UPDATE: Wet wipes may cause rashes
[Updates story posted Jun 21, 2010, as 20100621elin005 with comments from Kimberly Clark in paras 9 and 10, and new comments from researcher in paras 11-13. Also adds mention of methylisothiazolinone (MI) in para 2; changes "MCI" to "MI" in last sentence of para 3; and changes "MCI" to "MCI/MI" in paras 6 and 7.]
By Frederik Joelving
NEW YORK (Reuters Health) - Using wet wipes after going to the bathroom can be a less-than-soothing experience, according to a new report of four people who developed severe allergic reactions after using such products.
Doctors have long known that many of the preservatives used in wet wipes can cause rashes, especially on irritated skin. But the authors of the new report, from the Mayo Clinic in Rochester, Minnesota, singled out a pair of chemicals -- methylchloroisothiazolinone (MCI) and methylisothiazolinone (MI) -- as a cause of particular concern.
For instance, one of their four patients had a rash around his anus so painful that he couldn't walk for months. He had been treated by several doctors without success and had to take a two-month leave from his job. It wasn't until he stopped using Kimberly-Clark's Cottonelle moist wipes, some of which contain MI, that the problem cleared up.
Another man, who had psoriasis, automatically assumed the rash between his buttocks was a result of his disease. He suffered for 20 years, and then improved drastically within six weeks of dropping the moist wipes he'd been using.
"Patients with (rashes around their anus) often continue to use the moist toilet paper with the belief that the cleansing will help heal the lesions," the researchers write in the Archives of Dermatology. "They may not make the correlation that the moist toilet paper is the culprit."
While the report only describes four isolated cases, the authors note that wet wipes are becoming increasingly popular among adults. "We voice our concern about MCI/MI being used as a preservative in cosmetics, industrial products, and moist toilet paper," they write.
It is unclear how many people are allergic to MCI/MI, said Dr. Erin Warshaw, an allergy expert at the University of Minnesota who was not involved in the new study. Among those referred to specialists for suspected allergies, she told Reuters Health by e-mail, about 3% react to MCI/MI.
In her experience, she added, "wet wipes are a common cause of allergy. The allergens are almost always preservatives."
Kimberly-Clark told Reuters Health in an e-mail that its Cottonelle Flushable Moist Wipes only contained MI, not MCI. While the four patients in the study all reacted to patch tests of the combination MCI/MI, the company said it was unclear if the allergic reaction was caused by one or both of the preservatives.
"All of our products have been, and continue to be, assessed to ensure they adhere to strict safety guidelines and provide the exceptional performance our consumers expect from our brands," the company said.
Dr. Mark Davis, one of the authors of the new report, acknowledged that his study did not firmly establish that MI, and not MCI, had caused the allergic reaction in the patients.
But, he told Reuters Health by e-mail, "the bottom line is that 4 patients presented to our institution with recalcitrant rashes."
"When we looked to see what products they were using to the affected areas that possibly contained MCI/MI we concluded that Cottonelle was a possible culprit since it was known to contain MI," said Dr. Davis, of the Mayo Clinic in Rochester, Minnesota. "When the Cottonelle was stopped the dermatitis resolved in all 4."
SOURCE: http://archderm.ama-assn.org/cgi/content/full/2010.114 Archives of Dermatology, online June 21, 2010.
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