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Cocamidopropyl Betaine is permitted by the US FDA. Several countries restrict, warning-label, or have reviewed it for safety concerns. The US has more lenient additive rules than the EU, UK, Canada, and Japan, which is why this ingredient remains widely used here.
CAPB itself is well-tolerated by most people. However, it was named Allergen of the Year by the American Contact Dermatitis Society in 2004, indicating it can cause contact allergic reactions in a subset of sensitized individuals. The sensitizer is typically not CAPB itself but trace impurities from manufacturing (amidoamine or 3-dimethylaminopropylamine). High-purity CAPB has a very low sensitization rate. It is not a carcinogen or endocrine disruptor. The CIR concluded CAPB is safe for cosmetic use.
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