As a dermatologist, we see problems with the skin day in day out as our job, and we are in the position where we get queries about which products to use on the skin, not necessarily to treat a primary skin condition but more to do with every day use.
It is interesting to know that we are commonly advised by the patients that we see that products that are advertised as ‘natural’, ‘organic’, or ‘clean’ must therefore be better or safer, with less risk of adverse reactions. (And there is always the thought that the more money spent on a product must mean that the product is somehow better than its cheaper alternatives.)
It is always a surprise to hear that the terms ‘natural’, ‘organic’, ‘clean’ or similar such terminology bears no relevance to whether a product is safe to use on all types of skin.
An article analysing allergens in a range of children’s products such as baby washes, baby shampoos, bubble baths and moisturisers advertised as being ‘clean’ was published in the February edition of the journal Pediatric Dermatology.
[Brumley C, Banks T, Arora P et al. Are “clean” products safe for children? An analysis of contact allergens in “clean” children’s products from a popular retailer. Pediatr Dermatol 2024;1-3.]
Which popular retailer is it?
It was products sold by Target® online in the “Clean Baby” range. The definition of ‘clean’ by Target® was of cruelty-free products containing less than 100 parts per million of certain chemicals.
What chemicals were these?
These included chemicals with long unpronounceable names such as phthalates, propyl- and butyl-parabens, formaldehyde donors, aromatic solvents, nonylphenol ethoxylates, ethanolamines, other specific fragrances and more.
What did the authors do?
The authors screened 114 products from the Clean Baby range (57 baby washes/shampoos, 18 bubble baths and 39 moisturisers) for relevant contact allergens.
What are the relevant contact allergens?
There included fragrance, propylene glycol, lanolin, methylisothiazolinone, formaldehyde, cocamidopropyl betaine, glucosides and Compositae mix (ie chamomile and calendula).
What did they find?
94% of the products contained at least one relevant contact allergen.
Fragrance was most commonly found, in 82% of products, though thirty three products claimed to be ‘fragrance-free’ or ‘unscented’. Only seven products were free of all screened allergens. On average, the products in this range contained 1.8 screened contact allergens.
So what is the relevance of this to me or my child?
These contact allergens have been identified as chemicals which have the ability to sensitise and irritate the skin of any individual, regardless of whether or not they have skin disease.
They do become of marked relevance when we do have an individual with, for example, eczema as avoidance of the allergen can make the eczema more manageable without needing to escalate treatment.
Also, the rates of allergic contact dermatitis in children is comparable to that of adults but as a child’s skin is more delicate than an adult’s, gentle product formulations are important in maintaining a healthy skin barrier in children.
Were there any positive findings in this study?
There were actually.
They found no methylisothiazolinone in any of the products in the ‘Clean Baby’ range. For those not in the know, methylisothiazolinone was named Contact Allergen of the Year 2013, a badge proclaiming its notoriousness as a sensitiser and allergen.
Also all the products in the ‘Clean Baby’ range contained fewer allergens than those found in general baby products, which can have up to six allergens according to other studies.
[Bonchak JG, Prouty ME, de la Feld SF. Prevalence of contact allergens in personal care products for babies and children. Dermatitis 2018 ;29(2) :81-84.]
Where to from here?
The definition of a ‘clean’ product is not defined by law or industry. So what ‘clean’ means to the retail industry can mean a very different thing to the consumer. ‘Clean’ can also mean different things to different retailers in industry itself.
The same goes for the terms ‘natural’ and ‘organic’. A lot of modern medicines come from plants, eg digoxin a cardiac medicine, comes from digitalis obtained from the foxglove. And you can see that a couple of plant species, the chamomile and calendula contain recognised contact allergens of the Compositae mix.
The authors suggest more studies looking at other categories of childrens’ products and one which I would eagerly look forward to reading will be the one that looks at products labelled as ‘organic’.
Kind regards,
Sandy
Dr Sandy Flann, Consultant Dermatologist
