Ocena varne uporabe kozmetičnih izdelkov za nego kože, nagnjene k atopijskemu dermatitisu

Slavec, Mojca (author), Sollner Dolenc, Marija (mentor)

Atopijski dermatitis (AD) je ena izmed najpogostejših nenalezljivih bolezni, ki prizadene do 20‒30 % otrok in 2‒8 % odraslih po svetu. Izobraževanje pacienta, nega (kopanje, umivanje ter uporaba emolientov), prepoznava in izogibanje sprožilnim dejavnikom, ki povzročajo poslabšanje kožnih sprememb pri pacientih, je izrednega pomena pri nadzorovanju bolezni, saj z izogibanjem slednjim lahko podaljšamo fazo mirovanja bolezni (remisijo) in preprečimo pojav simptomov. Izbira sredstva za nego je odvisna od izbire posameznika. Pomembno je, da je učinkovito, varno, hipoalergeno. Najpogostejši vzrok kontaktne preobčutljivosti so poleg kontaktnih alergenov tudi dišave, konzervansi, barvila in drugi dodatki v kozmetičnih izdelkih (KI). Emolienti so glavni vir nege pri dolgoročnem zdravljenju AD. S pravilno in redno uporabo le-teh ga uspešno nadzorujemo. Zato je pomembno, da farmacevti v lekarni pacientom pravilno in dobro svetujejo o KI, ki so namenjeni za nego kože z AD. V naši nalogi smo izbrali 113 KI, ki so na voljo v lekarnah in so primerni za nego atopijske kože. KI smo razdelili na izdelke, ki se ne izpirajo iz kože ter na KI, ki se izpirajo iz kože. Nadalje smo jih razdelili še na KI, ki so namenjeni za dojenčke in na KI, ki so namenjeni za odrasle ter otroke od treh let naprej. Pregledali smo aktivne sestavine in grafično prikazali prisotnost najpogostejših emolientov, humektantov ter okluzivov (prisotnih v vsaj 6 KI). Osredotočili smo se na vsebnost konzervansov, dišav in barvil, ki so navedene v prilogah Uredbe (ES) št.1223/2009 o KI. S pomočjo literature smo najpogosteje prisotnim pomožnim sestavinam v KI ocenili toksikološki profil ter preverili, kako varni so za uporabnike. Ugotovili smo, da 51,3 % pregledanih KI za nego kože z AD vsebuje vsaj enega od dovoljenih konzervansov. Približno polovica od tega jih je namenjenih negi kože dojenčkov. 39,8 % pregledanih KI ne vsebuje nobenega dovoljenega konzervansa, v vsakem pa je prisoten vsaj eden od alternativnih konzervansov. Konzervansi so splošno varni, previdnost je potrebna le pri fenoksietanolu ter nanosu na plenično področje pri dojenčkih. V pregledanih KI jih 67,3 % ne vsebuje nobene dišave, 32,7 % jih vsebujejo dišave in parfume. Lahko povzamemo, da so pregledani KI varni glede dišav, posebna previdnost je potrebna le pri dišavah, ki lahko tvorijo oksidirane produkte ter pri KI, ki vsebujejo več dišav hkrati in dišave z oznako parfum ali aroma. 5 % pregledanih KI za nego atopijske kože vsebuje barvila. Od tega je 1 KI namenjen za nego odraslih, 5 KI (4,4 %) pa je namenjenih tudi negi dojenčkov. Slednji se vsi izpirajo iz kože. V magistrski nalogi smo potrdili, da so KI, ki so na voljo v lekarnah za nego atopijske kože, za uporabnika varni in vsebujejo zelo malo alergenih dišav, konzervansov in barvil.

• Language: Slovenian
• Keywords: atopijski dermatitis, ocena varnosti, konzervansi, dišave, barvila
• Work type: Master's thesis/paper
• Organization: FFA - Faculty of Pharmacy
• Year: 2021
• PID: 20.500.12556/RUL-131163
• Publication date in RUL: 23.09.2021

Secondary language

• Language: English
• Title: Safe use assessment of cosmetic products for care of atopic dermatitis-prone skin

Abstract

Atopic dermatitis (AD) is one of the most common non-communicable skin diseases, affecting up to 20-30 % of children and 2-8 % of adults worldwide. Patient education, self-care (bathing, washing and use of emollients), identification and avoidance of triggers that cause worsening of skin changes in patients is extremely important in disease control, as avoiding the latter can prolong the inactive phase and prevent symptoms. The choice of care product depends on the choice of the individual. It is important to be effective, safe, hypoallergenic. In addition to contact allergens, the most common causes of contact hypersensitivity are fragrances, preservatives, dyes and other additives in cosmetics. Emollients are a major source in the long-term treatment of AD. With proper and regular use of the latter, we successfully control atopic dermatitis. Therefore, it is important that the pharmacist in pharmacy gives proper and good advice to patient on cosmetic products for skin that is prone to atopy. In our thesis we selected 113 cosmetic products that are available in pharmacies and are suitable for atopic skin care. Cosmetic products (CP) were divided into rinse-off and leave-on products-. In addition, we further divided them into CP for children under the age of three (infants), CP for children above the age of three and adults. We first reviewed and described the active ingredients as they are very important in atopic skin care. We graphically displayed the presence of the most common emollients, humectants and occlusives (found in at least 6 CP). We focused on the contents of preservatives, fragrances and dyes, which are listed in Annex of Cosmetics Regulation (EC) 1223/2009. By using the literature and toxicological data we assessed the safety of the most common excipients in our cosmetic products. We found out that 51,3 % of our selected CP contain at least one of the officially permitted preservatives. About half of them are for baby skin care. 39.8 % of our selected CP do not contain any permitted preservative, and each contains at least one of the alternative preservatives. Preservatives are generally, safe, caution should be taken only on phenoxyethanol and application to the nappy area in infants. In the examinated CP, 67,3 % of them do not contain any fragrance and 32,7 % of them does. We can summarize that fragrances used in our examinated products are safe. Special care should be taken for fragrances who can form oxidized products, for cosmetic products containing several fragrances at the same time and also for fragrances labeled with the word parfum or aroma. 5 % of our examinated cosmetic products contain dyes. One cosmetic product is intended for the care of adult skin and 5 CP (4.4 %) are intended for the care of infants (all of them are rinse off products). In our thesis, we confirmed that CP available in pharmacies for atopic skin care are safe for the users and contain very few allergenic fragrances, preservatives and dyes.

• Keywords: atopic dermatitis, saftey assessment, preservatives, fragrances, dyes