Allergen, Not An AllergenFeatured

(We should talk about) BRUNO: Allergen or Not An Allergen?

Not An Allergen

Bruno Madrigal

A lot of people feared Bruno because he was different and his powers were not well understood. He himself isnā€™t an allergen but his exclusion and exile exposed him to more than a few top contact allergens (poor Bruno on many levels).

Living behind the walls means lots and lots of dust on almost every surface including his clothes and bedding. Dust mite allergies can be brutal on skin and tend to coexist with other allergies like asthma and allergic rhinitis. Depending on the dampness and other conditions behind those walls, moss might be an issue, too. Bruno could come into direct contact with that allergen when touching various surfeits and climbing the walls.

His rat buddies are risks for serious diseases like rabies and leptospirosis. They wouldnā€™t tend to be top contact allergens themselves but what they pick up on their fur and feet could be. They rummage through everything and Bruno touches his pet rodents constantly. It’s not unlikely that, by handling them, he’d come into contact with food bits with dyes, preservatives, and flavors as well as house cleaners with fragrance and formaldehydes. Reactions might not be limited to his hands either: he could transfer those allergens to his face or other parts of his body and experience reactions there as well.

Brunoā€™s footwear of choice (dark rubber sandals) also has top contact allergens but if heā€™s not allergic to rubber, disperse blues, PPD, or acrylates (used to make plastic parts flexible) he’d tend to be fine ā€” which is why patch testing is so important. Not only can it be life changing by showing you exactly what it is you need to avoid (random trial and error can be costly and painful), a patch test can show you what you can use, too. Why is this important? If you’ve had chronic skin issues (severe reactions or just consistently dry skin and even acne or dark blotches), you might be tempted to avoid everything “bad” ā€” but without a patch test, it’s difficult to determine what’s bad for your skin in particular. There’s a lot of information online and while some of it is helpful, a shocking amount is inaccurate, panic mongering, misleading, and/or dangerous. And even accurate information might not be applicable to your specific case. You could be needlessly avoiding things that you’re actually not allergic to or that could even be good for you. Like Bruno!

Another great example is the Madrigalsā€™ fave food: the arepa. Corn can be a food allergen but food and skin allergies rarely correlate. The cells and systems involved are so different that if the Madrigals prick tested positive to corn but didnā€™t patch test positive to it, itā€™s likely they could still use it (or corn-derived ingredients like citric acid) on their skins. Getting legitimate guidance backed by a medical consensus is important or you’ll find yourself using all kinds of things that are actually causing your skin problems and avoiding all kinds of things that are actually good for you.

Bigger risks for contact dermatitis in the Madrigal home would be the magic candle (especially if made of beeswax or infused with cinnamon, lavender, eucalyptus, citruses, or other fragrances) and Isabela’s plants and flowers, maaaaany of which are top contact allergens.

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If you have a history of sensitive skinā€¦

ā€¦donā€™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:

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 ā€” 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. 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.
  2. 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.
  3. 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.
  4. 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.
  5. W Uter et al. The European Baseline Series in 10 European Countries, 2005/2006ā€“Results of the European Surveillance System on Contact Allergies (ESSCA). Contact Dermatitis 61 (1), 31-38.7 2009.
  6. 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.
  7. 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.
  8. 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.
  9. Ruby Pawankar et al. World Health Organization. White Book on Allergy 2011-2012 Executive Summary.
  10. 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.
  11. 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.
  12. 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.
  13. Foliaki S et al. Antibiotic use in infancy and symptoms of asthma, rhinoconjunctivitis, and eczema in children 6 and 7 years old: International Study of Asthma and Allergies in Childhood Phase III. J Allergy Clin Immunol. 2009 Nov;124(5):982-9.
  14. Kei EF et al. Role of the gut microbiota in defining human health. Expert Rev Anti Infect Ther. 2010 Apr; 8(4): 435ā€“454.
  15. Thavagnanam S et al. A meta-analysis of the association between Caesarean section and childhood asthma. Clin Exp Allergy. 2008;38(4):629ā€“633.
  16. 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.
  17. 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.
  18. 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.
  19. Park G, Oh DS, Lee MG, Lee CE, Kim YU. 6-Shogaol, an active compound of ginger, alleviates allergic dermatitis-like skin lesions via cytokine inhibition by activating the Nrf2 pathway. Toxicol Appl Pharmacol. 2016 Nov 1;310:51-59. doi: 10.1016/j.taap.2016.08.019. Epub 2016 Aug 22. PMID: 27562088.
  20. de Groot AC. Monographs in Contact Allergy, Volume II ā€“ 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 SocietyDermnet New Zealand, the Contact Dermatitis Institute, and your countryā€™s contact dermatitis association.


Laura is our ā€œdewā€-good CEO at VMV Hypoallergenics and eldest daughter of VMVā€™s founding dermatologist-dermatopathologist. She has two children, Madison and Gavin, and works at VMV with her sister CC and husband Juan Pablo (Madison and Gavin frequently volunteer their ā€œusage testingā€ services). In addition to saving the worldā€™s skin, Laura is passionate about health, inclusion, cultural theory, human rights, happiness, and spreading (like a VMV cream!) goodness!

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