An example of contact allergic conjunctivitis

Mrs. Neary was a middle-aged woman used to a good social life. As such, she had frequent cause to 'make herself up', and very glamorous she was too! She knew that cheap jewellery gave her a rash, but that didn't bother her because she didn't like cheap jewellery anyway. She was bothered by a recurrent rash on her eyelids, though. She couldn't understand it, having never suffered from the like before. Patch tests confirmed her sensitivity to nickel, but they also revealed a problem with one of her favourite moisturisers. It contained avocado, and she had become allergic to it. 'But I've used it for years!' she protested. (You've heard it all before, right?) She had sensitised herself to it over time. 'But why are my hands not affected then?' she persisted. 'Because the skin over your eyes is only 0.55 mm thick, and it's very delicate, that's why!' All she had to do now was avoid the offending allergen. She should also be careful not to handle nickel (coins, keys, cutlery, etc.) as this could contribute to periorbital dermatitis as well.

The outcome is not always so clear for patients with suspected cosmetic allergy. Some unfortunates have 'status cosmeticus' — a non-specific irritation to virtually all cosmetics. To confound matters, they may have no outward sign of irritation or allergy, but they complain of burning or stinging whenever they wear cosmetics. Some of them will have slight redness over the cheeks, with or without slight swelling of the eyelids, but nothing more substantial than this. Treatment? Avoid all cosmetics!



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