Systems for detecting explosive traces at airport security checkpoints are engineered to spot tiny amounts of explosive substances using methods like ion mobility spectrometry. Nevertheless, their considerable sensitivity has a downside: False-positive alerts may arise when benign items chemically mimic explosive materials. In dermatology, this encompasses topical treatments and moisturizers with glycerin or nitrates, which are chemically akin to nitroglycerin, a vital ingredient in dynamite.

Glycerin is a widely used humectant found in creams and ointments prescribed for dry skin, eczema, and other persistent dermatological conditions. Topical products containing nitrates, such as nitroglycerin paste, are also employed in dermatological treatments, especially for chronic anal fissures or vascular ulcers. These substances can leave trace residues on patients’ hands or belongings, occasionally triggering alarms at security checkpoints. Since these therapies are routinely administered in dermatology, particularly in hospital-based, wound care, or procedural environments, this matter holds direct clinical significance.

Numerous real-life cases highlight this issue. In 2013, a traveler from Oklahoma reported that her hand lotion containing glycerin caused a false-positive explosive alert, resulting in prolonged secondary screening. In another account, a paramedic found that his bag tested positive for nitroglycerin residue, likely due to carrying nitroglycerin spray utilized for treating patients experiencing chest pain. Similar instances have been reported in Canada, with CATSA officials confirming that typical items like cosmetics and medicinal creams can trigger false-positive results. A case report from Germany also recounted an incident involving a flight crew member whose glycerin-based moisturizer led to a positive test during standard screening.

Although such occurrences are comparatively uncommon, they can lead to significant repercussions. Passengers may encounter delays, invasive searches, public humiliation, or even missed flights, particularly those with ongoing conditions that necessitate topical treatments. For dermatologists, this underscores a frequently neglected aspect: how the therapies we prescribe might yield unforeseen effects beyond clinical environments. It further highlights the necessity of considering the wider context in which our patients utilize these products.

Considering the rarity of this phenomenon, it may not be feasible for dermatologists to consistently advise patients about this risk. Nevertheless, it could be beneficial to raise awareness of this situation, particularly for patients utilizing high-risk substances who are frequent travelers. Public education and warning labels on packaging may assist in informing users regarding the potential for false alerts. Future studies are also essential to determine the minimum detectable amounts of these substances by airport scanners and ascertain whether specific formulations or methods of application present a higher risk.