Skin Adverse Reactions PDF

**4.0 ADVERSE REACTIONS** This section intends to give a clear, general understanding of the type of reactions that can be experienced when using cosmetics and an ability to assess if a particular ingredient or product is appropriate for a specific individual. Two of the more frequent types of reac...

**4.0 ADVERSE REACTIONS** This section intends to give a clear, general understanding of the type of reactions that can be experienced when using cosmetics and an ability to assess if a particular ingredient or product is appropriate for a specific individual. Two of the more frequent types of reactions observed in skin care are irritation and allergy. **4.1 Irritations** **[Basic or Simple Irritation]** Irritation can range from a simple, small, pale-red patch of skin to a large area that is intense crimson red in color. Skin irritation only appears in the area where a product has been applied and usually develops within 6 to 24 hours after product use. In the event a person develops this type of reaction they should; i. wash the product off the skin as soon as possible ii. Discontinue product use until the reaction completely disappears, usually within 72 to 96 hours. It is recommended that those who are very upset about the reaction, contact their doctor or dermatologist. Usually this type of reaction can be suppressed with a topical anti-itch and/or anti-inflammatory cream. **[Cumulative Irritation]** Cumulative irritation is something that occurs after continued product use. There will be no signs of irritation for three or more days and suddenly a reaction will occur. The skin will react in the same manner as basic or simple irritation described earlier and the product should be washed off and discontinued until the reaction has subsided. These types of reactions are more common when one or more products are being used at the same time. Often the skin can tolerate one or more products for a few days, but over time it becomes less tolerant and an irritation reaction occurs. For this reason, skin care professionals should consider contacting a client three to seven days after beginning a new skin care regime to ensure that the products are being tolerated and used correctly. **[Chemical Folliculitis]** Chemical folliculitis is a form of irritation that is commonly confused with acne. Like cumulative irritation, these reactions usually arise when clients use multiple products. However, instead of getting a rash or redness they develop small bumps. The reaction usually entails a cluster (10 to 20 small blemish-like lesions) that can appear red or white in color and can be filled with fluid. These lesions are inflammatory in nature and are not white or blackheads (non-inflammatory lesions or comedones). In cases of chemical folliculitis, stop all product use until the reaction is gone and then start using one product at a time. For example, the skin care regime can be resumed using the cleanser morning and night for the first week. If no reactions occur, the next product can be added the following week, for example a moisturizer after cleansing. If still no problems are observed when using two products, a third product can be reintroduced, and so on, leaving about a week in between each additional product. The schedule of product introduction can be adjusted according to the individual. If a person is very sensitive, the cleanser can be used once a day for the first week and twice a day the second, and in the third a moisturizer can be added to the mix, and so on. **[Subjective Irritation Reactions: Burning/Stinging/Itching]** Burning, stinging, and itching are subjective irritation reactions that are considered sub-clinical in nature, i.e., not visible to the eye. It is not clear why people experience this type of reaction; however, there is a direct correlation between subjective irritation reactions and a drop in temperature and humidity in the air. More specifically, when the climate goes from warm to cold and there is less humidity or moisture is in the air---in winter, for example---there is an increase in the amount of skin burning, stinging, and itching complaints. For these types of reactions, minimizing the number of products used, as described for chemical folliculitis, and/or using a simple cleanser with a heavy moisturizer such as a barrier cream can be helpful until the skin acclimates to the changes in the environment. **4.2 Allergic Reactions** Allergic reactions are often very complex and can be difficult to determine. Therefore, it is always best to leave it up to experts---for instance allergists or dermatologists---who are familiar with "Contact Dermatitis Patch Testing." There are several types of allergic reactions with many different mechanisms of action. Three of the most common forms are immediate hypersensitivity, delayed hypersensitivity or allergic reactions, and utricaria. Ingredients that can most often cause such sensitivity are fragrances, preservatives, and some chemical sunscreens. **[Immediate hypersensitivity]** It is exactly what its name implies:the reaction typically occurs within 30 minutes of being exposed to a product or ingredient to which one is allergic. These reactions can often be very severe, producing significant swelling and redness, and potentially causing a person to go into anaphylactic shock and stop breathing. In the event of a severe reaction, medical treatment should be obtained immediately at a nearby hospital emergency room. In reactions not involving difficulty in breathing, clients should see their physician as soon as possible to minimize the length and severity of the reaction. Treatment usually consists of either injectable or oral steroids, as topical treatment with creams or gels is too slow and usually avoided. **[Delayed hypersensitivity]** This is a reaction that normally occurs within 24 to 96 hours after a person comes in contact with a product or ingredient to which they are allergic. The reactions observed can range from mild to severe redness and swelling, and the skin can be itchy and somewhat uncomfortable. Normally, there is little potential for anaphylactic shock; however, medical treatment should be obtained as soon as possible to avoid the reaction from getting worse and lasting longer than 7 to 10 days. **[Utricaria ]** Relates to breaking out in hives which are raised red, itchy welts on the surface of the skin. While this type of reaction is more commonly reported as a result of excessive stress, certain foods, medicines, and topical skin care products can also be a cause. Most of the time, these reactions relate to histamine circulating in the blood. They occur within 30 to 60 minutes of coming in contact with a product, and normally go away by themselves within several hours (or faster with an oral anti-histamine). **[Post-inflammatory Hyper- or Hypopigmentation (PIH)]** Post-inflammatory hyperpigmentation (too much) or hypopigmentation (too little) reactions are either irritant or allergic in nature, and can be caused by the inflammation associated with either adverse reaction. A *hyper*pigmentation reaction causes an overproduction of melanin in the skin, resulting in a darker and uneven skin tone where the adverse reaction occurred. A *hypo*pigmentation reaction causes the opposite to occur leaving the area with less pigment than the surrounding skin. The latter reaction is more common in darker skin tones. Both types of pigmentation reactions are uncommon but can occur after an adverse event, and are very difficult and time-consuming **5.0 DIFFERENCES BETWEEN IRRITATIONS AND ALLERGY** - Irritation is normally less severe and shorter in duration. It usually lasts only a few days compared to allergic reactions, which can require immediate medical care and last up to 10 days. - Second, irritation is usually confined to the area to which the product was applied. Allergic reactions can spread to areas near the application site, and in cases where histamine is involved, reactions can occur anywhere on the body. - The major difference between irritation and allergy is that once an irritation reaction clears, the product can be reintroduced into a skin treatment regime. If there is an allergy to the product, a person will be allergic to it forever and should never use it again. **5.0 CONCLUSION** If there is any uncertainty as to how a person may react to a product, a good rule of thumb is to start low (maybe using one or two products) and go slow (add additional products after the first or second week). Lastly, in a professional context it is always best to call the client a few days to a week after they begin a new treatment regime to make sure the products are being correctly used, and no problems are being experienced. Following these suggestions will permit an effective skin treatment, minimize any possibility of adverse reaction, and build positive relationships.