Allergen

Contact Lenses

In terms of skin contact allergy, reactions to contact lenses are fairly low but contact lenses (and the contact lens solutions necessary for their care) do tend to contain some top contact allergens. We’d suggest extra caution if you’re considering colored contact lenses and/or if you’ve patch tested positive to certain substances commonly found in contact lenses or contact lens solutions (see below).

Modern contact lenses usually contain silicone, which tends to be fairly well tolerated, but also other components that can be cause for concern or caution (or at the very least, checking against your patch test and consultation with your dermatologist).

What to look out for:

• Most hydrogel contact lenses contain hydrating polymers like poly-HEMA or poly 2-hydroxyethyl methacrylate, methyl methacrylate, hydroxyethyl methacrylate, or glycerol methacrylate. Methyl methacrylate is published as a top contact allergen. While acrylates are more of a problem when wet or in their powder or paste form, and tend to be fine when hardened or finished (as in the case of contact lenses), they were the American Academy of Dermatology’s Allergen of the Year in 2012.
• Colored contact lenses can contain dyes, inks (both of which are allergens) and sometimes chlorine (a strong irritant). All these substances have the risk of leaking out of the lens onto the eye.
• Many contact lens solutions contain top contact allergens like polyquaternium, thimerosal, and propylene glycol.

Some things that can help:

• Get a patch test and work closely with your dermatologist and ophthalmologist to explore contact lenses that could work for you.
• Use a contact lens solution without your allergens.
• Consider eyeglasses instead of or to alternate with your contact lenses. Note that eyeglasses can contain several contact allergens as well so be guided by your patch test.
• Use fragrance-free, dye-free, paraben-free, preservative-free, allergen-free skincare and makeup. Eyelid contact dermatitis is not uncommon and can be due to many, many things, including allergens in your cleanser, shampoo, facial creams, sunscreen, eye makeup, etc.
• Follow your doctor’s instructions for cleaning and storing your contact lenses. Not doing so has many risks that can lead to serious infections of the eye and the skin around the eye.
• Do not buy contact lenses from non-licensed outlets. For example, some colored contacts are sold in beauty salons, gas stations, or online from unlicensed, non FDA-approved sellers. Your best bet is to ask your eye doctor for a prescription or guidance regarding colored contacts that are from reputable brands and that are FDA-approved.
• Do not touch or rub your eyes. This can increase the risk of irritation and transfer of allergens to the eye.

Additional “skinfo”:

The skin around the eye and of the eyeball itself are quite different. The layers of the conjunctiva cover the inner eyelids, the sclera (the white of the eye), and cornea that covers the pupil. This has a layer of cells that produce a fluid to keep the eye moist.

Skin around the eye is more like the skin on the rest of your body (it sloughs off the outer layer regularly, for example) but it is thinner and prone to T-cell mediated contact dermatitis from direct and airborne contact allergens such as fragrances, preservatives, paints, vape or cigarette smoke, dust mites, etc. as well as IgE-mediated allergic reactions from pollen.

Caring for both is important as the skin around the eye tends to be more sensitive and the eye itself can be prone to infection that can lead to more serious problems.

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If you have a history of sensitive skin…

…don’t guess! Random trial and error can cause more damage. Ask your dermatologist about a patch test.

To shop our selection of hypoallergenic products, visit vmvhypoallergenics.com. Need help? Ask us in the comments section below, or for more privacy (such as when asking us to customize recommendations for you based on your patch test results) contact us by email, or drop us a private message on Facebook.

For more:

• On the prevalence of skin allergies, see Skin Allergies Are More Common Than Ever. 
• For the difference between irritant and allergic reactions, see It’s Complicated: Allergic Versus Irritant Reaction.
• For the difference between food, skin, and other types of reactions: see Skin & Food Allergies Are Not The Same Thing. 
• On the differences between hypoallergenic, natural, and organic, check out Is Natural Hypoallergenic? and this video in our YouTube channel. 
• To learn about the VH-Rating System and hypoallergenicity: What Is The Validated Hypoallergenic Rating System?

Main References: 

Regularly published reports on the most common allergens by the North American Contact Dermatitis Group and European Surveillance System on Contact Allergies (based on over 28,000 patch test results, combined), plus other studies. Remember, we are all individuals — just because an ingredient is not on the most common allergen lists does not mean you cannot be sensitive to it, or that it will not become an allergen. These references, being based on so many patch test results, are a good basis but it is always best to get a patch test yourself.

1. Hui Dong, X, Shu-Xin Zhang, C, Min Liu, Y. Colored contact lens with all-weather humidity-triggered discoloration. Dyes and Pigments: Volume 218, 2023.
2. Fonacier, L, Boguniewicz, M. Contact Dermatitis, Editor(s): Leung, D, Szefler, S, Bonilla, F, Akdis, C, Sampson, H. Pediatric Allergy: Principles and Practice (Third Edition), Elsevier, 2016, Pages 467-481.e3, ISBN 9780323298759.
3. DeKoven JG, Warshaw EM, Reeder MJ, Atwater AR, Silverberg JI, Belsito DV, Sasseville D, Zug KA, Taylor JS, Pratt MD, Maibach HI, Fowler JF Jr, Adler BL, Houle MC, Mowad CM, Botto N, Yu J, Dunnick CA. North American Contact Dermatitis Group Patch Test Results: 2019-2020. Dermatitis. 2023 Mar-Apr;34(2):90-104. doi: 10.1089/derm.2022.29017.jdk. Epub 2023 Jan 19. PMID: 36917520.
4. Uter W, Wilkinson SM, Aerts O, Bauer A, Borrego L, Brans R, Buhl T, Dickel H, Dugonik A, Filon FL, Garcìa PM, Giménez-Arnau A, Patruno C, Pesonen M, Pónyai G, Rustemeyer T, Schubert S, Schuttelaar MA, Simon D, Stingeni L, Valiukevičienė S, Weisshaar E, Werfel T, Gonçalo M; ESSCA and EBS ESCD working groups, and the GEIDAC. Patch test results with the European baseline series, 2019/20-Joint European results of the ESSCA and the EBS working groups of the ESCD, and the GEIDAC. Contact Dermatitis. 2022 Oct;87(4):343-355. doi: 10.1111/cod.14170. Epub 2022 Jun 24. PMID: 35678309. https://pubmed.ncbi.nlm.nih.gov/35678309/
5. DeKoven JG, Silverberg JI, Warshaw EM, Atwater AR, et al. North American Contact Dermatitis Group Patch Test Results: 2017-2018. Dermatitis. 2021 Mar-Apr 01;32(2):111-123.
6. DeKoven JG, Warshaw EM, Zug KA, et al. North American Contact Dermatitis Group Patch Test Results: 2015-2016. Dermatitis. 2018 Nov/Dec;29(6):297-309.
7. DeKoven JG, Warshaw EM, Belsito DV, et al. North American Contact Dermatitis Group Patch Test Results 2013-2014. Dermatitis. 2017 Jan/Feb;28(1):33-46.
8. Warshaw, E.M., Maibach, H.I., Taylor, J.S., et al. North American contact dermatitis group patch test results: 2011-2012. Dermatitis. 2015; 26: 49-59.
9. W Uter et al. The European Baseline Series in 10 European Countries, 2005/2006–Results of the European Surveillance System on Contact Allergies (ESSCA). Contact Dermatitis 61 (1), 31-38.7 2009.
10. Wetter, DA et al. Results of patch testing to personal care product allergens in a standard series and a supplemental cosmetic series: An analysis of 945 patients from the Mayo Clinic Contact Dermatitis Group, 2000-2007. J Am Acad Dermatol. 2010 Nov;63(5):789-98.
11. Warshaw EM, Buonomo M, DeKoven JG, et al. Importance of Supplemental Patch Testing Beyond a Screening Series for Patients With Dermatitis: The North American Contact Dermatitis Group Experience. JAMA Dermatol. 2021 Dec 1;157(12):1456-1465.
12. Verallo-Rowell VM. The validated hypoallergenic cosmetics rating system: its 30-year evolution and effect on the prevalence of cosmetic reactions. Dermatitis 2011 Apr; 22(2):80-97.
13. Ruby Pawankar et al. World Health Organization. White Book on Allergy 2011-2012 Executive Summary.
14. Misery L et al. Sensitive skin in the American population: prevalence, clinical data, and role of the dermatologist. Int J Dermatol. 2011 Aug;50(8):961-7.
15. Warshaw EM1, Maibach HI, Taylor JS, Sasseville D, DeKoven JG, Zirwas MJ, Fransway AF, Mathias CG, Zug KA, DeLeo VA, Fowler JF Jr, Marks JG, Pratt MD, Storrs FJ, Belsito DV. North American contact dermatitis group patch test results: 2011-2012.Dermatitis. 2015 Jan-Feb;26(1):49-59.
16. Warshaw, E et al. Allergic patch test reactions associated with cosmetics: Retrospective analysis of cross-sectional data from the North American Contact Dermatitis Group, 2001-2004. J AmAcadDermatol 2009;60:23-38.
17. Marks JG, Belsito DV, DeLeo VA, et al. North American Contact Dermatitis Group patch-test results, 1998 to 2000. Am J Contact Dermat. 2003;14(2):59-62.
18. Warshaw EM, Belsito DV, Taylor JS, et al. North American Contact Dermatitis Group patch test results: 2009 to 2010. Dermatitis. 2013;24(2):50-99.
19. Verallo-Rowell V. M, Katalbas S.S. & Pangasinan J. P. Natural (Mineral, Vegetable, Coconut, Essential) Oils and Contact Dermatitis. Curr Allergy Asthma Rep 16,51 (2016) . https://doi.org/10.1007/s11882-016-0630-9.
20. de Groot AC. Monographs in Contact Allergy, Volume II – Fragrances and Essential Oils. Boca Raton, FL: CRC Press Taylor & Francis Group; 2019.
21. De Groot AC. Monographs in Contact Allergy Volume I. Non-Fragrance Allergens in Cosmetics (Part I and Part 2). Boca Raton, Fl, USA: CRC Press Taylor and Francis Group, 2018.
22. Zhu TH, Suresh R, Warshaw E, et al. The Medical Necessity of Comprehensive Patch Testing. Dermatitis. 2018 May/Jun;29(3):107-111.

Want more great information on contact dermatitis? Check out the American Contact Dermatitis Society, Dermnet New Zealand, the Contact Dermatitis Institute, and your country’s contact dermatitis association.

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