The allergenic role of cocamidopropyl betaine (CAPB) in contact dermatitis, including eyelid dermatitis, is well documented in the dermatology literature. Despite widespread use of this surfactant in many cosmetic and self-care products, including some commonly prescribed by ophthalmologists for eyelid hygiene, we found no mention of this allergen in the ophthalmic literature.
A 52-year-old woman was referred to our department with a 10-year history of recalcitrant blepharitis, conjunctivitis, and periorbital dermatitis. Her medical history included asthma, seasonal allergies, and atopic dermatitis. Her ocular history was significant for multiple topical and oral therapeutic regimens for her chief complaint with periods of only modest temporary relief.
Welling JD, Mauger TF, Schoenfield LR, Hendershot AJ. Chronic Eyelid Dermatitis Secondary to Cocamidopropyl Betaine Allergy in a Patient Using Baby Shampoo Eyelid Scrubs. JAMA Ophthalmol. 2014;132(3):357–359. doi:10.1001/jamaophthalmol.2013.6254