Abstract
BACKGROUND: Cosmetics have been suggested as sources of exposure in patients with positive patch tests to propolis. It has also been proposed that beeswax in cosmetic products may cause allergic contact dermatitis due to contamination with propolis. OBJECTIVES: To assess how often propolis is listed in cosmetics and to review evidence on the propolis-beeswax relationship, including whether residual propolis in beeswax can elicit dermatitis in propolis-sensitised individuals. MATERIALS AND METHODS: Market survey of ingredient lists for 500 cosmetics and a literature review on allergy to beeswax and its association with propolis allergy. RESULTS: None of the 500 cosmetics contained propolis. Evidence on the propolis-beeswax relationship is inconsistent, but occasional co-reactivity is reported. CONCLUSIONS: Based on the available evidence, propolis is not or only rarely used in conventional cosmetics on the European market and is therefore unlikely to be a relevant exposure source for patients with positive patch tests to propolis. Reactions to beeswax in propolis-sensitised individuals from residual propolis cannot be fully excluded but appear uncommon and mainly involve allergic contact cheilitis from lip balms. Within the scope of the present data, patients with positive patch tests to propolis do not need to avoid all cosmetics containing beeswax.