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1 514 781 patients shows methylisothiazolinone allergy prevalence is 5.48% in dermatitis casesLarge review shows contact allergy to isothiazolinones affects many dermatitis patients

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Key Takeaway
Note regional variations and increased benzisothiazolinone use requiring enhanced surveillance in dermatitis patients.

This systematic review and meta-analysis assessed the prevalence of contact allergy to isothiazolinones among 1 514 781 dermatitis patients. Data were sourced from PubMed, Embase, and Web of Science covering the period from 2000 to 2025. The primary outcome measured the prevalence of contact allergy to these specific substances.

The analysis reported a pooled prevalence of 5.48% for methylisothiazolinone. Methylchloroisothiazolinone/methylisothiazolinone showed a prevalence of 4.58%, while benzisothiazolinone showed a prevalence of 2.09%. Clinical relevance was observed in 55.6% of methylisothiazolinone cases, 60.1% of methylchloroisothiazolinone/methylisothiazolinone cases, and 35.3% of benzisothiazolinone cases.

The authors highlight substantial regional variations in usage patterns dependent on regulatory strictness. There is an indication of a decline particularly regarding methylisothiazolinone and methylchloroisothiazolinone/methylisothiazolinone. Conversely, there is an increase in the use of substances such as benzisothiazolinone necessitating enhanced surveillance measures. No adverse events or discontinuations were reported in this review.

The findings support the efficacy of proactive risk management for post-marketed substances. However, the study does not report causality or specific confidence intervals for the prevalence estimates.

Researchers combined data from medical databases to look at how often people with dermatitis have an allergy to isothiazolinones. These chemicals are common preservatives found in many consumer products. The team analyzed records from 2000 to 2025 involving more than 1.5 million patients. They wanted to know how widespread these allergies are and whether they matter for patient care.

The study found that about 4.6 percent of patients had an allergy to methylchloroisothiazolinone and methylisothiazolinone. Methylisothiazolinone alone caused allergies in roughly 5.5 percent of cases. Benzisothiazolinone was less common, affecting about 2.1 percent of patients. The researchers also looked at how clinically relevant these allergies were. They found that over 60 percent of the methylchloroisothiazolinone and methylisothiazolinone cases were considered clinically relevant. For methylisothiazolinone alone, 55.6 percent were relevant. Benzisothiazolinone cases were relevant in 35.3 percent of instances.

The authors noted that usage patterns vary greatly by region depending on local rules. They saw a decline in the use of methylisothiazolinone but an increase in benzisothiazolinone. This shift suggests a need for better monitoring of benzisothiazolinone. The study highlights the importance of proactive risk management for these substances after they are on the market. Readers should understand that these chemicals are common triggers for dermatitis patients.

What this means for you:
Contact allergy to isothiazolinones is common in dermatitis, with methylisothiazolinone being the most frequent trigger.

Study Details

Study typeMeta analysis
EvidenceLevel 1
PublishedJun 2026
View Original Abstract ↓
Isothiazolinones are employed in the preservation of cosmetic, consumer and industrial products, with the objective of preventing deterioration and spoilage. However, the utilization of isothiazolinones is associated with an elevated risk of developing contact allergy (CA). Herein, we assess the epidemiology of CA to isothiazolinones among dermatitis patients from year 2000 onwards. We systematically searched PubMed, Embase, and Web of Science from 1 January 2000 to 19 April 2025 yielding 115 studies comprising 1 514 781 dermatitis patients. The prevalence of CA to methylchloroisothiazolinone/methylisothiazolinone (MCI/MI) was 4.58%, methylisothiazolinone (MI) was 5.48%, and benzisothiazolinone (BIT) was 2.09%. The clinical relevance ranged from 60.1% for MCI/MI, 55.6% for MI, and 35.3% for BIT. Asia and North and South America exhibited the highest rates of CA to isothiazolinones, whereas Europe showed lower rates. These findings underscore the efficacy of proactive risk management for post-marketed substances such as MI, underscoring substantial regional variations in usage patterns, which are contingent on the strictness or permissiveness of their incorporation into everyday consumer products. There is an indication of a decline, particularly regarding MI and MCI/MI. However, there has been an increase in the use of substances such as BIT, which necessitates enhanced surveillance measures.
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