they have severe incidence of allergy, and is there more widespread inconvenience due to the use of cosmetics than we know of? If one takes your tribute, then really there ought not to be a need for special brands of cosmetics which are not allergic--to me this seems to be an obvious contradiction? Tn• L•CTURER: This is a good point and I just do not know the answer. MR. J. M. B•.AIrEWA¾: With reference to Dr. Elliott's point, I think the answer may be in the market place. Are these cosmetics making any impact on the market? I rather doubt that they are making any spectacular inroads into normal cosmetics I believe they derive from the U.S.A. where there tend to be rather more hypo- chondriacs than there are in Great Britain. A M•MBER OF TI• Am)IE•CE: In Liverpool we have been making a survey of cosmetic contact eczema over the last three years, and we have found a fairly large proportion of patients who have had positive patch tests, particularly to lanolin and parabens. I think it is true to say that well over half of the patients have probably developed their sensitivity to these materials because they are basically eczematous subjects who have been using these substances in either topical steroids or other local preparations.

CONTACT ALLERGY 485 MR. M. W. HINDLE: In the United Kingdom, I imagine, there is a great deal of over-the-counter buying of antihistamine creams for the treatment of certain urticarial rashes. Are there any dangers in this? THE LECTURER: It depends on the cause of the urticaria. If it is someone who gets midge bites or something similar, it will help, but otherwise I think the person should be consulting a doctor. MR. R. F. L. THOMAS: Have you come across any cases of members of the public who have developed an allergy after years of exposure to any particular material? Has there been any sign of repeated insult and slow loss of resistance by the body finally leading to the classical symptoms? THE LECTURER: This is one of the great paradoxes about allergy in that--and one sees this particularly in industrial situations where a person can be exposed to a material for years, have no rouble and then for some unknown reason, he will develop an allergy to this material. The converse is true, that allergies may go with continued exposure. For this one can think up some sort of plausible explanation, but why at any one moment of time a person will suddenly develop an allergy to a material to which he has been exposed for many years, I just do not know, but it does happen. DR. I. W. JAMIESON: What is your opinion of using panels of so-called dermatitis or eczema-prone subjects for testing cosmetics, in view of the difficulties of picking up sensitivity in normal populations? TIlE LECTURER: I think this is a bit immoral, and whether they are going to give you the right answer is another question. I think they may give you the answer as to what is going to happen in eczema-prone people when they are exposed to product X, but this is only a limited answer.