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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 can 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. It 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. Irritant contact dermatitis 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 allergic dermatitis
can develop in areas of the body that did not come into
contact with the offending substance.
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. True allergic reactions can take 7 to 10 days
to 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?
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 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 and
the ingredients of flavors and fragrances (considered
trade secrets) 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.
Reviewed
by the doctors at The Cleveland Clinic Department of
Pulmonary, Allergy and Critical Care Medicine.
Edited
by Charlotte E. Grayson, MD, Feb. 2004, WebMD.
Portions
of this page © The Cleveland Clinic 2000-2004
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