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Persistent eczema is often approached as a problem that needs a better cream. The work of UK consultant dermatologist and allergy specialist Dr Faheem Latheef, who leads cutaneous-allergy work in Leeds and conducts patch testing during planned visits to Dubai, points to another possibility: the product itself may be keeping the reaction alive.
The commercial direction of skincare in the Emirates is not in doubt. Mordor Intelligence values the UAE beauty and personal-care market at USD 3.29 billion in 2025 and forecasts it will reach USD 4.68 billion by 2031. A routine that once meant a cleanser and moisturiser now runs to serums, acids, retinoids, sunscreens, salon treatments and imported cosmetics, each carrying its own ingredient list and often purchased across several markets.
That expansion has created a problem the market is not built to solve. When skin reacts, the commercial answer is a different product. The clinical question is whether an ingredient in one of those products is keeping the reaction alive.
Dr Faheem Latheef‘s work sits on the diagnostic side of that question. He holds the post of consultant dermatologist and allergy specialist at the Leeds Centre for Dermatology at Leeds Teaching Hospitals NHS Trust, where his listed interests are cutaneous patch testing and skin prick testing. King’s College Hospital London in Dubai states that its patch testing is conducted by its visiting dermatologist from the UK, offered during his planned visits to the region, and describes Latheef as lead for the cutaneous allergy service in Leeds. That places him on the diagnostic side of Dubai’s expanding skincare market rather than its aesthetic-treatment side.
Two tests, two mechanisms
The distinction matters. Skin-prick and blood tests are used to investigate immediate, IgE-mediated allergies. Patch testing investigates delayed reactions that may take days to appear. That delay is precisely why the cause can be missed: the rash may appear long after the product was applied, by which point the patient may already have changed the routine.
Under the protocol King’s publishes for its Dubai clinic, substances are applied to the back at a first appointment, removed and assessed two days later, with a final reading another two days after that, three hospital visits inside one week. Patients are asked to bring the creams and ointments they use, including over the counter products, along with their own cosmetics, nail polish, perfumes and hair care products, with the packaging so the contents can be read. The test is built around what one person actually touches.
What the regional data shows
Regional clinic studies do not measure prevalence across the wider population, but they show which allergens recur among patients referred for suspected contact dermatitis. In Qatar, 43 of 87 tested adults reacted to at least one substance, with nickel, gold sodium thiosulfate and p-phenylenediamine among the leading positives. In Riyadh, 74 of 152 referred patients reacted, again led by nickel and p-phenylenediamine. The populations are different: the Qatar and Riyadh figures come from referred clinical groups, while the meta-analysis examined samples drawn from the general population. For context on the wider population, a 2019 meta-analysis of 28 studies covering 20,107 patch tested individuals put contact allergy at 20.1 percent, with p-phenylenediamine at 1.5 percent.
UAE concern over PPD exposure is longstanding. A 2010 University of Sharjah study analysing henna collected from salons across three emirates found PPD in every black-henna sample tested, at concentrations ranging from 0.4 to 29.5 percent, above the level recommended for hair dyes in most cases. Dubai Municipality prohibited salons from using black henna in 2009, and the Dubai Health Authority still advises customers to test dye on a small area of skin first. Contact sensitisation has long been treated as a consumer-safety issue in the UAE.
Why panel breadth can change the answer
Panels also age. Methylisothiazolinone began to be used widely on its own in cosmetics and household products from around 2005. It was named allergen of the year by the American Contact Dermatitis Society in 2013 and produced positive reactions in 13.4 percent of 5,597 patients tested by the North American Contact Dermatitis Group in its 2015–2016 cycle. Testing the older MCI/MI mixture alone misses roughly 40 percent of allergy to MI. That is where the breadth of Latheef’s testing becomes relevant. King’s states that places in the UAE offering patch testing typically cover fewer than 40 allergens, while Latheef tests an average of 150, with everyone tested to at least 70. That is the hospital’s own account of the local market rather than an independent audit.
The number alone is not the measure. The panel must also reflect the patient’s products, occupation and likely exposures, and a positive reaction matters only when it explains something the patient actually encounters.
Broad testing is not the answer for everyone. Not every chronic facial or eyelid rash is caused by contact allergy; atopic eczema, seborrhoeic dermatitis and irritation remain important alternative explanations, and wider panels raise the count of positives that turn out to be clinically irrelevant. King’s own patient information puts the chance of becoming allergic to a test substance at approximately 1 in 500, and rules out testing during pregnancy, with extensive eczema on the back, or on moderate to high dose steroids.
Even a negative result can carry weight by making allergy to the tested substances less likely and redirecting the investigation towards irritation, atopic eczema or another diagnosis. That is the outcome no product can sell. In a market with this much on the shelf, the most valuable thing a dermatology appointment produces is sometimes a list of what to stop using.
