The Rise and Regulation of Natural Skincare Products
As consumers become more and more aware of harmful ingredients in their skincare products, many are turning to “healthier” and “safer” options that include labels such as “natural” and “organic.”1 The term “organic” used in skincare products is not defined by the FDA, and the term “natural” has no legal definition.1,2 Without clear definitions and guidelines, consumers are increasingly swayed by savvy marketing techniques and may think that natural products do not have side effects. While natural products have seen an impressive growth and our knowledge of the science of ingredients has expanded, your patients should be aware that “natural” products may still have hidden ingredients that are not so “natural” and may cause irritation. Below, are four not-so-natural ingredients hiding in natural skincare products.
Preservatives that are used to increase the shelf life of skincare products and inhibit microbial growth are often used in products that are marketed as “natural,” “organic,” “gentle,” and “hypoallergenic.”3-6 The use of preservatives in skincare products has been linked to allergic contact dermatitis.8,9 The following are 4 common preservatives found in natural skincare products.3,7,8
- Sodium benzoate
- Potassium sorbate
The following products may contain preservatives:3
- Facial/ body wipes
- Bubble baths
- Shaving products
- Shampoos/ conditioners
Fragrances are used in skincare products to enhance their scent.10 The term “fragrance” on a label is an unregulated, catch-all term that includes thousands of synthetic fragrances that are not required to be on the product label.10,11 Products that are labeled as “unscented” may still contain fragrances to hide the scent of other ingredients used in the product.10 Products that are labeled “fragrance-free” may contain fragrances that are used for a different intention (such as a preservative) and may be allowed in as an ingredient.
Common synthetic fragrances that may be found in natural skincare products:12-14
- Benzyl salicylate
- Benzyl alcohol
- Synthetic nitro musks
Common plant-derived fragrances that may be found in natural skincare products:15
- Cinnamyl alcohol
Topical exposure to fragrances can lead to contact dermatitis.16 Even plant-derived fragrances used topically can contribute to allergic contact dermatitis and photosensitivity.17 In a study looking at sensitizing fragrances, limonene was the most commonly reported fragrance allergen in causing allergic contact dermatitis.18
The following products may contain fragrances:10,19
- Perfume/ cologne
- Shampoo/ conditioner
- Shaving products
- Facial cleansers
- Facial/body wipes
Coloring dyes are used in hair dyes, coloring shampoos, and eyelash dyes to alter one’s natural hair color. Coloring dyes are also used in henna inks to create temporary tattoos on the skin.20,21 Those most exposed to harmful coloring dyes are typically hair stylists, beauticians, and henna artists.20
Common coloring dyes:20,22
- Rose Bengal
- Methelyne blue
Coloring dyes can become more irritating when exposed to the sun and cause toxic and allergic effects.20 Exposure to coloring dyes can cause allergic contact dermatitis, and if used on the eyelashes can cause irritating reactions and potentially damage the cornea.21
The following products may contain coloring dyes:20,21
- Hair dyes
- Coloring shampoos/ conditioners
- Henna ink
- Eyelash dyes
- Color cosmetics
Propylene glycol is a synthetic, organic compound that is used in foods, skincare products, medications, and plastics.23 In natural skincare products, propylene glycol is often listed under the term “fragrance” and is used as a humectant, preservative, and to increase absorption and promote the spread of the product into and onto the skin.23,24
Propylene glycol was named the American Contact Dermatitis Society’s Allergen of the Year for 2018.23 In 2007, propylene glycol was considered to be the sixth most common skin allergen.24 Systemic reactions, along with contact and irritant reactions, have been documented with patch tests of propylene glycol.23-26 Even 2% of propylene glycol administered to the skin can cause contact dermatitis.27 The topical use of propylene glycol has been shown to increase the penetration of other topical medications, such as cortisone, that can lead to an increase systemic level of cortisol, which can be dangerous, especially in children.28,29
The following products may contain propylene glycol:30
- Personal lubricants
Summary and Practical Tips
The growth in research and the use of “natural products” is exciting. As a healthcare practitioner, it is important to teach your patients that “natural” does not automatically mean safer and it is still important to read ingredient labels. More importantly, any new product has the potential to cause an allergy and should be tested in a small area prior to use. A good area to test the product is on the inside of the arm so that if the skin reacts, it will be in a hidden location.
- Kessler R. More than cosmetic changes: taking stock of personal care product safety. Environ Health Perspect. 2015;123(5):A120-127.
- FDA. “Organic” Cosmetics 2010; https://www.fda.gov/cosmetics/labeling/claims/ucm203078.htm.
- Schlichte MJ, Katta R. Methylisothiazolinone: an emergent allergen in common pediatric skin care products. Dermatol Res Pract. 2014;2014:132564.
- Scheman A, Jacob S, Katta R, et al. Part 4 of a 4-part series Miscellaneous Products: Trends and Alternatives in Deodorants, Antiperspirants, Sunblocks, Shaving Products, Powders, and Wipes: Data from the American Contact Alternatives Group. J Clin Aesthet Dermatol. 2011;4(10):35-39.
- Varvaresou A, Papageorgiou S, Tsirivas E, et al. Self-preserving cosmetics. Int J Cosmet Sci. 2009;31(3):163-17
- Halla N, Fernandes IP, Heleno SA, et al. Cosmetics Preservation: A Review on Present Strategies. Molecules. 2018;23(7).
- Pastor-Nieto MA, Alcantara-Nicolas F, Melgar-Molero V, et al. Preservatives in Personal Hygiene and Cosmetic Products, Topical Medications, and Household Cleaners in Spain. Actas Dermosifiliogr. 2017;108(8):758-770.
- Scherrer MA, Rocha VB, Andrade AR. Contact dermatitis to methylisothiazolinone. An Bras Dermatol. 2015;90(6):912-914.
- Yim E, Baquerizo Nole KL, Tosti A. Contact dermatitis caused by preservatives. Dermatitis. 2014;25(5):215-231.
- FDA. Fragrances in Cosmetics 2018; Accessed on September 20, 2018
- Klaschka U. Natural personal care products-analysis of ingredient lists and legal situation. Environ Sci Eur. 2016;28(1):8.
- Taylor KM, Weisskopf M, Shine J. Human exposure to nitro musks and the evaluation of their potential toxicity: an overview. Environ Health. 2014;13(1):14.
- Juhasz ML, Marmur ES. A review of selected chemical additives in cosmetic products. Dermatol Ther. 2014;27(6):317-322.
- Cheong SH, Choi YW, Myung KB, Choi HY. Comparison of Marketed Cosmetic Products Constituents with the Antigens Included in Cosmetic-related Patch Test. Ann Dermatol. 2010;22(3):262-268.
- Schnuch A, Uter W, Geier J, Lessmann H, Frosch PJ. Sensitization to 26 fragrances to be labelled according to current European regulation. Results of the IVDK and review of the literature. Contact Dermatitis. 2007;57(1):1-10.
- Bennike NH, Oturai NB, Muller S, et al. Fragrance contact allergens in 5588 cosmetic products identified through a novel smartphone application. J Eur Acad Dermatol Venereol. 2018;32(1):79-85.
- Pesonen M, Suomela S, Kuuliala O, Henriks-Eckerman ML, Aalto-Korte K. Occupational contact dermatitis caused by D-limonene. Contact Dermatitis. 2014;71(5):273-279.
- Nardelli A, Drieghe J, Claes L, Boey L, Goossens A. Fragrance allergens in 'specific' cosmetic products. Contact Dermatitis. 2011;64(4):212-219.
- Klaschka U. Risk management by labelling 26 fragrances? Evaluation of Article 10 (1) of the seventh Amendment (Guideline 2003/15/EC) of the Cosmetic Directive. Int J Hyg Environ Health. 2010;213(4):308-320.
- Zukiewicz-Sobczak WA, Adamczuk P, Wroblewska P, et al. Allergy to selected cosmetic ingredients. Postepy Dermatol Alergol. 2013;30(5):307-310.
- Krasteva M, Cristaudo A, Hall B, et al. Contact sensitivity to hair dyes can be detected by the consumer open test. Eur J Dermatol. 2002;12(4):322-326.
- Marcoux D, Couture-Trudel PM, Riboulet-Delmas G, Sasseville D. Sensitization to para-phenylenediamine from a streetside temporary tattoo. Pediatr Dermatol. 2002;19(6):498-502.
- McGowan MA, Scheman A, Jacob SE. Propylene Glycol in Contact Dermatitis: A Systematic Review. Dermatitis. 2018;29(1):6-12.
- Scheman A, Jacob S, Zirwas M, et al. Contact Allergy: alternatives for the 2007 North American contact dermatitis group (NACDG) Standard Screening Tray. Dis Mon. 2008;54(1-2):7-156.
- Lalla SC, Nguyen H, Chaudhry H, et al. Patch Testing to Propylene Glycol: The Mayo Clinic Experience. Dermatitis. 2018;29(4):200-205.
- Lowther A, McCormick T, Nedorost S. Systemic contact dermatitis from propylene glycol. Dermatitis. 2008;19(2):105-108.
- Andersen KE, Storrs FJ. [Skin irritation caused by propylene glycols]. Hautarzt. 1982;33(1):12-14.
- Turpeinen M. Absorption of hydrocortisone from the skin reservoir in atopic dermatitis. Br J Dermatol. 1991;124(4):358-360.
- Zirwas MJ, Stechschulte SA. Moisturizer allergy: diagnosis and management. J Clin Aesthet Dermatol. 2008;1(4):38-44.
- 30. Nelson JL, Mowad CM. Allergic Contact Dermatitis: Patch Testing Beyond the TRUE Test. J Clin Aesthet Dermatol. 2010;3(10):36-41.