A review of some of the best-selling over-the-counter moisturizers finds that most products contain at least one allergen that could worsen the very skin condition it is designed to treat.
The review, published online Sept. 6 in JAMA Dermatology, found that of 153 products, 88 percent contained at least one allergen of the North American Contact Dermatitis Group (NACDG) series, such as fragrances, parabens and tocopherol. Most of these contained more than one allergen: 43 percent contained three to four allergens and 13 percent contained five or more allergens.
Over-the-counter moisturizes are often recommended by dermatologists to treat skin conditions, such as atopic dermatitis, allergic contact dermatitis, contact dermatitis and psoriasis. These recommendations are made by physicians who may not realize they may be exposing patients to a myriad of ingredients that could possibly cause an allergic reaction.
“The concept of hypoallergenic as perceived by lay people and physicians is often misunderstood,” says senior author Jonathan Silverberg, M.D., Ph.D., MPH, an assistant professor of dermatology at Northwestern University Feinberg School of Medicine in Chicago. “For instance, physicians who recommend certain products to patients believe that the patient will not be allergic to them and, therefore, the products will be safe to use. But in fact, with enough exposure and an underlying predisposition, patients can develop allergies to many of these personal care products.”
“Our analysis of best-selling moisturizers across three major online retailers reveals products that differ substantially in price and characteristics. Given the wide number of product choices and inherent challenges in interpreting ingredient lists for consumers, dermatologists may have to provide specific product and manufacturer recommendations to guide patients toward the most appropriate moisturizer,” Dr. Silverberg and authors wrote.
Especially concerning is the practice of recommending moisturizers to patients with sensitive skin, underlying eczema and other inflammatory skin conditions, where patients frequently apply topical agents to areas with an impaired skin barrier. “For these patients, I tend to recommend products that have a minimal ingredient profile to try to decrease the exposure that the patient will have long term,” he says.