Contact dermatitis to cocamidopropylbetaine is caused by residual amines: Relevance, clinical characteristics, and review of the literature

Cocamidopropylbetaine (CAPE) is an amphoteric surfactant mainly sold as Tegobetaine L7; it is often included in shampoos, cleansing lotions, and disinfectants. In the last 2 years, this was responsible for 15 cases of allergic contact dermatitis seen in our clinics. The causes were shampoos, face cleansing lotions, gynecological antiseptic syndets, liquid shower soaps, and anal hygienic detergents. Although there are only a few cases of contact dermatitis reported in the literature from CAPB and detergents are generally considered rare sensitizing agents, the sensitizing potential of CAPB may be greater than previously thought. This seems to be because of a contaminant, dimethylaminopropylamine, found in some of the cosmetic products.