Eyelid dermatitis and contact sensitization to nickel: results from an Italian multi-centric observational study.

BACKGROUND: due to the sensitizing constituents of eye cosmetics, allergic contact dermatitis is considered a frequent cause of eyelid dermatitis. An association between eyelid dermatitis and the nickel contained in make-ups remains controversial.

OBJECTIVE: to assess the association between nickel allergy, the use of pigmented make-up products and self-reported eyelid dermatitis.

METHOD: this multi-centric, cross-sectional study enrolled 165 women sensitized to nickel (patients) and 103 women without intolerance to metals (controls). We recorded: demographics, atopy, use of pigmented eye cosmetics (mascara, eye shadow, eyeliner, eyebrow pencil), previous eyelid dermatitis. Among the patients, any co-sensitization to cosmetics or metals was recorded.

RESULTS: 87.3% of the patients and 91.3% of the controls reported their use of eye make-up; 44.9% and 52.4%, respectively, reported previous episodes of eyelid dermatitis, without significant differences. Occurrence of eyelid dermatitis was significantly associated with the use of eye make-up products, both in general and considering each product separately. Age, atopy, or co-sensitization to other metals or cosmetics did not affect the occurrence of eyelid dermatitis.

CONCLUSION: nickel allergy should not be considered a main risk factor for eyelid dermatitis. The use of pigmented eye make-up may be a triggering factor for eyelid dermatitis, probably due to an irritant action.