A trip to the hair salon or spa is usually a chance to relax and enjoy some pampering. But for someone dealing with moderate to severe eczema, it means staying on high alert to ingredients that may be lurking in products that can cause your skin to instantly flare.
For Ashley Wall, asking questions about every product before a stylist or technician puts it on her skin has become routine. Sometimes, a nail technician will want to spray a mixture of alcohol on her nails.
“That would be like pouring acid on my hands,” Wall said. “Or they want to use a lotion with fragrance. I tell them no.”
Your skin talks to you
Wall, 29, writes about life with eczema in her popular blog, Itchin Since ’87. She has been dealing with eczema flares since she was 2 years old. After spending nearly her whole life with eczema, she often looks for tried-and-true products she knows will work for her. When scanning for new products, she’ll look for phrases like “for sensitive skin,” “for dry, cracked skin” or “healing ointment.”
“Anything with a fragrance, I’ll avoid like the plague,” Wall said. “But it can still involve a lot of trial and error.”
Ashley has thick, dry hair and she’s prone to getting eczema on her scalp. There have been times when a product has backfired, leaving her hair stripped of oils and so dry it’s nearly impossible to brush or comb. That’s when she’ll whip up an egg and olive oil mixture which she'll then slather on her hair. It helps repair some of the damage, she said.
There is one saving grace for her; most make-up is usually okay to use, although she is still careful to read labels and usually keeps it to a minimum, focusing on eyes or lips instead of heavy makeup on her whole face.
“Your skin talks to you, you have to listen,” she said. “If my skin is bad, I don’t do anything. I let it breathe.”
Avoiding harmful chemicals
For people with eczema, the most important step in their beauty routine is making sure they are treating their skin with the right products, said Dr. Cheryl Lee Eberting, a Utah-based dermatologist who is a former clinical research fellow of the Dermatology Branch of the National Cancer Institute and National Institutes of Health. The best thing is to avoid chemicals that people with eczema tend to be allergic to, she said.
In broad terms, substances that should be avoided include fragrances, preservatives and dyes. Also, avoid any kind of exfoliating agent such as retinols, alpha hydroxyl acids of salicylic acids, as they can exacerbate eczema, Eberting said.
Sometimes there are other seemingly harmless ingredients that eczema patients react to, she said. For instance, it’s easy to assume that natural or organic products are better. Not so for people with eczema, Eberting said. Many natural products have plant based oils in them which may cross-react with the chemicals used in fragrances in other products. People with eczema tend to be allergic to products with fragrances, she said.
As for cosmetics, Eberting said to look for lines that are designed for sensitive skin.
“In general you want to find a line that is hypoallergenic,” she said. “For most foundations, the preservatives they use are not ones that people with eczema are allergic to.”
If you’ve avoided all the most common chemicals known to trigger eczema and you can’t figure out what ingredient is causing you a problem, you may want to consider visiting a dermatologist and having a patch test done, Eberting said. Patch testing is a non-invasive skin test that can help determine what chemicals you are allergic to.
The National Eczema Association (NEA) also evaluates products that have been created for people with eczema. You can find a list of products on the NEA’s website that has the association’s Seal of Acceptance, including a skin care product line developed by Eberting.
Ingredients to look for in products:
- Skin barrier lipids, such as ceramides or cholesteryl esters
- Skin-friendly acids such as polyhydroxy acids, gluconolactone, and lactobionic acid
- Niacinamide, a molecule that has been shown to be effective for eczema, acne and rosacea and is also DNA reparative in sun exposed skin. It's also naturally anti-inflammatory.
- 18-B glycyrrhetinic acid. This is a naturally occurring anti-inflammatory molecule.
Top 10 ingredients to avoid
- Neomycin sulfate, found in triple antibiotic creams
- Balsam of Peru
- Benzalkonium chloride, a preservative in many moisturizers and even in some eczema creams
- Lanolin; up to 7 percent of people with eczema are allergic to it
- Cocamidopropyl betaine (found in many soaps and shampoos)
- Methylchloroisothiazolinone/methylisothiazolinone (MCI/MI)
Others ingredients to aware of:
- Tixocortol-21-pivalate (cross-reacts to hydrocortisone)
- Budesonide, a steroid
- Betamethasone, a steroid
- Clobetasol, a steroid
- Dexamethasone, a steroid
- Propolis, found in bees wax
- Compositae plant family (includes bisabolol and chamomile)
- Bacitracin (in triple antibiotic creams)
- Glutaraldehyde (a preservative)
- Disperse dyes (blue 106/124; yellow 3/9)
- Carba mix
- cobalt chloride (found in vitamins)
- potassium dichromate (found in vitamins)
- Nickel sulfate (can be found in jewelry, vitamins and most metals)