Contact allergy to beeswax and propolis among patients with cheilitis or facial dermatitis
Journal article, 2019

Background: Beeswax, both white and yellow, has many uses, such as in lip balm. This material can cause contact allergy, although not many cases have been described.
Methods: Ninety-five patients with contact cheilitis, facial eczema or a suspicion of contact allergy to beeswax were patch tested with yellow and white beeswax and with propolis, in addition to the Swedish baseline series. Patients who reacted positively to beeswax were additionally tested with caffeic acid, and two derivatives thereof that are believed to be important haptens in propolis.
Results: Seventeen patients had positive reactions to beeswax. Fourteen of these patients had been tested with both yellow and white beeswax. Among those 14, eight had positive reactions to both types of wax, five only to yellow wax, and one only to white wax. Of the 10 wax-positive patients tested with caffeic acid derivatives, three reacted positively. Fourteen beeswax-positive patients also had positive reactions to propolis.
Conclusion: Patch testing cheilitis patients is important, as contact allergy is common. Our suggestion is to patch test, apart from the baseline series and the patient's own products, also with beeswax and propolis. Many beeswax-allergic cheilitis patients would not have been diagnosed with a relevant contact allergy if only the Swedish baseline series had been used.


cera alba

cera flava


caffeic acid



contact allergy


Gunnar S.A. Nyman

University of Gothenburg

Sahlgrenska University Hospital

Mimmi Tang

University of Gothenburg

Sahlgrenska University Hospital

Annika Inerot

Sahlgrenska University Hospital

University of Gothenburg

Amra Osmancevic

Sahlgrenska University Hospital

University of Gothenburg

Per Malmberg

Chalmers, Chemistry and Chemical Engineering, Chemistry and Biochemistry

Lina Hagvall

University of Gothenburg

Sahlgrenska University Hospital

Contact Dermatitis

0105-1873 (ISSN) 1600-0536 (eISSN)

Vol. 81 2 110-116

Subject Categories

Dermatology and Venereal Diseases

Gastroenterology and Hepatology

Rheumatology and Autoimmunity


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