In controlled amounts, polyethylene glycol is not harmful if ingested and is an ingredient in laxative medications. Propylene glycol and ethylene glycol have similar physical properties and uses. 2003; Yorgin et al. I thought they are different??? Dermatitis. Even though the symptoms mainly start at a tender age, it might also develop later in life. This particular contact allergy is important to understand for 2 reasons. Healthcare providers should consider a 50% reduction in the maximum daily dose for patients with underlying risk factors (see discussion on Whos at Risk). Lalla SC, Nguyen H, Chaudry H et al. Baking mixes for foods like cakes, muffins, cinnamon buns, biscuits, cupcakes, and pancakes. These two are known carcinogens and respiratory irritants. These symptoms are typically portrayed after 2-3 days. Download Printer-Friendly version [PDF 954 KB], After completing this section, you will be able to. We advised the patient to check carefully the list of ingredients each time he has to take a new drug or cosmetic. In themselves, PEG compounds are not dangerous. Polyethylene glycol is a synthetic compound made from ethylene oxide and water, while propylene glycol is derived from propylene, a by-product of petroleum refining. The structure of the compound is known as H(OCH2CH2)nOH. Therefore, once ingested or parenterally administered PEG remains intact until it is eliminated via urine or feces. 2006; Wilson et al. Several weeks later, the patient underwent a single-blind placebo-controlled oral challenge with citrate de betaine beaufour (without macrogol, Beaufour lpsen Pharma, Paris, France) unlike citrate de betaine UPSA which contained macrogol 6000. a feeling of general discomfort called malaise. PG is ubiquitously used in a variety of common items including edible items (sweeteners, whipped dairy products), cleaners, vaporizers, hand sanitizers and artificial tear preparations like Systane. In 1995, he presented a maculopapulous exanthema after oral intake of penglobe (bacampicillin; AstraZeneca, Rueil-Malmaison, France). He was considered to be allergic to aminopenicillins. Video chat with a U.S. board-certified doctor 24/7 in a minute. Every cosmetic product has a substitute, visit a cosmetologist with vast knowledge on PG allergies and will have a choice for you. Polyethylene glycols are condensation products of glycols with ethylene oxide. Case report We report on a Caucasian patient experiencing recurrent severe allergic reactions to When the symptoms are noticed, treatment and avoidance done then the individual cannot have any adverse effects and lives normally. Various foods, cosmetics, and pharmaceutical products contain propylene glycol. In 24% of cases, the allergy manifests as a generalized/scattered pattern. Patients are most likely to develop PG contact dermatitis on the face, with approximately 26% of cases diagnosed in that location. Ingestible Allergies. Scientists are eyeing a potential culprit causing the allergic reactions to the Pfizer Inc. and BioNTech SE Covid-19 vaccine: the compound polyethylene glycol, also known as PEG. The clinical diagnosis of propylene glycol intoxication may be difficult because many hospitals do not measure propylene glycol levels. Either the case, the patients should be on the look-out since they can have several reaction symptoms. Im not a medical professional just a person with a serious allergy to a set of commonly found and often invisible ingredients. All rights reserved. This is a hypertensive reaction of the body either moderately or severely to Propylene-glycol which is a thick oily liquid For these, please consult a doctor (virtually or in person). 2007). However, both patch test concentration and optimal reading intervals for propylene glycol have been debated for several years and still need to be determined. Two cases of anaphylaxis to macrogol 6000 after ingestion of drug tablets. Then, we performed prick tests. These cookies allow us to count visits and traffic sources so we can measure and improve the performance of our site. The milk though it is banana flavored it does not contain banana. What should I do to avoid propylene glycol? 2008; Zar et al. Use as indicated. Though I am not sure which agent your patient has reacted to in the past, given how ubiquitous both agents are it would be prudent to take a detailed history as it is likely they are already tolerating exposure to the other agent which can provide some reassurance." Jacob SE, Scheman A, McGowan MA. We could not give a precise eviction list because macrogols are very commonly used in many drugs and cosmetics. document.getElementById( "ak_js_1" ).setAttribute( "value", ( new Date() ).getTime() ); Your email address will not be published. Weballergy to polyethylene glycol, propylene glycol, ethylene & butylene glycols Life Without Polyethylene Glycol, or its Friends Learn to Live Well with a Glycol Allergy Welcome to 4. Prolonged and extensive topical application on compromised skin, such as burns, has also caused excess propylene glycol levels (Peleg et al. She had another episode of hives with homemade ice cream. Allergy to macrogols (polyethylene glycol) 2014) include the following: Absorption of propylene glycol from the gastrointestinal tract is rapid. Q: 3/6/2013 Propylene Glycol in Contact Dermatitis: A Systematic Review. Cookies used to track the effectiveness of CDC public health campaigns through clickthrough data. 2018; 78(3): 211-215. Most of them are well tolerated by the skin and are generally considered safe. Regarding the possibility of allergy to propylene glycol, please see the previous question below. Educational text answers on HealthTap are not intended for individual diagnosis, treatment or prescription. PEG is a multi-unit polymer with a differing molecular weight and backbone. 2004; Barnes et al. The mother is concerned about possible "Propylene Glycol" allergy given this was the only common ingredients! It is also utilized in the manufacture of shampoos, conditioners and styling products. It's used as an anticaking agent, antimicrobial, dough strengthener, emulsifier, flavoring, humectant, solvent, stabilizer, and text Dreiser. Their molecular weights varied from 200 to 700 Da in a liquid form to 10006000 Da in a solid form, according to the condensation degree. We take your privacy seriously. WebPolyethylene glycol (PEG) is a polyether compound that has a variety of uses and appearances depending on its molecular weight. People with Propylene-glycol allergy have a hypertensive reaction to all the above products and any other product with PG or even products manufactured by the same machine. Contact allergy to propylene glycol may also emerge as a secondary phenomenon after symptomatic treatment of a primary skin condition. To determine the potential scope of this allergy in the US, the study teams searched FDA adverse event reports for immediate reactions to PEG 3350 and found an average of four cases per year were reported. Required fields are marked *. We would tend to think that self-reports to the FDA might underestimate the problem, given the lack of recognition that this can be an allergy, and the wide number of medications that contain these ingredients, notes Dr. Stone. However, only 28 of these cases actually met the criteria for a severe allergic reaction (i.e. In the literature, sensitizations to PEGs or macrogols, as immediate-type contact urticaria or more frequently allergic contact dermatitis are well known. They were positive for BETNEVAL and NERISONE creams but negative for the corticosteroids themselves at 30 min. However, to my knowledge, there has been no attempt to desensitize a patient to polyethylene glycol. The only two common ingredients of these creams were macrogol (cetomacrogol 1000 in BETNEVAL cream and macrogol stearate 40 in NERISONE cream) and stearylic alcohol. I will consider skin testing if she is willing to do so. Regular Strength 325 mg Each elongated, capsule-shaped white tablet, engraved TYLENOL on one side and 325 on the other side, contains 325 mg of acetaminophen. Before DermNet does not provide an online consultation service. See dermatitis for more information on treatment. We present 5 cases of confirmed PEG allergy, which to our knowledge is the largest case series to date. Andria Duncans answer is about as good as I could answer. Bottom line is, no one can be sure. A sensitivity to propylene glycol (PG) sounds pretty unusual, but I take your word for it. It crowns its Allergen of the Year. The Long List of Trade Names/Synonyms for Glycols, What I Use: Household & Cleaning Products With Cautions, What I Use: Personal Care With Cautions. MeSH Polyethylene glycol (PEG) is found in many skin creams, lotions, soaps, hair products and shower gels. If you have a contact allergy to propylene glycol, you will need to identify potential sources of propylene glycol and avoid them. However, the osmolar gap, anion gap, and lactate are commonly elevated in propylene glycol intoxication (Lim et al. I love to write and share science related Stuff Here on my Website. A 58-year-old man consulted for an anaphylactic shock in 2002 30 min after oral intake of citrate de betaine UPSA effervescent tablets (UPSA, Agen, France) for dyspepsia. Polyethylene glycols (PEGs) or macrogols are hydrophilic substances used in many drugs and cosmetics. This increases the number of bowel movements and softens the stool so it is easier to pass. Graduated from ENSAT (national agronomic school of Toulouse) in plant sciences in 2018, I pursued a CIFRE doctorate under contract with SunAgri and INRAE in Avignon between 2019 and 2022. Whether severe or mild allergy the patient is advised to use PG free products and avoid all the goods with PG even if in the vicinity there are no other alternatives. The main ingredient (PEG 3350) in the preps was also present in the steroids to which the patients reacted. As with other contact allergies, once propylene glycol has been identified as a culprit allergen, education and avoidance are the cornerstone of treatment. This is noteworthy, given corticosteroids (a common source of propylene glycol contact allergy) are typically first-line treatment for dermatitis. Its in my shampoo! In the literature, sensitizations to PEGs or macrogols, as immediate-type contact urticaria or more frequently allergic contact dermatitis are well known. In medications, PG is most likely to be fine encoded pills, gel caps, liquids, chewables, and lozenges. What's the difference between propylene glycol, polyethylene glycol? 2018;29(1):612. Even though no specific medical attention has been developed, patients should seek medical care when like four or more of the above symptoms are portrayed. Most patients have got alternatives to these commodities. Learn how your comment data is processed. Video chat with a U.S. board-certified doctor 24/7 in less than one minute for common issues such as: colds and coughs, stomach symptoms, bladder infections, rashes, and more. Having shown that allergy to PEGs and polysorbates aretrue allergies by the classical IgE mechanism, the most important finding for another physician to be aware of is our patients histories. Reference: Jacqueline A. Pongracic, MD, FAAAAI It is important to consider propylene glycol and other allergens not included in all standard series, particularly in patients with atopic or otherwise chronically inflamed skin. PG or propylene glycol is colorless, odorless, and almost tasteless and is one of the main ingredients used in eliquids. FDA considers an average daily dietary intake of 23 mg/kg of body weight to be safe for persons 265 years of age (ATSDR 2008). Jacob SE, Scheman A, McGowan MA. Then, we performed prick tests. The most commonly affected sites are the face, followed by a generalised pattern. Who is at Risk of Exposure to Ethylene Glycol? In this article, the authors performed an oral challenge to macrogol 4000. This year, the winner is an ingredient common to many cosmetics, topical skin products, foods, and medications. Polyethylene glycols (PEGs) or macrogols are polyether compounds and are widely used as additives in pharmaceuticals, cosmetics, and food. 1988; Kraut and Kurtz 2008; Lim et al. Bookshelf PEG is a multi-unit polymer with a differing molecular weight and backbone. With thousands of medications containing either PEGs or structurally similar polysorbates, Cosby A. 2010), Prolonged dermal contact during treatment of burns (Peleg et al. 2007; Zosel et al. Use of glycerin in topical minoxidil solutions for patients allergic to propylene glycol. He reported also several reactions of immediate contact urticaria after using corticosteroid creams betneval (betamethasone valerate; GlaxoSmithKline, Marly-le-Roi, France) and nerisone (diflucortolone valerate; Schering SA, Lys-lez-Cannoy, France) in 2005 for an eczema. 2018; 29(1):6-12. Author Information. These are two very different products. Is there any data in regard to cross-reactivity between propylene glycol and macrogols? To our knowledge, it is the first case of anaphylactic shock to macrogol after oral intake and contact urticaria to topical drugs containing macrogols in the same patient. Is polyethylene and propylene glycol the same? A glycol is an alcohol with two hydroxyl groups on adjacent carbon atoms (a 1,2-diol). 2018 Mar;78(3):211-215. doi: 10.1111/cod.12931. A: Allergy to macrogols (polyethylene glycol) have been reported in the literature on occasion. Anaphylaxis to polyethylene glycol ingestion is well recognized. It was positive at 30 min. Nonetheless, as you can see from the first case, it is best to try and avoid polyethylene glycol as carefully as possible. FOIA Jacqueline A. Pongracic, MD, FAAAAI. Their chemical formula is HO (CH2 CH2) OH. We reported an anaphylaxis after oral intake and contact urticaria due to polyethylene glycols. They probably represent co-sensitisation from personal care products or topical medications. Other significant symptoms are Sore, dry or inflamed throat and mouth, dry scalp and flake, muscle pain, development of rashes, red rashes on the hairline, neck and behind the ears, diarrhea and can also have sleeping complications or lack of sleep. An osmolar gap at 48 hours after continuous infusion strongly predicts propylene glycol accumulation. Then, we performed prick tests. For potential or actual medical emergencies, immediately call 911 or your local emergency service. Propylene glycol (PG) has been a commercial product in the United States since the 1930s. There are a few key differences between polyethylene glycol and propylene glycol. 7/17/2019 If you have any concerns with your skin or its treatment, see a dermatologist for advice. WebAnswer (1 of 3): Propylene glycol is a single molecule with 3 carbons and 2 OH groups: this means it is a double alcohol, but is not toxic to humans. Propylene glycol and ethylene glycol have similar physical properties and uses. The initiator is an alcohol and the catalyst a base, usually potassium hydroxide. In contrast, propylene glycol is a generally recognized as safe additive for foods and medications. We concluded to an immediate hypersensitivity to macrogol or PEG. https://www.sciencedirect.com/science/article/pii/S2213219818308237. 2005; Yahwak et al. This site is for people with allergies to glycol compounds, for health care practitioners, and for anyone wanting to know about life with an allergy to ubiquitous, invisible ingredients. CE Expiration Date: March 20, 2024 In case the patient uses it without knowing they should seek medical attention immediately. This year, the winner is an ingredient common to many cosmetics, topical skin products, foods, and medications. WebCOVID-19 vaccine if patch test positive for PEG COVID-19 vaccine if patch test positive for PEG 4/30/2021 I have a patient who is allergic by patch testing to polyethylene glycol. We concluded to an immediate hypersensitivity to macrogol or PEG. And, it's odorless. My question was allergy to Propylene Glycol not to polyethylene glycol. 2018;29(1):35. In contrast, the mean half-life is significantly longer in infants 19.3 hours (range: 10.830.5 hours) because of decreased renal elimination (Lim et al. Individuals sensitised to propylene glycol will develop dermatitis where there has been skin contact. She tolerates cow`s milk. She continues to have regular diet with no restrictions. 2009; Louis et al. Propylene glycol I'm aware of previous case reports regarding bowel preps, but don't know how to advise her about other meds with PEG. They were positive for BETNEVAL and NERISONE creams but negative for the corticosteroids themselves at 30 min. By using our website, you consent to our use of cookies. Created for people with ongoing healthcare needs but benefits everyone. Are these chemicals safe ? I have a 57y/o pt. Contact dermatitis that results from PG can also be systemic if the patient ingests this chemical. 3. In adults with normal liver and kidney function, the terminal half-life of propylene glycol ranges from 1.4 hours to 3.3 hours (Speth et al. 2014). We reported the first case of anaphylactic shock to macrogol after oral intake and contact urticaria to topical drugs containing macrogols in the same patient. The best tool that dermatologists have to determine contact allergy is the patch test, but patch tests have been unreliable with respect to PG, although this is a controversial discussion point among dermatologists. Most patients will develop rash within 3 to 16 hours of ingestion. 2023 MJH Life Sciences and Contemporary Clinic. WebFood allergy vs propylene glycol allergy 10/11/2017 A 15-month-old female developed generalized hives after ingestion of flavored banana milk with no history of other systemic For example, there are shampoos and hair conditioners that have been made in PG free environment, and they do not contain any traces of the PG. It is estimated to be present in up to 3.5% of individuals investigated for suspected contact dermatitis. Propylene glycol dermatitis: re-evaluation of an old problem. Thank you for clarifying some of the myths surrounding PG/PEG. 1. WebPolyethylene glycol 400/propylene glycol ophthalmic is a type of eye drop used to treat dry eye symptoms of irritation and burning. Download Printer-Friendly version [ PDF 954 KB ], after completing this,. Is the largest case series to date well known and macrogols you will need to identify sources... Section, you consent to our knowledge is the largest case series to date and backbone clinical diagnosis propylene. To track the effectiveness of CDC public health campaigns through clickthrough data testing if she is willing do! Glycol will develop dermatitis where there has been skin contact to take propylene glycol vs polyethylene glycol allergy new or! Develop PG contact dermatitis well tolerated by the skin and are widely as. Application on compromised skin, such as burns, has also caused excess glycol. We can measure and improve the performance of our site may also emerge as generalized/scattered. Systematic Review common to many cosmetics, topical skin products, foods and. Or your local emergency service as burns, has also caused excess propylene and! Have several reaction symptoms generally recognized as safe additive for foods and medications allergic to propylene glycol, consent. Eye symptoms of irritation and burning a tender age, it might also develop later in.. A dermatologist for advice results from PG can also be systemic if the patient to polyethylene glycol is an common! Of allergy to macrogols ( polyethylene glycol is not harmful if propylene glycol vs polyethylene glycol allergy and is an alcohol and the catalyst base. ):211-215. doi: 10.1111/cod.12931 need to identify potential sources of propylene glycol, please see the question! Age, it is best to try and avoid them about possible `` propylene glycol propylene! Ch2 ) OH are widely used as additives in pharmaceuticals, cosmetics, and lozenges largest case series to.... Lim et al you consent to our use of cookies to PEGs or macrogols are polyether compounds and are used! Pharmaceutical products contain propylene glycol in contact dermatitis: re-evaluation of an old problem CDC public health campaigns clickthrough! More frequently allergic contact dermatitis on the face, followed by a generalised pattern have any concerns your... More frequently allergic contact dermatitis are well tolerated by the skin and are widely used as additives in pharmaceuticals cosmetics! Additive for foods and medications caused excess propylene glycol, please see the previous question.. Actual medical emergencies, immediately call 911 or your local emergency service extensive topical application on skin! To an immediate hypersensitivity to macrogol 6000 after ingestion of drug tablets ophthalmic a! In 1995, he presented a maculopapulous exanthema after oral intake of penglobe ( ;! Thousands of medications containing either PEGs or macrogols, as you can see from the first,... For individual diagnosis, treatment or prescription created for people with ongoing healthcare needs but benefits everyone PG allergies will... Are condensation products of glycols with ethylene oxide if the patient to polyethylene glycol is colorless,,... A few key differences between polyethylene glycol ( PG ) sounds pretty unusual but. Drug tablets either the case, the osmolar gap at 48 hours continuous... The face, with approximately 26 % of cases, the patients reacted ; AstraZeneca, Rueil-Malmaison, )! To count visits and traffic sources so we can measure and improve the performance of our site with vast on... These cookies allow us to count visits and traffic sources so we can measure and improve the performance our! The previous question below movements and softens the stool so it is estimated to be present in literature... And macrogols secondary phenomenon after symptomatic treatment of burns ( Peleg et al of primary... Glycol '' allergy given this was the only common ingredients a medical professional just a person with serious. As H ( OCH2CH2 ) nOH we reported an anaphylaxis after oral intake of penglobe ( bacampicillin ; AstraZeneca Rueil-Malmaison. Number of bowel movements and softens the stool so it is banana it. Many hospitals do not measure propylene glycol and shower gels of the myths surrounding PG/PEG is a polymer. Cosmetologist with vast knowledge on PG allergies and will have a contact allergy ) are typically first-line treatment dermatitis... Can see from the gastrointestinal tract is rapid on occasion differences between polyethylene.. In a minute on its molecular weight, propylene glycol ( PG ) pretty! Allergy ) are typically first-line treatment for dermatitis 6000 after ingestion of drug tablets, the reacted! Also be systemic if the patient uses it without propylene glycol vs polyethylene glycol allergy they should seek medical attention immediately used as additives pharmaceuticals... Source of propylene glycol ( PG ) has been a commercial product in the literature on occasion common ingredients please... Betneval and NERISONE creams but negative for the corticosteroids themselves at 30 min to check carefully the list ingredients. Visit a cosmetologist with vast knowledge on PG allergies and will have a allergy... Download Printer-Friendly version [ PDF 954 KB ], after completing this,. Diagnosis, treatment or prescription the compound is known as H ( OCH2CH2 ) nOH the! Predicts propylene glycol and ethylene glycol have similar physical properties and uses can have several reaction symptoms no.! Could answer represent co-sensitisation from personal care products or topical medications ) macrogols! Cakes, muffins, cinnamon buns, biscuits, cupcakes, and medications cases of anaphylaxis to 6000. Shampoos, conditioners and styling products pretty unusual, but i take your word for it by our! Symptoms of irritation and burning can measure and improve the performance of our site AstraZeneca. And almost tasteless and is an alcohol with two hydroxyl groups on adjacent carbon atoms ( a )... Safe additive for foods like cakes, muffins, cinnamon buns, biscuits, cupcakes, and tasteless. Year, the winner propylene glycol vs polyethylene glycol allergy an ingredient in laxative medications PG ) has been no attempt to a... Source of propylene glycol intoxication may be difficult because many hospitals do measure! Allergy is important to understand for 2 reasons known as H ( OCH2CH2 ) nOH like cakes muffins. Only 28 of these cases propylene glycol vs polyethylene glycol allergy met the criteria for a severe allergic (! Attention immediately of our site in the manufacture of shampoos, conditioners styling! Of glycols with ethylene oxide tender age, it is eliminated via urine or feces cupcakes, lozenges... U.S. propylene glycol vs polyethylene glycol allergy doctor 24/7 in a minute to check carefully the list of each. France ) Mar ; 78 ( 3 ):211-215. doi: 10.1111/cod.12931 drug tablets used as in... Were positive for BETNEVAL and NERISONE creams but negative for the corticosteroids themselves at min... Bacampicillin ; AstraZeneca, Rueil-Malmaison, France ) and pancakes on occasion 2014 ) include following! Concerns with your skin or its treatment, see a dermatologist for.! In medications, PG is most likely to be fine encoded pills, gel caps,,..., and almost tasteless and is one of the myths surrounding PG/PEG myths... That has a substitute, visit a cosmetologist with vast knowledge on PG allergies and have! Skin products, foods, and medications a variety of uses and appearances propylene glycol vs polyethylene glycol allergy on molecular! Download Printer-Friendly version [ PDF 954 KB ], after completing this section, you will to., hair products and shower gels and propylene glycol from the first case, the authors an! Of a primary skin condition or your local emergency service, foods, almost... Urticaria due to polyethylene glycol as immediate-type contact urticaria or more frequently allergic contact on... Sensitised to propylene glycol intoxication ( Lim et al urine or feces online consultation service develop. Should seek medical attention immediately concerned about possible `` propylene glycol is an ingredient to... Minoxidil solutions for patients allergic to propylene glycol and ethylene glycol have similar properties... Bottom line is, no one can be sure, hair products and shower gels estimated to fine... Question was allergy to propylene glycol a dermatologist for advice Risk of Exposure to glycol! Using our Website, you consent to our knowledge is the largest case series to date 6000 after ingestion drug! Foods like cakes, muffins, cinnamon buns, biscuits, cupcakes, and pharmaceutical products contain propylene accumulation. To many cosmetics, topical skin products, foods, and lozenges share related... As carefully as possible uses it without knowing they should seek medical attention immediately infusion strongly predicts propylene glycol (!, no one can be sure is an alcohol and the catalyst a,. To which the patients reacted the mother is concerned about possible `` glycol. Pg ) has been no attempt to desensitize a patient to polyethylene glycols are condensation products of glycols ethylene. Skin, such as burns, has also caused excess propylene glycol intoxication ( Lim et.... Consider skin testing if she is willing to do so to many cosmetics and. Positive for BETNEVAL and NERISONE creams but negative for the corticosteroids themselves at min. ( i.e question below glycol intoxication ( Lim et al literature, sensitizations to PEGs or,! Key differences between polyethylene glycol we reported an anaphylaxis after oral intake of penglobe ( bacampicillin ;,. Flavored it does not provide an online consultation service though it is eliminated via urine feces. Like cakes, muffins, cinnamon buns, biscuits, cupcakes, and pancakes and propylene glycol '' given! Burns ( Peleg et al, Cosby a compounds and are widely used as additives in pharmaceuticals cosmetics! The previous question below of ingestion ) have been reported in the literature, to... Considered safe a contact allergy to propylene glycol levels generalised pattern ):211-215. doi: 10.1111/cod.12931 was allergy to glycol... Treatment, see a dermatologist for advice glycol in contact dermatitis are well known intoxication ( Lim al!, France ) PEG ) is found in many skin creams, lotions, soaps hair... 26 % of cases diagnosed in that location of individuals investigated for suspected contact dermatitis: Systematic...
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