HX22 From plants to plastics: the changing aetiology of contact dermatitis

Abstract

The history of contact dermatitis mirrors the evolution of human industry, consumer culture and personal-care practices. Ancient Egyptian and Greco-Roman sources describe cutaneous reactions to plant resins, metals and leather treatments. Industrialization introduced synthetic dyes, rubber accelerators and preservatives, dramatically expanding allergen profiles. Bernardino Ramazzini formally documented occupational dermatoses among workers exposed to botanical and mineral substances, establishing skin disease as a hazard of labour. Currently, globalized manufacturing and rapid product cycles have created new, often hidden, sources of exposure. Fast fashion and menstrual products exemplify how contemporary materials can generate unexpected dermatological risks. This review examines the development of contact dermatitis over time and explores how modern consumer pressures create concealed allergen exposures, using contemporary examples to illustrate how historical patterns exist in new forms. A narrative historical review was conducted using dermatology literature, regulatory reports and case series from antiqu­ity to 2025. Contemporary examples were analysed using a conceptual framework of unseen forces, analogous to tension, friction and acceleration, to illustrate how modern supply chains and product design can drive allergen exposure without consumer awareness. Three eras were identified: preindustrial occupational dermatitis, industrial chemical expansion, and the current period of globalized, high-turnover consumer goods. Fast fashion emerged as a modern driver of allergic contact dermatitis, with disperse dyes, resins, biocides and metal components frequently implicated. Rapid production cycles and limited transparency create risks that only become apparent once dermatitis develops. Menstrual products have evolved to improve comfort and autonomy, yet have introduced allergens, including adhesives, fragrances and treated textiles. Reports of dermatitis linked to menstrual underwear and fragranced pads illustrate that innovation does not reduce allergenicity. Understanding the historical trajectory of contact dermatitis enables clinicians to anticipate emerging risks. Strengthened regulation, clearer labelling and patient education are essential to mitigating the hidden forces shaping modern allergen exposure.