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Cocamidopropyl betaine hypersensitivity more likely among AD patients

Patients with atopic dermatitis were significantly more likely to exhibit cutaneous delayed-type hypersensitivity to the surfactant cocamidopropyl betaine than patients without the skin disorder, according to recent study results.

Researchers conducted a retrospective study of 1,674 patients (66.2% female) who underwent patch testing between 2001 and June 3, 2013, including 242 patients (15.05%) with atopic dermatitis (AD), using the North American Contact Dermatitis Group standard allergen series. AD incidence was 18.12% among females tested. Positive patch tests to cocamidopropyl betaine (CAPB) and cocamide diethanolamide (DEA) and amidoamine were assessed, and a chi-square test was used for statistical analysis.

Patients with AD had greater incidence of CAPB compared with those without AD (P=.009). There was no significant difference between the cohorts for amidoamine and cocamide DEA (P=.198 and P=.235, respectively).

Thirty-nine patients (2.33%) had a positive reaction to CAPB, 22 (1.31%) reacted positively to amidoamine and 28 (1.67%) reacted positively to cocamide DEA.

Patients could not be matched for age, gender or other parameters, since it was a retrospective study, and the patient population was limited to metropolitan Kansas City, Mo., and New York.

“We did not find atopics to be significantly more likely to react to amidoamine or cocamide DEA than nonatopics, although there was a trend, especially in females with AD,” the researchers concluded. “Patients with AD should avoid the use of skin care products containing the surfactant CAPB. … We recommend that health care practitioners counsel their atopic patients to minimize cutaneous contact with personal care products containing these surfactants.”

Disclosure: The researchers report no relevant financial disclosures.