A pervasive and potentially irritating ingredient, benzyl alcohol (BA), has been named Allergen of the Year for 2026 by the American Contact Dermatitis Society (ACDS). 

BA is present in processed products and occurs naturally in some foods and plants, “including but not limited to cranberries, apricots, mushrooms, snap peas, cocoa, honey, and in the essential oils of plants such as jasmine, hyacinth, and ylang-ylang,” wrote Nicholas T. Le and Peggy A. Wu, MD, MPH, professor of clinical dermatology at the University of California, Davis, in a paper published in Dermatitis.

BA was also presented as the Allergen of the Year today at the annual meeting of the ACDS in Denver. 

Although BA is generally considered safe, it can cause allergic dermatitis with extended or repeated exposure, the authors noted. However, BA is not included in many standard patch test series, and the ACDS selected it as the Allergen of the Year for 2026 to raise awareness of its allergenic potential through a diverse range of exposures and to encourage patch testing if indicated, the authors said. 

BA is related to benzoic acid in chemical structure and appears as a liquid ranging from clear to pale yellow, with a subtle floral/balsam odor that has contributed to its use in personal care products. BA’s use expanded when it was approved by the FDA in 2009 to treat head lice, based on data from supporting trials. The product, a lotion called Ulesfia, has since been discontinued, although there were few reports of irritation, which occurred in approximately 2% of patients.

Making the Diagnosis

BA, also known as phenylmethanol, benzenemethanol, alpha-toluenol, hydroxytoluene benzylic alcohol, phenylmethyl alcohol, and phenylcarbinol (CAS 100-51-6), appears in many common products as a preservative, solvent, pH adjuster, pesticide, fragrance ingredient, or agent to decrease viscosity. In medical settings, it is used in external analgesics, oral and intravenous drugs, and solvents. 

Given its ubiquitous nature, manifestations of contact allergy to BA can present after varying levels of exposure, the authors noted. Some documented culprits include corticosteroids, epoxy adhesives, and fragrances. The most common presentations involve the hands, legs, neck, and face.

Contact allergy to BA has been identified mainly through patch testing of individuals with possible allergic contact dermatitis.

“Benzyl alcohol has been linked to type IV hypersensitivity reactions, detected with patch testing, as well as urticarial reactions,” Wu told Medscape Medical News. Some increased risk for patch-test positivity to substances such as benzyl alcohol has been linked to patients who may be using multiple products on skin that may be compromised, Wu noted. BA also has been associated with co- or cross-reactivity with other allergens, such as balsam of Peru, and shares structural similarity to benzoic acid and benzoates, she said.

Data from the Information Network of Departments of Dermatology showed a contact allergy rate of 0.21% among patients with dermatitis who underwent patch testing for BA 1% petrolatum between 2010 and 2019; 24% of these cases involved hand dermatitis.

Several case reports involving BA reactions include contact dermatitis from exposure to hearing aid impression material, workplace floor paint, topical antibiotics, sunscreen, lip balm, and over-the-counter moisturizers, the authors noted. 

Awareness and Treatment

Proper identification is the first step to managing BA allergy, Wu told Medscape Medical News. “Benzyl alcohol may not be on some initial screening series for allergic contact dermatitis, and greater awareness is needed for its inclusion in patch testing,” she said. Once identified, the management strategy is avoidance of the source of the allergen, she said. Several tools are available to help patients with avoidance, such as the Contact Allergen Management Program provided with ACDS membership, she added.

Although BA is included in the North American Contact Dermatitis Group, ACDS, Contact Dermatitis Institute series, Contact Dermatitis Institute reduced series, American core baseline, American core reduced baseline, and Australian baseline series, knowledge gaps remain about the optimal test concentration and vehicle for testing, which have fluctuated over the years, the authors wrote. 

“The optimal concentration and vehicle of testing benzyl alcohol could be further explored — some series test it as 10% in Softisan 649, others as a 5% concentration in petrolatum,” Wu said. “Additionally, it remains to be seen how the increased use of benzyl alcohol in personal care products will affect its contact allergy rate.” 

Standardization of test concentrations and vehicles, along with more investigation of potential cross-/co-reactivities and characterization of population-specific risk factors, would enhance the diagnosis of BA allergy, Wu and Le noted in their paper.

The increased prevalence of BA in medications and consumer products supports its selection as the 2026 Allergen of the Year, the authors wrote. Including BA in more patch testing standard series is important to help monitor its impact and keep it as part of the differential diagnosis in patients with unexpected dermatitis or with possible allergies to fragrances or preservatives, they said. 

The article in Dermatitis received no outside funding. Wu disclosed no financial conflicts of interest.