12 Worst Skin-Care Ingredients for Eczemaby Dori Price Health Writer
Like any health condition, eczema isn't one size fits all: A skin- or personal-care product that doesn’t annoy your complexion could make someone else’s throw a fit. That said, there are certain ingredients that raise lots of red-faced flags—and we’ve rounded those bad boys up! Use this list of the most common eczema irritants to help you read product labels and avoid unnecessary flares. (And, of course, monitor your skin’s reaction to anything new.)
Glucocorticoids, a Type of Steroid
When moisturizers and over-the-counter products just aren’t doing enough, many dermatologists will prescribe glucocorticoid, a topical steroid that has been used to treat eczema for years. (Fun fact: Glucocorticoids are actually found naturally in the body and can help it respond to stress and environmental changes.) But sometimes there are other ingredients within the steroid cream that could cause an adverse reaction. Talk to your dermatologist about patch testing, which could pinpoint other irritating ingredients and help you find a different topical steroid to use instead, suggests Marisa Garshick, M.D., a clinical assistant professor of dermatology at New York-Presbyterian/Weill Cornell Medical Center in New York City.
Preservatives Methylchloroisothiazolinone (MCI) and Methylisothiazolinone (MI)
While MCI and MI can help preserve a product, they don’t always preserve the health of your skin. These ingredients are added to many cosmetic and personal care items—including baby products, skin-care creams, and makeup—to thwart the growth of fungi and bacteria and to prevent the breakdown of the product itself. Common side effects include redness, itchiness, or flakiness on the area where you've applied the product or even on other zones of the body. If you are a new parent and notice irritation on your hands, check the baby wipes you’re using—it may be time to try something new.
Moisturizer Propylene Glycol
Recently named the 2018 Allergen of the Year by the American Contact Dermatitis Society, propylene glycol is found in many skin-care products, cosmetics, medications, food, and, ironically, certain topical eczema treatments, says Dr. Garshick. And while it can work as a powerful moisturizer and emulsifier (helping various ingredients blend together), it also can cause skin ouch even if you aren’t allergic to it. If you’ve been using eczema-specific moisturizers or prescription creams, check to see if they contain propylene glycol—it could easily be the culprit.
Antibacterial Benzalkonium Chloride
If you wear contacts or use hand sanitizer (#everyone), listen up: Benzalkonium chloride is a preservative most often found in eye-care products (medications, contact lens solution, artificial tears) and no-wash hand cleansers, says Francesca J. Fusco, M.D., an assistant clinical professor of dermatology at the Icahn School of Medicine at Mount Sinai in New York City. On the plus side, it has antiseptic properties and is good at killing bacteria. But even a low concentration of the stuff is enough to infuriate eczema. (At a high-enough concentration, it can make even non-sensitive skin red and flaky.)
Cocamidopropyl Betaine, From Coconut Oil
Something derived from coconut oil must be safe for your skin, right? Not so fast. Cocamidopropyl betaine is a surfactant, a foaming agent in cleansing products—shampoo, facial cleanser, liquid soap, bath gel—that also nixes oil and dirt. On the surfactant scale, it’s on the gentler side, but it still can cause redness and flaking, specifically around the eyes, scalp, hands, or mouth, says Dr. Garshick.
Using a scented product can be a catch-22—it makes your skin smell great, but not always feel that way. The National Eczema Association (NEA) reports that 8% to 15% of eczema patients have a fragrance allergy. And with fragrance accounting for up to 40 percent of allergic reactions from cosmetics, the NEA no longer considers products with scent for its Seal of Acceptance Program.
Most Common Fragrance Irritants
Finding cleansers and moisturizers without scent isn’t as easy as it should be: Even those labeled “unscented” or “fragrance-free” sometimes still contain a “masking” fragrance, says Dr. Fusco. This is used to cover up unwanted natural odors from herbal or botanical ingredients and can itself cause a skin reaction. “It’s important to check labels for common fragrance ingredients as opposed to just the term ‘fragrance mix,’” says Dr. Garshick. Beware these six, which might contain fragrance: cinnamic alcohol, cinnamic aldehyde, eugenol, isoeugenol (which can be found in nutmeg oil or ylang ylang oil), geraniol (present in many essential oils), hydroxycitronellal, and oakmoss.
Botanical Oil Scents
Fragrance is quite the minefield for eczema. Last but not least on the scented front: You may think "natural" ingredients are less problematic than chemical ones, but it's just not the case. Certain “botanical oils or other herbal ingredients can lead to skin sensitivity, such as rose oil, vanilla, and sweet almond oil," says Dr. Garshick.
Balsam of Peru
The name certainly creates an image of an exotic, good-for-you ingredient. But the sweet-smelling fragrance (and sometimes flavoring agent) can be a big ‘ol N-O for those with sensitive skin and especially eczema. You'll see it in products of all types, including shampoos, deodorants, lotions, air fresheners, pesticides, flavored tobacco, and even certain foods, such as tomatoes, cola, chocolate, and citrus. For extreme irritation where avoiding contact with the topical fragrance isn't enough, you may need to follow a diet low in Balsam of Peru, but discuss this with your dermatologist before trying.
Antibiotic Neomycin Sulfate
Excellent for wounds, not for eczema. You’ll most often find neomycin sulfate, an antibiotic, in antibacterial ointments and eye drops. It can help fight off bacterial infections when treating wounds or minor cuts. But it can also cause redness, itching, and flaking where it's rubbed on, and Dr. Garshick says that neomycin sensitivity is becoming more common among eczema patients.
Bummer truth: People who are allergic to neomycin may also react to other antibiotics, says Dr. Fusco. So if you have a neomycin allergy, consult your dermatologist about other ingredients you may be allergic to as well.
You may have heard the negative hype about formaldehyde in nail polishes and hair-straightening treatments—it has since been removed from many of those. But it's a popular preservative that, the EPA notes, is also found in many cleaning products, building materials, clothing, fertilizers, and pesticides, and as a by-product of gas-burning appliances and cigarettes. While the actual concentration of formaldehyde in many of these products is low, it can still lead to an allergic reaction that can exacerbate eczema. Keep your eyes peeled for formaldehyde on ingredient lists, beauty products included.
Derived from the oil glands of sheep and often formed into wool fat, wool wax, and wool alcohol, this moisturizer has softening benefits, making it a regular in creams, ointments, lip balms, and makeup removers. Unfortunately, people with eczema are more likely than those without it to have a sensitivity to lanolin.