Allergen

Clothes, Textiles

No, not all clothes, but yes, enough clothes have top published contact allergens in them for us to call the category an allergen. If you’re noticing dryness, darkening, itching, redness, or other skin issues on areas that come into contact with your clothing — from underwear areas to your knees, elbows, abdomen, back, neck, forehead (if you wear head wraps or hats), etc. — it’s worth getting a patch test. Textile dermatitis (or clothing contact dermatitis) is a thing and if your dermatologist suspects it, they might suggest a patch test with textile allergens along with a standard patch test tray.

Some of the top contact allergens commonly found in lots of clothing include:

• Dyes, including black paraphenylenediamine (PPD), tolouene 2-5 diamene sulfate (PTDS), disperse blue (and more colorants), and the mordants (related to metal) used to help them bind to fabric
• Latex, rubber, elastics, and other rubber-related substances like thiuram or carba mix
• Formaldehyde
• Nickel, chrome, cobalt
• Leather and the many things used to process it
• Plus the perfumes, preservatives, dyes, and other allergens in popular laundry detergents and fabric softeners

Some other things might not be contact allergens but can be irritating such as chlorine, bleach, and scratchy fabrics.

How allergens and irritants in clothing might affect your skin:

In addition to itching, discomfort, redness, and scaling, these contact allergens (if your patch test shows that you are sensitive to them) can also cause chronic dryness and skin darkening.

Very dark pigmented contact dermatitis — which tends to occur on the bra line, waistline, mid-back, and genital, anal and inguinal areas — can happen even without symptoms preceding it.

Other skin problems like folliculitis, intertrigo or secondary yeast or bacterial infections can also occur. See your dermatologist to ensure a proper diagnosis and treatment.

Areas that tend to be affected are the backs of the knees, ankles, groin, buttocks, thighs, crooks of the arm, armpits, and neck (where the skin comes into contact with clothing the most).

Sweat and hot or humid conditions can worsen skin reactions.

What to do?

• Get a patch test FIRST. There’s no point in stressing yourself out with clothing selection when you can be guided by knowing the specific allergens you need to avoid. You might be able to use lots more clothes than you think. And, you might not be allergic to the materials in the clothnig themselves but ingredients in laundry soaps and products used to clean them. A patch test saves you lots of time, error, and discomfort.
  • A patch test can also save you money: you might be splurging on premium or “natural” or “safer” clothes that you might actually need to avoid! Many natural substances are proven contact allergens, enough so that a recent study in the Journal of Drugs in Dermatology states, “We emphasize the misconception of clean, natural, organic, and vegan to equal safe.” The same study notes that “Many naturally derived ingredients are the cause of dermatitis.”
• Try to use clothes in natural, breathable fabric like organic cotton (especially that are uncolored and untreated) and elastic-free. Cottonique sells great options.
  • Looser-fitting clothes are also less likely to promote skin reactions.
  • Synthetic fabrics don’t tend to breathe as well as natural fabrics. This can be a problem if you’re also dealing with and sweat “acne,” which is actually Malassezia folliculitis (a fungal condition). Fungi love humid conditions and this particular fungus loves sweat. More breathable clothing (plus changing frequently during periods of lots of sweating and immediateley after) can help.
• Choose light-colored or uncolored clothing items. Be wary of clothes that say “wash separately” because the colorants may bleed (meaning more contact with skin).
• Do not use “non-iron” or “dirt-repellent” clothing as these items tend to be treated with additional chemicals that are contact allergens.
• If you do tend to have fungal issues on the face, body, or feet, apply Id Monolaurin Gel followed by Essence Antiperspirant or Stay Fresh-ener before putting on clothes, socks and shoes.
• If you have bumps on the face, back, chest, arms, buttocks, thighs, etc., add Id Monolaurin Gel to your Id or SuperSkin Care regimen.
• Wash your clothing in a fragrance-free, dye-free, paraben-free, preservative-free, allergen-free laundry soap like Fawn & Launder or even one of our hair and body shampoos.
• Use fragrance-free, dye-free, paraben-free, preservative-free, allergen-free skincare and makeup — skin safe clothing won’t matter much if you’re using other products with allergens (be guided by your patch test results).

If you work with textiles …

• When on the job, use protective gloves (make sure they’re of a material and color that you are not sensitive to; your patch test can guide you). Applying a purely mineral, non-comedogenic barrier-protective product like Stay-On-Point! or Armada Baby or Post-Procedure on your hands before putting on gloves may provide further protection from the textile chemicals and the gloves themselves.
• Change out of soiled clothes frequently. Use an allergen-free laundry soap such as Fawn & Lauder or even Superwash!
• Wash hands with Essence Skin-Saving Soap, Superwash, or any of our facial cleansers.
• Use our allergen-free moisturizers liberally on hands every day and even multiple times during the day such as after hand washing.
• For very irritated hands, try this overnight layering intensive moisturization technique: apply moisturizer liberally all over hands. Follow with Know-It-Oil virgin coconut oil then Boo-Boo Balm. Wrap in cling wrap or pure, organic cotton cloth or socks (Cottonique makes some) and leave on overnight.

Subscribe to VMVinSKIN.com and our YouTube channel for more hypoallergenic tips and helpful “skinformation”!

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. Nijman L, Rustemeyer T, Franken SM, Ipenburg NA. The prevalence and relevance of patch testing with textile dyes. Contact Dermatitis. 2023 Mar;88(3):220-229. doi: 10.1111/cod.14260. Epub 2022 Dec 12.
2. Armengol, ES, Kerezsi, AB, Laffleur, F. Allergies caused by textiles: control, research and future perspective in the medical field, International Immunopharmacology, Volume 110, 2022, 109043, ISSN 1567-5769, https://doi.org/10.1016/j.intimp.2022.109043.
3. Stenton J, Dahlin J, Antelmi A, et al. Patch testing with a textile dye mix with and without Disperse Orange 3. Contact Dermatitis. 2020 Nov;83(5):387-390. doi: 10.1111/cod.13660. Epub 2020 Sep 14.
4. Wentworth AB, Richardson DM, Davis MD. Patch testing with textile allergens: the mayo clinic experience. Dermatitis. 2012 Nov-Dec;23(6):269-74.
5. Herman-Kideckel, S.M., Holness, D.L. Results of patch testing with the textile colour and finish tray. All Asth Clin Immun 6 (Suppl 2), P9 (2010).
6. Urban K, Giesey R, et al. A Guide to Informed Skincare: The Meaning of Clean, Natural, Organic, Vegan, and Cruelty-Free. J Drugs Dermatol. 2022 Sep 1;21(9):1012-1013.
7. 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.
8. 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/
9. 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.
10. 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.
11. 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.
12. 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.
13. 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.
14. 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.
15. 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.
16. 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.
17. Ruby Pawankar et al. World Health Organization. White Book on Allergy 2011-2012 Executive Summary.
18. 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.
19. 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.
20. 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.
21. 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.
22. 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.
23. 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.
24. de Groot AC. Monographs in Contact Allergy, Volume II – Fragrances and Essential Oils. Boca Raton, FL: CRC Press Taylor & Francis Group; 2019.
25. 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.
26. 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.

Laura is our “dew”-good CEO at VMV Hypoallergenics and eldest daughter of VMV’s founding dermatologist-dermatopathologist. She has two children, Madison and Gavin, and works at VMV with her family and VMV’s signature “skinfatuated, skintellectual, skingenious” team. In addition to saving the world’s skin, Laura is passionate about health, cultural theory, human rights, happiness, and spreading goodness (like a VMV cream)!