Natural, clean, yet still allergenic: contact allergen burden in vulvar soothing products
Leah McAleer, Olivia Negris, Melissa M. Mauskar, Sydney Rivera DixonObjectives:
To characterize the prevalence of contact allergens in over-the-counter nonhormonal vulvar soothing products and determine whether common marketing claims identify products with lower allergen burden.
Methods:
A cross-sectional analysis of externally applied vulvar soothing products sold through major US retailers was performed. Ingredients were compared with the North American Contact Dermatitis Group 80-allergen series. Product characteristics, marketing descriptors, and allergen burden were analyzed using descriptive and comparative statistics.
Results:
Among 65 products, 78% contained at least one allergen, and 49% contained botanical-derived allergens. Fragrance ingredients were the most common allergens (39%), followed by sodium benzoate (25%), phenoxyethanol (12%), and propylene glycol (9%). Marketing descriptors, including “natural,” “hypoallergenic,” and “fragrance-free,” were not associated with lower allergen burden. Twenty-eight percent of “fragrance-free” products contained botanical scent allergens, and all “hypoallergenic” products contained at least one allergen. Ointments had lower allergen burden than other vehicles (
Conclusions:
Most nonhormonal vulvar soothing products contain common contact allergens despite marketing suggesting improved tolerability. These findings support ingredient-based counseling by Menopause Society Certified Practitioners and other menopause health care professionals when recommending over-the-counter vulvar products to minimize contact allergen exposure and contact dermatitis risk.