Anyone who has wandered through the maze of cosmetics in their local department store or drugstore knows that there are thousands of products that promise flawless skin. Unfortunately for certain people, these same products can lead to an unsightly allergic reaction called contact dermatitis. So how do you make sure the products you choose will help put your best face forward?
Unfortunately, avoiding allergic reactions isn’t as simple as choosing products labeled "hypoallergenic" or “all natural.” Below, Dr. Frances J. Storrs, a professor of dermatology emerita at Oregon Health and Science University in Portland who specializes in contact dermatitis, explains how to wisely choose your skin products.
What kinds of allergic reactions to skin products do people usually have?
They usually develop contact dermatitis, which is the allergic reaction similar to poison oak or poison ivy. As they begin to use a product, their skin becomes more and more red. They might also develop what doctors call vesicles which are tiny blisters that become crusty and ooze and then spread to other parts of the body. The dermatitis might spread up an arm or to the whole face or the eyelids might be involved. Depending on how strong an allergen you’re dealing with, you may get an allergic eczema, which is an itchy rash. The allergic reaction just gets worse and worse until the person stops using the product.
Who is most likely to have an allergic reaction to a skin product?
Occasionally allergic reactions occur in people with normal skin, but more often then not, they occur in people in which the skin barrier has been broken. This includes someone with a little bit of flaking on their face—something doctors call seborrheic dermatitis—or someone with eczema or someone who just has dry skin.
What products cause allergic reactions?
Lotions and creams, foundations, moisturizers, sunscreens, shampoos, salon hair care products and nail care products are most likely to cause allergic reactions.
What ingredients in skin care products are most likely to cause an allergic reaction?
It depends on the product, but the most common problems are caused by preservatives. Any agent that contains water requires a preservative to keep bacteria or fungi from growing in it. The most common preservatives associated with allergy are those that release formaldehyde. A good example of that is quaternium 15 found in various lotions or creams, shampoos and cleansing agents. There’s also a collection of moisturizing lotions that are preserved with a chemical called methyldibromo glutaronitrile.
Parabens are another type of preservative that are used in thousands of products, but it causes fewer allergic reactions. If you are allergic to any chemicals, then it is important to read the label and make sure they are not included.
What ingredients other than preservatives can cause allergic reactions?
In addition to the preservatives, some people think perfumes are common causes. “I think fragrances are an unlikely cause of allergic reactions,” says Storrs, “but they are very complicated compounds that contain hundreds of chemicals that might cause an allergic reaction.”
Another ingredient doctors are seeing more and more of are the botanicals which are plant extracts, or the so-called “natural” chemicals. They are often found in products like shampoos. They may have an odor, but they are not officially designated as fragrances on the label. “In my office, I’ve seen three people who were using a deodorant that contained some extracts of lichens, little primitive plants that grow on trees, who developed severe underarm dermatitis,” says Storrs.
Can people have allergic reactions to products that are too old?
It’s rare. When bacteria and fungus grow on the product because the preservative is no longer active, you can see them, and most likely will throw them away. It’s like seeing a piece of moldy bread. If you ate the moldy bread, probably nothing would happen to you, but it’s going to taste and look awful.
However, there is some concern about bacteria and fungus in products that are used around the eye. So the advice for using products around the eyes, such as mascara, is usually to replace them every 6 months to make sure that it’s properly preserved and fresh.
Why do sunscreens cause allergic reactions?
In the United States, some sunscreens contain chemicals called oxybenzone and octyl dimethyl PABA, which have been associated with allergic contact dermatitis reactions. Unfortunately, the cosmetics industry does not require that those chemicals be designated by those names on the label, so they may be listed by an alternative name.
Luckily there are excellent alterative sunscreens that don’t contain these chemicals; instead, they contain zinc oxide or titanium dioxide, which are pretty inert substances and excellent sunscreens.
What causes people to react to hair care products?
The main culprits responsible for an allergic reaction are specific chemicals in hair dyes and permanent waves. Most of the blame lays with certain kinds of permanent hair dyes, specifically those with a chemical called paraphenylenediamine. Fortunately, there are lots of substitutes for those permanent hair dyes, and the semi-permanent hair dyes usually don’t contain that chemical.
And the second most common hair product to cause allergic reactions is permanent waves that contain a chemical called glyceryl thioglycolate. These are usually three-part permanent waves, or so-called "acid perms." Cysteamine is a new chemical in permanent waves that can also cause allergy. “However, I think it’s going to be a very rare problem,” says Storrs.
What about nail care products?
Doctors see extremely interesting problems from chemicals in both nail polishes and artificial fingernails. An artificial fingernail problem can actually be quite bad because they are caused by complicated acrylate chemicals. These are the same chemicals that are used by mechanics while working on motors and sometimes used as sealants for a glasswork.
If you’re allergic to some of these acrylates, or you’re allergic to some of the formaldehyde resins that are used in nail polishes, you may break out in a very interesting way. Most likely you’ll break out on your eyelids and around your mouth and on the sides of your neck yet the skin around the nails and hands looks perfectly normal. That’s because the acrylate hasn’t touched the surrounding area. Before these nails get hard, people will touch their eyelids, mouth or neck, and consequently deposit the chemical in those areas and break out.
Luckily all these reactions are rare so you shouldn’t think of these products as containing poisonous or toxic compounds.
What does treatment involve?
Avoiding the allergen is the best treatment. If people don’t know what’s causing the allergic reaction, a dermatologist can help determine your particular allergery trigger(s) by performing “patch testing.” They apply chemicals in very low concentration, but high enough concentration to elicit an allergic reaction, so the doctor can tell people what they’re allergic to.
Allergic dermatitis is usually treated with corticosteroid derivatives, either by mouth or by a topical application such as a cream.
What does it mean when a product is labeled as hypoallergenic?
Unfortunately there really isn’t a good definition or standard of hypoallergenic that is followed by all the major cosmetic companies. What defines “hypoallergenic” in one product might be very different than another “hypoallergenic” product.
What should people look for when they’re purchasing products?
Cosmetic products used on the skin have a fabulous safety record. It’s a real testament to their safety considering how many people use cosmetic products.
But people with underlying skin conditions should try to use products with as few ingredients as possible in it. “For example, I encourage people, particularly older people, to use plain 100 percent petrolatum as a moisturizer,” says Storrs. And people should avoid products with preservatives.
©2007 Healthology, Inc.