Propylene Glycol was investigated as a disinfectant back in the old days. Treatment. Propylene glycol toxicity must be differentiated from allergic sensitization; toxicity reactions generally manifest as serum hyperosmolality, respiratory depression, central nervous system depression and seizures, and an anion gap metabolic acidosis after topical, oral, or parenteral exposure. Sixteen of eighteen (89 percent) in the group treated with propylene glycol showed healing, compared to six of nineteen (32 percent) in the other group. This is a toxic chemical compound whose usage is mainly in some household products and many types of antifreeze. I know we all have stories to tell. What is propylene glycol? J Am Acad Dermatol 54(4):723-7 (2006 Apr). This is primarily attributed to the difficulty in determining the ideal concentration for patch testing that would be nonirritating, but high enough to elicit an allergic response. It has been associated with irritant and allergic contact dermatitis as well as contact urticaria in humans; these sensitization effects can be manifested at propylene glycol concentrations as low as 2%. Avoiding propylene glycol is a daunting task, but at least I know what I’m dealing with now. In a recent study by the North American Contact Dermatitis Group (NACDG), personal care products were found to be the most common sources of exposure to PG (53.8%), followed by topical steroids, and other topical medicaments.3, Cutaneous reactions to PG are classified into four groups: irritant contact dermatitis, allergic contact dermatitis (ACD), non-immunologic contact urticaria, and subjective or sensory irritation.4 The incidence of true ACD to PG is unknown. This product is considered to be highly poisonous and when ingested, either by accident or purposefully, immediate medical attention is required for treatment of its toxic substances. Although it is considered safe, large intravenous doses given over a short period of time can be toxic. Well, welcome to that help! Phototoxic dermatitis occurs when the allergen or irritant is activated by sunlight. 1,2 Dihydroxypropane. It was not until 2017 that I finally found a doctor who discovered I was allergic to propylene glycol. Consequently, we switched her to tacrolimus 0.1% ointment (PG- and corticosteroid-free) for treating both the eyelid and leg dermatitis. Moreover, studies have reported a significant number of patients have a concomitant reaction to both topical CS and PG, which suggests the possibility of cosensitization.3,8. Containing two alcohol groups, it is classed as a diol.It is miscible with a broad range of solvents, including water, acetone, and chloroform.In general, glycols are non-irritating and have very low volatility. Possible Benefits of Fish Oil for Seborrheic Dermatitis, Examining the Use of Jojoba Oil for Seborrheic Dermatitis, Examining the Use of Argan Oil for Seborrheic Dermatitis, The Merits of Castor Oil for Seborrheic Dermatitis Treatment, Reviewing the Claimed Use of Garlic for the Treatment of Seborrheic Dermatitis, Sea Salt for Seborrheic Dermatitis – Treatment Guide and Research Summary, Treating Seborrheic Dermatitis With Apple Cider Vinegar, Nystatin A Potential Seborrheic Dermatitis Treatment, Treating Seborrheic Dermatitis with Raw Honey. Propylene Glycol May be to Blame. Propylene glycol is safe in small doses. This is a toxic chemical compound whose usage is mainly in some household products and many types of antifreeze. 1982 Jan;33(1):12-4. The difference was statistically significant (p-value <0,03). Propylene glycol (PG) was described by Wurtz in 1859, and it was first considered for use in pharmaceutical preparations in 1932. PG is a useful, flexible multipurpose chemical. Propylene glycol is used as an organic solvent and diluent in pharmaceuticals and many other industrial applications. 1,2 Propanediol. Keep polyethylene glycol/propylene glycol gel out of the reach of children and away from pets. There was a positive family history of atopy, but she denied any personal history of atopy. Where is propylene glycol found? Humectants, including glycerin, lecithin, and propylene glycol, draw water into the outer ... this product to help treat diaper rash, ... commencing or discontinuing any course of treatment. Crisaborole 2% Ointment for Mild-to-Moderate Atopic Dermatitis, Long-term Efficacy and Safety of Once-daily Efinaconazole 10% Topical Solution (Jublia) for Dermatophyte Toenail Onychomycosis: An Interim Analysis, 2020 Index for Skin Therapy Letter – Dermatology Edition, Moisturizers: What They Are And How They Work, Management of Chronic Hand Dermatitis: A Practical Guideline for the General Practitioner, Moisturizers: What They Are and a Practical Approach to Product Selection. If treatment was not continued, at least on an intermittent basis, the patient’s condition worsened.) Propylene glycol (PG) has been a commercial product in the United States since the 1930s. Propylene glycol is an additive, not something you’d find at the drug store and use on its own. It is important to note that the steroid formulations discussed in this paper pertain only to topical CS products available in Canada, as products from other countries may contain different compositions of non-medicinal ingredients. If you are allergic to propylene glycol, you should avoid using the topical MXD solution as it is known to provoke dermatitis in some people. Propylene glycol is used as an emollient because it forms an oily layer on the skin, and prevents water loss. ACD can result from an allergy to the steroid molecule or to a component of the vehicle. Dr. William Lages answered. “The propylene glycol itself was a potent germicide. We could not identify the source of PG (amcinonide 0.1% and fusidic acid 2% ointments are both PG-free), but this patient could have been sensitized to PG from her personal care products. She was most likely sensitized to budesonide from prolonged application of amcinonide 1% ointment (a class B corticosteroid). Herein, we describe five MICU patients who acquired severe propylene glycol toxicity due to IV lorazepam or diazepam administration. Empirically, one can prescribe a PG-free class C topical corticosteroid given the rarity of ACD to class C topical CS. My question is this. The statements made here have not been approved by the Food and Drug Administration. Propylene glycol in the treatment of seborrheic dermatitis of the scalp: a double-blind study. Treatment approaches included selenium sulfide shampoo, topical econazole, and 50% propylene glycol in water. Cutaneous reactions to PG are mostly irritant, but allergic contact dermatitis to PG is well-documented. Rare reports of contact dermatitis have been associated with the cream or 1 of its excipients (i.e., sodium sulfite or propylene glycol) during postmarketing experience. It has been associated with irritant and allergic contact dermatitis as well as contact urticaria in humans; these sensitization effects can be manifested at propylene glycol concentrations as low as 2%. But in larger doses, it can take a toll on your kidneys and liver. Nearly: PEG is propylene glycol. Subsequently, the eyelid dermatitis cleared. Propylene glycol is used in foods, medicine and cosmetics because it is a good solvent which has, simultaneously, moisture-regulating, antiseptic, and preservative effects. It results from either exposure to allergens (allergic contact dermatitis) or irritants (irritant contact dermatitis). Toxic ef …. ... Avoid using baby wipes if your baby has a rash. (In a fifty-one-patient study, marked improvement was seen in patients receiving treatment for Pityrosporum folliculitis. What is propylene glycol? Propylene glycol is a routine treatment for ketosis. Mimesh S, Pratt M. Allergic contact dermatitis from corticosteroids: reproducibility of patch testing and correlation with intradermal testing. Fusidic acid 2% ointment contains lanolin, which was an additional factor for the persistence of her dermatitis. Was ist Propylene Glycol? Does anyone know if Curology adds propylene glycol in their treatment moisturizer? Propylene glycol is used as a softening agent, preservative, humectants, and solvent in cosmetics, fragrances, topical medications, soaps and cleansers, hair care products, and deodorants. Proper storage of polyethylene glycol/propylene glycol gel: Store polyethylene glycol/propylene glycol gel at room temperature, between 59 and 86 degrees F (15 and 30 degrees C). Ideally, patch testing should be done if the clinical picture is suggestive of allergy to PG and/or topical CS. Propylene glycol is also found in oral treatments as well as many foods. Propylene glycol is a small organic alcohol commonly used as a skin conditioning agent. ABSTRACT Attracts water: Zeichner says at low concentrations, propylene glycol acts like a humectant, which means it binds water and pulls in hydration to the outer skin layer.When used in cosmetic products, it helps give the skin a hydrated, dewy appearance. Allergy to macrogols (polyethylene glycol) Q: 3/6/2013 I have a patient who is allergic to Macrogols. Lymphadenopathy fever and eosinophilia and hepatitis may also occur. Her left leg dermatitis also recently worsened. Kidney and liver toxicity. The reaction looks very similar to my skin after using products containing propylene glycol. Contact Dermatitis 4(1):41-5 (1978 Feb). There are different screening markers that are used for patch testing to the corticosteroid classes. Lightly moisturizes: Herrmann adds that as a humectant, it also offers moisturizing benefits and smoothes the skin with a light, non-sticky feel. The propylene glycols are clear, viscous, colorless liquids that have very little odor, a slightly bittersweet taste, and low vapor pressures. Home Products How to Use About Us Only 2 oral formulations are approved for use in cattle as a treatment and the dose rate is 8 oz, q 12 h, for up to 10 days (2 other formulations labeled for use as preventive treatment). It is found in many cosmetic and pharmaceutical preparations, food (for coloring, thickening, and flavoring), and household cleansers. The fact that propylene glycol is used in both antifreeze and food products may seem alarming, but the reason it’s used in both substances may come as a surprise. So now it’s coming to light that there might be some issues with the use of this additive. Blisters or wheals. Pro­py­lene Glycol werden die unter­schied­lichsten Eigen­schaften zuge­schrieben. The screening markers used on the NACGD screening series are as follows: tixocortol-21-pivalate (class A), budesonide and triamcinolone acetonide (class B), clobetasol-17-propionate (class D1), and hydrocortisone-17-butyrate (class D2).6 Patch test reactions to class A steroids are the most common.7 Reactions to classes B and D steroids are less common, whereas reactions to class C steroids are extremely rare.7 The most common cross-reactions are between steroids in classes A and D2, followed by classes B and D2, and classes A and B.8, An investigation by the NACDG demonstrated that topical CS were responsible for 18.3% of the positive patch test reactions to PG.3 In a recent study, PG was found to be the most common allergen in topical CS, being present in 64% of the steroidal products.7 It was especially common in branded ointments and gels. Allergens in corticosteroid vehicles. Minoxidil products that are available without a prescription contain these additives, which are known to cause itchy scalps, irritation and dandruff. Given that PG is the most common allergen in topical CS, it is important to know which topical corticosteroid to prescribe to a PG-allergic patient. The most convincing evidence of allergic sensitization to PG is the development of systemic contact dermatitis after giving PG orally to PG-allergic patients.5 The overall prevalence of allergic reactions to PG was found to be relatively low (3.5%) by the NACDG.3 The NACDG currently recommends using a 30% aqueous PG solution for patch testing.3 In our experience at the University of British Columbia Contact Dermatitis Clinic, the prevalence of positive patch test reactions to PG over a 2 year period was 1.57% (13/828 patients). (Table 2 on page 7). A syndrome resembling lupus erythematosus has been described. Doch was ist richtig? Propylene glycol is a commonly used solvent for oral, intravenous, and topical pharmaceutical preparations. Underlying renal insufficiency and hepatic dysfunction raise risk for toxicity. Coloe J, Zirwas MJ. It is traditionally a petroleum derivative. Diprolene Glycol: Betamethasone dipropionate belongs to the class of medications called topical corticosteroids. Propylene glycol (PG) was described by Wurtz in 1859, and it was first considered for use in pharmaceutical preparations in 1932. Positive patch-test reactions to propylene glycol: a retrospective cross-sectional analysis from the North American Contact Dermatitis Group, 1996 to 2006. If the toxicity is caused by ingesting of food that have high levels of propylene glycol, the local poison control must be contacted immediately and they should be … We hope that this review will be of benefit in guiding physicians when choosing the appropriate topical corticosteroid in patients allergic to PG. PG is used as a plasticizer, solvent (in lacquers and varnishes), and as a component in antifreeze products, lubricants, cutting-fluids, and inks. Find patient medical information for propylene glycol-glycerin topical on WebMD including its uses, side effects and safety, interactions, pictures, warnings and user ratings. Propylene glycol is used as a softening agent, preservative, humectants, andsolvent in cosmetics, fragrances, topical medications, soaps and cleansers, haircare products, and deodorants. To me, it is unfathomable why doctors would wait so long to recommend patch testing when their treatments are not working. Leave me a message using the form below and I'll get back to you as soon as possible. They may contain urea (5–40%), salicylic acid (0.5–10%) or propylene glycol (for example, propylene glycol 20% in aqueous cream). (positive skin prick). Therapeutic Update on Seborrheic Dermatitis, Dupilumab for Moderate-to-Severe Atopic Dermatitis, Hydrocortisone 0.5%, 1% [OI] (Cortoderm®), Hydrocortisone 1%, 2.5% [CR, LO]; 2.5% [SL] (Emo-Cort®), Fluocinolone acetonide 0.01% [OL] (Derma-Smoothe/FS®), Betamethasone valerate 0.05% [OI] (Betaderm®), Betamethasone valerate 0.05% [CR, LO] (ratio-Ectosone), Betamethasone valerate 0.1% [CR] (Prevex® B, ratio-Ectosone), Betamethasone valerate 0.1% [LO] (Betaderm®, ratio-Ectosone, Valisone®), Triamcinolone acetonide 0.1% [OI, CR] (Aristocort®), Amcinonide 0.1% [CR, LO] Cyclocort®, ratio-Amcinonide), Diflucortolone valerate 0.1% [CR, OC, OI] (Nerisone®), Triamcinolone acetonide 0.5% [CR] (Aristocort®), Betamethasone valerate 0.1% [OI] (Betaderm®), Betamethasone dipropionate 0.05% [CR] (Diprosone®), Betamethasone dipropionate 0.05% [LO] (Diprosone®, ratio-Topisone), Amcinonide 0.1% [OI] (Cyclocort®, ratio-Amcinonide), Desoximetasone 0.25% [CR]; 0.05% [GL] (Topicort®), Betamethasone dipropionate 0.05% [OI] (Diprosone®, ratio-Topisone), Clobetasol propionate 0.05% [OI, LO] (ratio-Clobetasol), Clobetasol propionate 0.05% [SL] (Dermovate®), Clobetasol propionate 0.05% [SH, SP] (Clobex®). It was actually found to be a pretty effective one at that. ... Clindamycin 2% in Triamcinolone acetonide 0.1% solution in equal parts propylene glycol and water. Propylene glycol (PG) is a common ingredient in many cosmetics, topical skin preparations, medications, and foods. Patch testing was done with the 2010 NACDG screening series (Table 1). If patch testing is unavailable and the physician is highly suspecting PG allergy, we recommend prescribing any PG-free topical corticosteroid. We then searched carefully for preparations that are PG-free. All website subscribers and community members will get free access to my first draft of the essential guide to managment and treatment of seborrheic dermatitis. Is it possible to desensitize such a patient? Propylene glycol (IUPAC name: propane-1,2-diol) is a viscous, colorless liquid, which is nearly odorless but possesses a faintly sweet taste.Its chemical formula is CH 3 CH(OH)CH 2 OH. This propylene-glycol-containing solution was easy to apply, cosmetically attractive, and may be an alternative to corticosteroids for the treatment of seborrheic dermatitis of the scalp. Regarding the possibility of allergy to propylene glycol, please see the previous question below. It is also utilized in the manufacture of shampoos, conditioners and styling products. This review is aimed at guiding clinicians in the selection of a suitable topical corticosteroid when presented with patients allergic to PG. Propylene glycol is everywhere! 3 The annual PG production and global demand are rapidly increasing. Blisters, wheals (welts), and urticaria (hives) often form in a pattern where skin was directly exposed to the allergen or irritant. Viscosity control: Propylene glycol is used to reduce the thickness of cosmetic formulations and products. For a quick response consider checking out the community. Positive patch test react … There are different types of glycol; ethylene glycol and propylene glycol, both primarily used for deicing solutions and antifreeze. 8,9 It was proposed to replace ethylene glycol as a solvent and vehicle for a bismuth product used in the treatment of syphilis. All rights reserved. First things first. Would this be performed through skin testing? The patient’s past medical history was significant for a previously treated venous ulcer of the left leg and chronic venous insufficiency dermatitis. There’s not much research on this topic, but some studies have found that its presence appears to increase the transdermal absorption rate of some other compounds it is mixed with. By Jop de Vrieze Dec. 21, 2020 , 5:10 PM. Propylene glycol's potential as a contact allergen has long been recognized, and the first study of patch tests to PG was performed in the 1950s. Another option is to consider tacrolimus ointment, which is a PG-free steroid-sparing agent (pimecrolimus 1% cream contains PG). Propylene glycol is certainly less dangerous than ethylene glycol. 1,2 It is a multifunctional excipient that is used in many products as a solvent, vehicle, humectant, or emulsifier. Propylene glycol may produce eczematous skin reactions of toxic and, more rarely, of allergic nature. Freshman’s Minoxidil solution is a proprietary extra strength formula, which is without alcohol and propylene glycol. Contact Dermatitis 53(5):247-59 (2005 Nov). Skin-sensitizing and irritant properties of propylene glycol. If I were going outside, my regiment would also … In the group treated with ivermectin + doxycycline, 61% had recovered within 7 days, and in the control group, 44% had recovered within 7 days. Propylene Glycol or PG as its commonly referred to in vaping circles, is a type of alcohol. It became a very common product in air fresheners when a researcher’s work indicated it could sterilize air. I followed every recommendation given to me by dermatologist. Treatment & Drugs for Diaper Rash in Babies. Some wipes contain propylene glycol which is an alcohol and will burn your baby’s skin and cause the infection to spread. Suspicions grow that nanoparticles in Pfizer’s COVID-19 vaccine trigger rare allergic reactions. PG is the most common allergen in topical CS. A propylene glycol allergy caused my face to be red, irritated and swollen. Two patients did not return for follow-up. Mohammed Al Jasser, MD, Nino Mebuke, Gillian de Gannes, MD, FRCPC. But today, propylene glycol is also available as a biobased derivative of 100% renewable resources like yeast, corn, vegetable oils, and miscellaneous carbohydrates. Propylene glycol is an additive, not something you’d find at the drug store and use on its own. He stated that Polyethylene Glycol (PEG) is a very rare allergy. It was not until 2017 that I finally found a doctor who discovered I was allergic to propylene glycol . Propylene glycol is certainly less dangerous than ethylene glycol. 1 However, the significance of PG as a contact allergen has been ambiguous. She had been applying amcinonide 0.1% (Cyclocort®) and fusidic acid 2% (Fucidin®) ointments on the leg dermatitis for many years with only intermittent improvement. The number of organisms was reduced significantly after treatment with the propylene-glycol-containing solution but not in the other group. Is there any protocol in place to follow for this type of allergy? Experimental: Arm 2: Reactive Treatment Pts will receive treatment at initiation of rash. Treatment. Topical steroids . Reactions were graded using a scoring system recommended by the International Contact Dermatitis Research Group: + = erythema and papules, ++ = edema or vesicles, +++ = bullae and/or erosions, Cosensitization to PG and topical CS can occur, making it challenging to choose the appropriate topical CS in a PG-allergic patient. Propylene glycol (PG) is considered to be a ubiquitous formulary ingredient used in many personal care products and pharmaceutical preparations. Propylene glycol is a synthetic food additive that belongs to the same chemical group as alcohol. The 8 is the number of ethylene glycol units attached. Propylene glycol is also found in oral treatments as well as many foods. Propylene glycol dermatitis: re-evaluation of an old problem. September 28, 2016. If you determine that you do have a propylene glycol allergy you may have to make some adjustments to your product arsenal. Most often, the plan was to use a gentle cleanser and a soothing moisturizer, which was topped off with a medicated cream (usually some type of anti-inflammatory or cortisone, prescription medication). It’s even in hydrocortisone cream, a common topical steroid used to treat allergic skin reactions. In addition to topical steroids, PG can also be found in other topical pharmacologic preparations, including antibacterials, antifungals, benzoyl peroxide, and emollients,1 Cutaneous reactions to PG have been recognized since 1952.1, Approximately half of the PG produced is used in the synthesis of other chemicals.2 The other half is utilized in the manufacturing of many industrial and personal care products. In twenty patients quantitative cultures for Pityrosporum orbiculare were taken. She was found to be allergic to PG, budesonide, lanolin alcohol, balsam of Peru, and glyceryl thioglycolate. Department of Dermatology and Skin Science, University of British Columbia, Vancouver, BC,Canada The sensitizing potential of PG is well documented, but the true incidence of its role in ACD is unknown. It is an organic compound commonly found in topical corticosteroids (CS). Estimates on the prevalence of PG allergy range from 0.8% (10% PG in aqueous solution) to 3.5% (30% PG in aqueous solution).2–4 The North American Contact Dermatitis Group (NACDG) data from 1996 to 2006 showed that the most common site for PG contact dermatitis was the face (25.9%), followed by a generalized or scattered pattern (23.7%).2 Personal care products, such as creams, lotions, and cosmetics were associated with reactions in 12.8% of these patients and were the most common sourc… In fact, before it was uncool to randomly experiment on sick kids, one study looked at using the stuff to cut down on infections in a children’s convalescent home. J Am Acad Dermatol 24(1):90-5 (1991 Jan). The procedure used for treatment depends on how serious the rashes are. After being affected by seborrheic dermatitis, I have made it my goal to gather and organize all the information that has helped me in my journey. Contact Dermatitis 31(4):236-41 (1994 Oct). ENJOY FREE SHIPPING ON ALL ORDERS. Hannuksela M, Forstrom L. Reactions to peroral propylene glycol. You can either subscribe using the form below or by joining the community. Oread Therapeutics, LLC. If you have experienced a rash after applying a skincare product or topical corticosteroid medication, a common ingredient found in these products, known as propylene glycol, may be the culprit. Given that she was allergic to both PG and budesonide, it would have been helpful to know which topical CS were PG-free. Propylene-glycol is also used as a solvent, food preservative of … Propylene glycol is in a lot of personal care products, and some people get contact dermatitis (AKA a red, itchy rash) when they come into contact with it. As you will read throughout these pages, I have suffered for years with a mysterious allergy–“eczema” to be exact. As you will read throughout these pages, I have suffered for years with a mysterious allergy–“eczema” to be exact. My question is how to test for a potential allergic response to macrogols/polyethylene glycol/propylene glycol. 2 Hydroxypropyl. The number of organisms was reduced significantly after treatment with the propylene-glycol-containing solution but not in the other group. Propylene glycol is a small organic alcohol commonly used as a skin conditioning agent. The Antifreeze Connection. Treatment advice can be obtained from a regional poison control center or medical specialists such as the following with expertise and experience treating patients exposed to ethylene glycol: Because of these properties, PG is produced in the US on a massive scale and is used in a dizzying array of products. Warshaw EM, Botto NC, Maibach HI, et al. Propylene glycol is used as a softening agent, preservative, humectants, and solvent in cosmetics, fragrances, topical medications, soaps and cleansers, hair care products, and deodorants. Since ethylene glycol … Well, welcome to that help! Trimethyl Glycol. CS are divided into four classes on the basis of structure and cross-reactivity pattern: classes A (hydrocortisone type), B (triamcinolone acetonide type), C (betamethasone type), and D.6 Class D is further divided into D1 (betamethasone dipropionate type) and D2 (methylprednisolone aceponate type). Specialty: Dermatology: Contact dermatitis is a type of inflammation of the skin.. Symptoms of a propylene glycol allergy include dry throat, sore throat, swollen gums, skin problems and rashes, and sinus problems. We have created a chart containing all PG-free topical CS available in Canada sorted on the basis of potency and structural class In twenty patients quantitative cultures for Pityrosporum orbiculare were taken. Propylene glycol is a colourless and nearly odourless liquid with a slightly sweet taste. Although propylene glycol toxicity is increasingly recognized and reported, its incidence is unknown. Propylene glycol (1,2-propanediol) is the solvent used to deliver lorazepam and diazepam IV. The most important member of the family is monopropylene glycol, also known as 1,2-propylene glycol, 1,2-dihydroxypropane, 1,2-propanediol, methylene glycol, and methyl glycol. Sixteen of eighteen (89 percent) in the group treated with propylene glycol showed healing, compared to six of nineteen (32 percent) in the other group. Contact dermatitis; Rash resulting from skin reactions. Dermatitis 19(1):38-42 (2008 Jan-Feb).