Cosmetic Adverse Reactions and Prognostic Factors: A Retrospective Cohort Study in Wuhan, China

BACKGROUND Despite the increasing prevalence of cosmetic-related adverse reactions, their potential prognoses and associated risk factors have received limited attention within the medical community.

METHODS A retrospective analysis was conducted on 7794 cases of cosmetics-related adverse reactions reported in Wuhan, China, from 2017 to 2023. Data were collected from multiple sources, including medical institutions, cosmetic manufacturers, distributors, individual consumers and regulatory agencies. Demographic characteristics, clinical diagnoses, symptom profiles and allergy histories were systematically analysed using descriptive statistics. Cases were stratified by recovery outcome into complete versus incomplete groups to identify prognostic factors. Comparative analyses were performed using χ2 tests, with statistically significant variables (p < 0.05) further evaluated through multivariate logistic regression to calculate odds ratios (ORs) and 95% confidence intervals (CIs). All statistical analyses were performed using SPSS version 25.0, with a significance level set at p < 0.05.

RESULTS Among the 7794 patients, the majority (76.56%) achieved complete recovery, while a substantial proportion (23.44%) experienced persistent or permanent symptoms, such as post-inflammatory hyperpigmentation (PIH), atrophic scarring and other forms of skin damage. Statistical analysis identified age and a history of allergies as significant risk factors for long-term skin damage. Patients under 20 years of age were 2.06 times more likely to suffer persistent or permanent symptoms compared to those over 50 years (p = 0.000). Additionally, individuals with a history of food allergy were 3.16 times more prone to long-term skin damage (p < 0.05). A history of drug allergy also significantly increased the risk, with an OR of 1.887 (95% CI: 1.34, 2.66; p = 0.000).

CONCLUSION This study identified younger age (< 20 years) and a history of food or drug allergies as significant risk factors for long-term symptoms following cosmetic adverse reactions. These insights assist dermatologists in recognising high-risk individuals and guiding tailored preventive strategies. Integrating these indicators into clinical evaluation and patient counselling may enhance early intervention, ultimately reducing the likelihood of persistent or irreversible cutaneous sequelae. Overall, the findings highlight the importance of individualised risk assessment and proactive management in ensuring cosmetic safety and optimising dermatological and public health outcomes.