Allergies and Cosmetics

Products such as moisturizers, shampoos, deodorants, make-up, colognes, and other cosmetics have become part of our daily grooming habits. The American Academy of Dermatology reports the average adult uses at least seven different cosmetic products each day. Although cosmetics can help us feel more beautiful, they can cause skin irritation or allergic reactions. Certain ingredients used in cosmetics, such as fragrances and preservatives, can act as antigens, substances that trigger an allergic reaction.

What Are the Symptoms of a Cosmetic Reaction?

There are two reactions that might occur following exposure to cosmetics: irritant contact dermatitis and allergic contact dermatitis. Contact dermatitis is a condition marked by areas of inflammation (redness, itching and swelling) that form after a substance comes into contact with your skin.

• Irritant contact dermatitis: This is more common than allergic contact dermatitis and can occur in anyone. It develops when an irritating or harsh substance actually damages the skin. Irritant contact dermatitis usually begins as patches of itchy, scaly skin or a red rash, but can develop into blisters that ooze, especially if the skin is further irritated from scratching. It generally occurs at the site of contact with the irritating substance. Areas where the outermost layer of skin is thin, such as the eyelids, or where the skin is dry and cracked are more susceptible to irritant contact dermatitis.
• Allergic contact dermatitis: This occurs in people who are allergic to a specific ingredient or ingredients in a product. Symptoms include redness, swelling, itching, and hive-like breakouts. In some cases, the skin becomes red and raw. The face, lips, eyes, ears, and neck are the most common sites for cosmetic allergies, although reactions may appear anywhere on the body.

The time it takes for symptoms of irritant contact dermatitis to appear varies. For stronger irritants, such as perfumes, a reaction may occur within minutes or hours of exposure. However, it may take days or weeks of continued exposure to a weaker irritant, such as soap, before symptoms appear. In some cases, a person can develop an allergic sensitivity to a product after years of use.

What Causes Cosmetic Reactions?

With irritant contact dermatitis, the skin breaks down when it comes into contact with harsh substances, most often chemicals that directly injure the outer layer of the skin, resulting in symptoms.

Allergic contact dermatitis occurs because the body's immune system is reacting against a specific substance (the allergen) that it considers foreign and harmful.

How Common Are Reactions to Cosmetics?

Serious allergic reactions associated with cosmetics are rare. However, it is not uncommon for a person to have a mild reaction or irritation to an ingredient in a cosmetic product. Studies suggest that up to 10% of the population will have some type of reaction to a cosmetic over the course of a lifetime. Reactions to cosmetics occur more often in women, most likely because women tend to use more cosmetic products than do men.

What Should I Do If I Have a Reaction?

If you have a reaction, stop using all cosmetics. When your symptoms are gone, start using them again, one product at a time. This may help you determine which product or products are responsible for the reaction. If you cannot identify the source of the reaction or if your symptoms do not go away after you stop using the cosmetics, consult your healthcare provider.

How Are Allergic Reactions Diagnosed?

Reactions are diagnosed by the appearance of symptoms and your history of exposure to various cosmetic products. Because most adults use many cosmetic products, identifying the product responsible for the reaction may be difficult. If your doctor suspects allergic contact dermatitis, he or she may use a patch skin test to identify the substances to which you are allergic.

How Are Cosmetic Reactions Treated?

Treatment generally involves avoiding the products causing the symptoms. Over-the-counter creams and ointments that contain cortisone, such as hydrocortisone (Cortisone 10) and hydrocortisone acetate (Cort-aid), may be used to help control itching, swelling, and redness. In more severe cases, a prescription-strength medication may be needed to relieve symptoms. If blistered skin becomes infected, an antibiotic medication may also be needed.

What Can I Do to Prevent Cosmetic Reactions?

There are several steps you can take to try and avoid cosmetic allergy reactions, including:

• Read the list of ingredients on all cosmetic products. If you find an ingredient that has caused a reaction in the past, don't use that product. Keep track of ingredients that have caused reactions, and look for products that do not contain those ingredients.
• When considering a new product, do a "mini-patch test" first to see if it causes a reaction. Put a sample of the product on your inner wrist or elbow and wait 24 hours to see if a reaction occurs.
• Keep it simple. Choose products with simple formulas. More ingredients mean more potential allergens. With fewer ingredients, it's also easier to pinpoint the source if you do have a reaction.
• Apply perfume to your clothes rather than your skin, and allow the perfume to dry before putting on the clothes.
• Be especially careful with makeup because it stays in contact with the skin for a long time. Look for products that are hypoallergenic, fragrance free, and non-comedogenic, although products with these labels may still cause reactions.

Making Sense of Product Labels

To get the best benefit from cosmetics and skin care products, it's important to be aware of each product's ingredients and to look for and avoid ingredients that are known allergens for you. To make this easier, the FDA requires cosmetic manufacturers to list the ingredients on the product label. Ingredients are listed in descending order of amount. Keep in mind, however, that trade secrets (including certain fragrances) do not have to be specifically listed.

Also, keep in mind that products labeled "unscented" or "fragrance free" may still contain small amounts of fragrances needed to cover the odor of other chemical ingredients. "Natural" generally means that the product includes ingredients extracted from plants or animal products rather than ingredients produced chemically. Products labeled "non-comedogenic" do not contain ingredients that commonly clog pores, which can lead to acne.

Labeling of cosmetics can be helpful when looking for specific ingredients, but be wary of certain product claims. For example, many products use the term "hypoallergenic," although there are no regulations or standards for use of this term. "Hypoallergenic" suggests that a product is less likely than another, similar product to cause an allergic reaction, but manufacturers are not required to prove this claim. In addition, products labeled "organic" are not less likely to cause an allergic reaction. Just remember: There is no cosmetic product that can guarantee never to produce an allergic reaction.

More Safety Tips:

• Always use good personal hygiene. Be sure to clean your hands and face before applying make-up.
• Never share make-up.
• If you want to test a product in the store, ask for a new, unused applicator and ask the salesperson to wipe the opening of the tester with alcohol.
• Keep cosmetic containers tightly closed, except when being used. Keep containers free of dust and dirt.
• Keep cosmetics away from heat and out of direct sunlight.
• Do not use eye make-up if you have an eye infection, such as conjunctivitis. Discard those products and use new ones when your infection is gone.
• Discard products if the color changes or they develop an odor. This may mean the preservatives in the products are no longer able to fight bacteria.
• If the consistency of a product changes, do not add water. Discard the product.
• Clean cosmetic brushes and applicators frequently.