It’s not an allergy which many people, including experts, have heard of, and yet for some, titanium – in the form of the colouring and UV absorber titanium dioxide – could be causing sensitivities and other problems. Alex Gazzola reports.

Named after the Titans of Greek mythology, titanium is an extremely strong metal, highly resistant to corrosion, which is the seventh most abundant metallic element in the earth’s crust. As a literal ‘titan’ of the metal world, it is widely used in engineering, aviation and other industries – but has been put to use in more recent years in reconstructive medicine in the form of prosthetics, hip and joint replacements, as well as dental and other implants, which clearly have introduced the material more directly onto or into the body. It’s also in building materials such as cements, and sports equipment such as tennis rackets, plus coins and jewellery.

In the form of titanium dioxide – a bright white powder, chemically expressed as TiO2 – it has an even wider range of applications, many of which bring people into additional close contact with it. It is found in paints, for example – the gloss paint on your skirting board, for instance, and famously the white lines of the lawns on the Wimbledon tennis courts. It is also found in white carrier bags and other plastics, bright white papers, some inks, and occasionally as a glaze or film on ceramics, mirrors and gemstones to sharpen optical intensity.

It is especially common in cosmetic products – principally in products such as make-up, sunscreen and toothpastes – occasionally in ‘nano’ particle form, which boast additional applications.

Titanium dioxide is also found in food, as the food colouring E171 – to add whiteness to confectionary, icing sugar and vegan dairy-replacement foods – and in many pills, supplements and drugs, sometimes merely on the casing. It’s regularly used in products such as nicotine gums too.

In recent years, several reports of titanium allergy or sensitivity have come to light, although there is very little research in the medical literature about it. Should you be worried? And could titanium be the underlying cause of sensitivities, reactions or symptoms for which no other culprit can be found?

Titanium sensitivity

Although metals are not allergens in themselves, their ions can bind to biological protein molecules and convert them into proteins which have greater allergenic potential. This happens with the well-documented nickel allergy, which may affect up to 10% of the population, mainly women.

Titanium allergy is less documented or understood, but it has been a subject the Breakspear Medical Group – a private UK clinic, specialising in allergy and environmental illness – have been interested in for some years. It may effect up to 4% of people with titanium implants, and smaller numbers of the wider population. The only current blood test for titanium allergy, a test called the MELISA® test, is available through Breakspear. For those with skin sensitivities, potentially to cosmetics, patch testing is an alternative means of testing, but it may not work well as an alternative in the case of titanium, unfortunately, as skin penetration may not be sufficient.

Symptoms of sensitivity can include dermatitis and other skin-focused reactions, but there has been speculation that neurological effects – such as headaches, migraines, depression, muscular pain, insomnia and fatigue – may also be sometimes caused by longer term or heavier exposure to titanium in those who have developed reactivity to it.

Titanium dioxide in food

In March earlier this year, doughnut company Dunkin donuts made the news after announcing it would remove titanium dioxide from its products. The move appeared to be triggered by pressure from an advocacy group, who were concerned about the presence of ‘nano’ titanium dioxide in the food grade titanium dioxide they were using. Although there are some naturally occurring ‘nano’ particles in E171, most of the TiO2 is non-nano – it needs to be in order for the whitening / brightening effects the ingredient is used for in food to be present. As a highly unreactive ingredient, it is widely considered safe – again, it would have to be, to be EU approved, as it is.

That said, some expert commentators have pointed out that some theoretical longer-term risks we don’t yet know about may exist, and in line with the trend for so-called ‘clean eating’, many may choose to avoid the colouring as they might other colourings or additives in their diets. It is used widely in confectionary and chewing gum and the matter has in the past raised some concerns with regard to the health of children, its primary consumers.

There have been some reports on the internet that suggest it may be used to replace lost or absent whiteness in skimmed milks, cottage cheeses and ultra-white cheeses such as Mozzarella, but the Dairy Council state it is definitely not used in milk (although it may be used in the cartons of skimmed milk), and in the EU the only dairy products it appears to be authorised for use in are ‘flavoured fermented milk products’. According to the Food Additives section of the EC database, it is also permitted for use in fruit and vegetable preparations, processed fish and seafood products, edible ices, ‘starch based snacks’, chewing gum, desserts and flavoured drinks.

Those on ‘free from’ diets may find it used in products such as prepared white sauces and condiments, vegan coffee whiteners and vegan / dairy free cheeses such as those by Violife and Daiya.

There have been calls to replace it with rice starch, which is also white, and can be used as an alternative. This ingredient has the added advantage of being a widely tolerated one, as rice allergy is extremely rare in the UK and indeed Europe.

Dairy free and vegan brands who have confirmed to us that they do not use E171 are Oatly, Bute Island Foods (Sheeze), The Coconut Collaborative and Plamil. Lactofree (low-lactose / lactose-free products) also do not use it. Peppersmith chewing gum is free from E171.

Titanium dioxide in Supplements and Medicines

Viridian Nutrition supplements state that they do not use titanium dioxide in any of their products.

Titanium Dioxide in Sunscreens

As it helps reflect ultraviolet light – which can increase the risk of skin cancer – titanium dioxide has been used for decades in sunscreens to help protect us against the sun’s harmful rays. Non-nano titanium dioxide particles of ‘ordinary’ size reflect light and make traditional sunscreens appear white – the same characteristic which the food industry exploits for use as a white colouring. It is used by brands such as Neal’s Yard Remedies in its suncare products, and it meets Soil Association standards.

But nano titanium dioxide particles – which retain their UV protective characteristics, and may even be slightly more effective – carry further cosmetic advantages. First, they scatter light, making them appear transparent on the skin, avoiding telltale white streaks on the beach! They tend to be more stable, reducing the need for frequent reapplication, and they feel lighter and smoother on the skin.

Although health concerns – including cancer, lung disease, and degenerative brain disorders – have been raised in regard to nano titanium dioxide, the little research there has been supporting these worries tend to have been conducted on rats or mice.

Research is a little mixed on the issue of penetrability through the skin, although the consensus currently appears to be that a negligible amount gets through in normal circumstances, and that the body can deal effectively with any which does. The European Commission’s Scientific Committee on Consumer Safety (SCCS) have confirmed in an opinion statement that, used at a concentration of up to 25% as a UV filter in sunscreens, it “can be considered safe for humans after application on a healthy, intact or sunburnt skin” – although some other experts have suggested that penetrability may be increased in those with sensitive / damaged skins or problem skin conditions such as eczema, and this may need to be studied separately to form a clearer understanding. There may also be increased penetration through sweat glands or hair follicles, other experts have speculated. Questions and gaps in our knowledge certainly remain.

They add that while titanium dioxide nano particles may be capable of causing damage to the genetic material of cells, “such effects are unlikely to occur with dermal application”.

The SCCS do acknowledge a risk in inhaling such nano-particles, which is why they advise against their use in, for example, spray sun care protection products.

They also state that titanium dioxide nano particles can additionally act as photo catalysts – this is that they react with UV light from the sun’s rays to trigger the oxidising of some biological molecules and generating free radicals, which could have toxic side effects in the body. Coated nano-particles do not act as photo-catalysts and do retain their UV protective attributes, and so the SCCS recommend that cosmetic manufacturers wishing to use nano titanium dioxide use surface-treated samples. This is what Green People do – the nano titanium dioxide they use is coated with a thin layer of silicates.

Titanium-free natural sun care

The difficulty in finding titanium-free sun protection with additional natural properties is that of the UV filters with ‘blocking’ action, titanium dioxide is the only one currently listed on the EU Cosmetic Regulation Annex VI for UV filters. Zinc oxide, which has a similar action, is not listed, which means that strictly speaking a product containing only zinc oxide as an active UV filtering ingredient is not permitted to describe itself as ‘sunscreen’. There are several such products on the market, however, which appear to be infringing this regulation – which is being reviewed this year. Approval for zinc oxide to be added to the UV filters list is expected, as the Scientific Committee on Consumer Safety has published an opinion in favour of its inclusion. (Zinc Oxide-only preparations are permitted in the US.) Many products include both titanium dioxide and zinc oxide in combination.

Aside from the inorganic mineral-based blocks of titanium dioxide and zinc oxide, other active ingredients used in sunscreens are organic or ‘chemical’ compounds that absorb into the skin and in turn absorb UV light, ‘neutralising’ it. These include some salicylates (such as octyl salicylate) and cinnamates (such as cinoxate, octyl methoxycinnamate – which can be derived from cinnamon). These ingredients can cause sensitivities too, it should be noted – in fact, they’re far more likely to occur than sensitivities to titanium. For example people who react to balsam of Peru or cinnamon can react to cinnamates in sunscreen. Green People use a naturally derived cinnamate along with their titanium dioxide in their products, as well as diethylamino hydroxybenzoyl hexyl benzoate, which is synthetic. NYR rely on zinc oxide and titanium dioxide only. JASON use titanium dioxide along with a mix of chemical UV filters.

What is known for certain is that these sunscreens do block or absorb UV radiation and that they are without doubt protective against damage to the skin’s DNA, which is known to increase the risk of skin cancer. Always use some form of protection when on holiday, or at home during sunnier periods. UV filters are absolutely necessary.

Some natural and titanium-free sunscreens, which only use zinc oxide, are by the small natural cosmetics companies Unica Cosmetics, Bareskin Beauty, Naturally Cool Kids and Ultra Bee Health.

Titanium Dioxide in Make up

Titanium dioxide is an opacifier – which means it brightens and intensifies colour. For this reason it is regularly found in make-up, such as blusher, lipstick, nail polish and powders. When used in this way it is more likely to appear in a list of ingredients by its cosmetic ‘Colour Index’ abbreviation – CI 77891.

Again make-up ranges free from titanium are very tough to come across. There is a titanium-free make-up page on the Beautifully Organic ( website, featuring many Miessence products, which are TiO2-free. Mirror and Make up ( have TiO2-free lip gloss and mineral veil.

Titanium Dioxide in Toothpastes

Also of concern to those sensitive to titanium dioxide is its use in most high-street toothpastes – specifically in ‘whitening’ or ‘ultra brightening’ products.

UK Toothpastes by Earthpaste, JASON, Green People, Weleda and Kingfisher are free from titanium dioxide, and are widely available in health stores or via Amazon.


This article was first published in Allergy Newsletter No. 115, Winter 2015.

Ref 2022 (Zinc Oxide-only preparations are permitted in the US.) Many products include both titanium dioxide and zinc oxide in combination.