Warning: “Hypoallergenic” products may not be as safe for your skin as you think. (Stone/Getty Images)
If you have sensitive skin, your bathroom is likely stocked with “hypoallergenic” products — lotions, creams, soaps, and shampoos you assume won’t leave you itching and uncomfortable. But new research in the Journal of Allergy and Clinical Immunology suggests that this claim may be nothing more than marketing jargon.
The researchers analyzed 187 “hypoallergenic” cosmetic products for kids to see if they contained any of the 80 most common allergens, as determined by the North American Contact Dermatitis Group. What they found: 89 percent of the products contained at least one contact allergen, and nearly a quarter contained four or more contact allergens, including a number of potentially irritating fragrances and preservatives.
“When parents who have kids suffering from contact dermatitis or atopic dermatitis see ‘hypoallergenic,’ they think, ‘That’s safe for my kid,’” says study co-author Stewart Bernard, a medical student at the Loma Linda University School of Medicine in California. “Our study shows that there’s the potential for hypoallergenic products to cause the same types of reactions [as regular products] in sensitized kids.”
What’s going on? Simple: The U.S. Food and Drug Administration doesn’t regulate the term “hypoallergenic.”
“It’s just a generic marketing term,” says Bernard. In other words, it’s the cosmetics industry equivalent of the word “natural” in the food world — a term that sounds appealing to consumers, but isn’t necessarily backed by science.
“There is no FDA requirement that defines what a product has to contain or not contain in order to meet the standard of hypoallergenic,” says Rajani Katta, M.D. a professor of dermatology and director of the Contact Dermatitis Clinic at the Baylor College of Medicine. As the FDA website puts it, “The term means whatever a particular company wants it to mean.”
In the 1970s, the FDA did attempt to regulate the term, but ultimately with little success. The agency’s proposed regulation stated that in order to label a product “hypoallergenic,” manufacturers would have to prove it caused fewer adverse skin reactions than similar products.
What sounds like a common-sense proposal proved to be controversial: Some thought the term was useless, since most people don’t have allergies; others thought it should be banned because “hypoallergenic” claims can’t possibly ensure the safety of all allergic people. And, as you’d expect, manufacturers complained about the cost of testing.
Although the regulation was initially passed, two cosmetics giants — Almay and Clinique — quickly challenged the FDA ruling, which was eventually overturned. “As a result,” the FDA states, “manufacturers may continue to label and advertise their cosmetics as ‘hypoallergenic’ or make similar claims without any supportive evidence.”
There are a handful of similar phrases, designed to imply safety for people with sensitive skin, that are equally meaningless. Take “dermatologist recommended” or “dermatologist tested,” for example. “I’m sure [these products] have undergone some kind of testing, but ‘dermatologist tested’ does not mean ‘less likely to cause allergic reactions,’” says Katta.
And although the FDA does regulate “fragrance free” claims, the phrase doesn’t mean what you might think it does. “It’s more a legal definition than a medical definition,” Katta says. If a manufacturer adds a fragrance — say, rose oil or sweet almond oil — to a product, but specifies that it’s being used as a moisturizer or a preservative, the product can legally be labeled “fragrance free,” even though the oil is clearly an odoriferous ingredient. Why that’s worrisome: “Fragrance additives are a top cause of allergic reactions,” she says.
Oddly enough, baby products are often the most loaded down with potentially irritating fragrances, since parents “want their baby to smell like a baby,” says Katta. In fact, among allergy experts, pediatric products are considered some of the most troublesome, since they’re so notoriously fragrance-laden, she says. In the Journal of Allergy and Clinical Immunology study, 81 percent of “fragrance free” pediatric products contained known allergens.
It’s not just fragrances that parents have to worry about in “hypoallergenic” products, either. The study found that 11 percent of the supposedly allergen-free kiddie products contained methylisothiazolinone, a preservative named “Allergen of the Year” in 2013 by the American Contact Dermatitis Society. In a recent study analyzing 153 pediatric skincare products — ranging from shampoos to wipes to sunscreens — sold at big-box stores, Katta found that 20 percent contained methylisothiazolinone; a number of these products were labeled “hypoallergenic” or “gentle.”
In recent years, methylisothiazolinone has emerged as a frequent cause of allergic skin reactions, probably because it’s being increasingly used as a preservative in lieu of parabens. “There’s been a public backlash against parabens, so manufacturers have been forced to find other preservatives to put in their products,” Katta says. The irony? Methylisothiazolinone is much more likely to cause allergic reactions than parabens, she notes.
The most common allergen in children’s products, the Journal of Allergy and Clinical Immunology study found, was cocamidopropyl betaine, a synthetic detergent often used in shampoos, contact lens solutions, bath gels, and skincare products. It’s estimated to trigger contact allergic reactions in 3 to 7 percent of people, according to a 2008 paper in Dermatitis, and was named “Allergen of the Year” in 2004.
Those numbers may not sound significant, but Bernard cautions that contact dermatitis — characterized by a red, itchy rash — isn’t the only threat these allergens pose. Even if your child doesn’t develop contact dermatitis in response to allergen-containing products, the ingredients may prime sensitive kids for atopic dermatitis, a type of chronic eczema. “These products could be worsening their atopic dermatitis, or even in some cases causing it,” he says.
So how can people with sensitive skin find truly gentle products? Step one: Look for skincare products that come in a tub. Generally, these moisturizers are ointments, which contain less water than creams or lotions, and therefore require fewer preservatives, says Katta. “Pure Vaseline, petroleum jelly, is actually a really good choice,” she says. (Warning: Avoid the petroleum jelly sold in the baby aisle, since it often contains added fragrance.)
Another option? Steer clear of products — moisturizers or otherwise — that contain these three ingredients: methylisothiazolinone, formaldehyde preservatives (such as quaternium-15 and DMDM hydantoin), and fragrances. “Those are the top three ingredients that I try to stay away from,” Katta says. She likes Vanicream, Cerave, and Aveeno Eczema Therapy products.
Of course, there are hundreds of other potential allergens out there, which means eliminating these three won’t necessarily address your issue. If you still break out in a rash after using these products, talk to your doctor about patch testing. “We place different allergens on your back, and then you come back two or three days later so we can see what you reacted to,” says Katta. (Allergic contact dermatitis is a “delayed allergy,” meaning you probably won’t react to the allergen-containing product right away — it can take a few days.)
Once you’ve identified the culprits behind your allergies, your doctor can create a list of ingredients for you to avoid — or if your M.D. is a member of the American Contact Dermatitis Society (ACDS), he or she can even assemble a list of products you can safely use. “We maintain a database of over 5,000 cosmetic products,” says Katta, who sits on the board of directors for ACDS. “So if you have a customized [allergens] profile, we can access that database and create a list of makeup and skincare products that are okay for you.”