Should Paraben Mix Be Removed from The European Baseline Series?

The European Baseline Series (EBS) of contact allergens is used throughout Europe as a screening test to diagnose contact allergy as a proxy for allergy contact dermatitis and other hypersensitivity skin diseases (1). Parabens are alkyl esters of p-hydroxybenzoic acid with antimicrobial effects used as preservatives in cosmetics, foods, and drugs that have been included in the so called “baseline series” (2) for more than 40 years. Parabens, which are considered allergologically safe biocides and are classified as safe by the US Food and Drug Administration (FDA) and the Scientific Committee on Consumer Safety (SCCS) in Europe (2-4), are frequently present in cosmetics (5). Despite extensive and progressively expanding use worldwide, studies confirm that parabens are seldom responsible for allergic contact dermatitis to cosmetics, and the frequency of sensitivity to parabens has been low and stable for many decades (2). The frequency of positive reactions to paraben mix is less than 0.5% in most clinical series, although it seems that when it occurs it is often of high clinical relevance (6). Nevertheless, several authors have stated that these patients rarely or never have to avoid foods or cosmetics that contain parabens to control their dermatitis (2)