MooGoo… Learning about a Natural Skin Care brand (Part 2 of 2)

Interview with MooGoo Skincare (picture credit moogoo.com.au)

This is the second segment of the interview with Craig Jones, founder of MooGoo. MooGoo is an Australian company that makes a range of skincare products, founded by adapting the ‘diary’ version of udder cream for a family member. Refer to the first segment of interview here.

Marcie Mom: I noted also on your website that ‘MooGoo creams have been independently tested to ensure they remain pure and uncontaminated for at least two years, when stored below 30 Degrees Celsius. This is a called a “Challenge Test. It is not a compulsory test in Australia.’ Could you give further details as to who conducted this test, how the test is conducted and what is your definition of ‘pure’ and ‘uncontaminated’?

Preservatives is one area of our formulation that we are very proud. A product that is often used on broken skin, or babies, needs to be properly preserved so it is sterile. Everyone would be aware of ingredients like Parabens, Benzoates, Formaldehyde Donors and other ingredients often used to keep skin care products sterile. It doesn’t take too much research to see that if we had the choice, we probably wouldn’t put these chemicals on our skin. (It is also interesting to see how often they aren’t on the list of ingredients published on websites, but are on the label of products). These ingredients are used as they are inexpensive ways of preserving a cream.

Obviously most natural companies want to avoid being seen in the company of these type of ingredients. The temptation can be to try and cut corners in preserving a cream and use fairly ineffective preservatives like Grapefruit Seed Extract. Not all companies do this at all, but it can be a temptation, especially as nobody checks for preservative efficacy in Australia.

We accidentally discovered a new way of preserving our creams based on Hops. I stumbled across i when talking to a food ingredient supplier who used it for Apple Juice. We tried it in the creams and after a bit of tinkering (at first some people found it changed the smell of the cream so we had to cut the percentage down) we now use that as a total edible preservative.

We have our creams tested by Conmac labs. The BP Preservative Efficacy Test is a program of deliberately contaminating the cream sample with a range of bacteria and mould, and then tracking the growth of the bacteria and mould over a 30 day period. To pass, the preservation system must kill all the bacteria and mould. I have included a sample report so you can see.

Because we have so many infants using our products, and because we are using a novel edible preservation system, we make sure our products pass this test.

Marcie Mom: You have some products suited for eczema and one of them is the ‘Eczema and Psoriasis Balm’. It is AUD18.50 for 120g which translates to about SGD24. I would say the price is about mid-range. Aloe vera, matricaria chamomilla extract, centella asiatica and sage oil are listed as active ingredients (and very good that you list amount of mg of ingredient per gram, which in aggregate is 30.5mg/g). Why did you choose these ingredients and what research can you point us to that concludes these ingredients applied on skin are beneficial for eczema? Also, are these ingredients listed as allergens by any national dermatitis group, e.g. NACDG?

Craig Jones: This is a complicated question. Before we created the Eczema Balm, a lot of people were already using our Udder Cream for skin problems. In fact, the Udder Cream was first made for my mother who had psoriasis. At that time I had no intention of starting a skin care company, and if that cream hadn’t worked as well as it did, I am sure I would still be enjoying my previous profession of being a pilot and MooGoo would have gone no further than our kitchen and my mother’s skin.

The original Udder Cream we made  probably worked quite well due to the oils such as Sweet Almond Oil that we used, combined with the Aloe and Allantoin. I am the first to admit it is not a “miracle” formula. I think the reason it helped so many people is that they had been using poorer quality creams (often sorbolene type creams) for years and so when they switched to a repair moisturiser of better quality, some found a huge improvement. But it was probably the choice of oils, the fact it didn’t contain some certain preservatives that helped the most.

However, to register a product for Eczema with the Therapeutic Goods Administration, we needed to add some approved “Actives”. So we looked for those with the best evidence we could find as natural anti-inflammatories and wound healing, and added those. But I don’t think it is just the actives that help. I personally think the natural oils and Allantoin also assist.

Incidentally, over the last 4 years i have kept researching lots of different natural actives. In a few months we are releasing a second Eczema Balm. On paper it should work even better. We are keeping the original as it is so popular and still a very good product. However it doesn’t work for everybody, and so this is another option. It was also the result of my personal belief that the combination of ingredients should result in the best possible natural anti-inflammatory cream it is possible to make. So we will see how it goes.

As for allergies, even the best ingredients can have people that are allergic to them. As you know, we compare it to food. People can be allergic to nuts or dairy or shellfish. However, for the vast majority of the population, these foods are very healthy. Nobody is allergic to Cola. This doesn’t make Cola a superior food to shellfish.

It is the same in skin care. Typical examples of allergies can be to Aloe Vera and Vitamin E. For most people however, these are excellent ingredients for the skin. It would be detrimental to most people if they were taken out because a very small number of people have allergies.

We do however avoid Essential Oils as much as possible due to allergies. We used to use them in a lot of our products, including the Milk Shampoo, Wash and Conditioner. People would sometimes react to these. So we instead worked with a company that specialized in phthalate free fragrant oils that didn’t cause allergic reactions and now use these. The number of people with reactions in the products without essential oils is almost nil.

Anti-ageing products though do have more potential for allergies with some people if they are genuinely effective. This is because genuine anti-ageing actives need to penetrate and work with the skin metabolism, so they need to be reasonably concentrated and fairly bio-active. So they are more powerful. An inert ingredient or an ingredient that was in the product at a tiny concentration would not be an allergy risk for anyone, but nor would it do what people hoped.

So what we do it put the best ingredients in the product we can at the concentration we think we need, and then encourage everyone to patch test all natural products before use.  This is much better for most people we think than not using any ingredient that may end up causing an allergy. Paraffin and Water (Sorbolene) may not cause many allergies, but it won’t do a lot of good either.

Marcie Mom: Thanks Craig for being open and sharing insights to your products and the decisions behind them. p.s. to readers of eczemablues.com, I didn’t receive any money from MooGoo for this interview.

MooGoo… Learning about a Natural Skin Care brand (Part 1 of 2)

Interview with MooGoo Skincare (picture credit Moogoo.com.au)

MarcieMom heard from a mom in Malaysia of how well received MooGoo is among moms with eczema children. MooGoo is an Australian company that makes a range of skincare products, founded by adapting the ‘diary’ version of udder cream for a family member. As you know, while MarcieMom doesn’t do product review (no, Marcie is not available for testing), she is open to writing and introducing and more importantly, finding out more in-depth about eczema products so that parents reading this blog can have more information. Thus, MarcieMom looked up Moogoo.com.au and asked Craig Jones, founder of MooGoo for an interview to find out more about their products targeted at eczema children and infants.

Marcie Mom: Thank you Craig for taking time for this interview. I haven’t used MooGoo but like to ask questions that another ‘self-educated!’ mom with eczema child would likely ask reading your website. I’m very pleased to see that you do highlight on your website that natural doesn’t mean not allergenic and you encourage testing on a small skin patch before using. Now, we know there is no certification for natural and ingredients extracted from nature will need to be processed to fit into the packaging and be of a form that can be used. For instance, olive oil needs to be preserved and the preservatives can irritate. Is there a certification for organic in Australia and if there is, do you think it’d be more objective to brand MooGoo as such? And if not, how do you think you can help explain to your customers how to assess the extent of ‘natural-ness’ of MooGoo or another brand?

Craig Jones: Very good question. In fact, a pure oil like Olive Oil doesn’t need a preservative. When we buy Olive Oil, or Sweet Almond Oil or any other natural ingredient, it is already pure. A preservative is only needed when an oil is mixed with water as bacteria and mould need water. (That is why, if you ever see on a website an ingredient list that contains water, but they don’t show a preservative, you know there is something missing from the preservative list.) If an ingredient came blended with a preservative, this should be put on the finished label of the product.

There are lots of organic certification system in Australia. For food, organic certification can be important for many people. For skin care, because the ingredients we buy are already pure and cosmetic grade, I know it doesn’t really make any difference. They do not come contaminated with pesticides or preservative.

It would certainly help from a marketing perspective to have “organic” splashed across the label. It would also be a simple process for us to become “Organic” certified. I think all of our products would already qualify. All we have to do is to pay the license fee to whichever certification body we chose and a bit more record keeping concerning ingredient supply chain. But I personally feel “organic” in skin care is more of a marketing tool than anything else and I would feel insincere using it. That is why we choose not to. Perhaps we should.

Marcie Mom: Your website gives a very homely and cosy feel and I noticed that a message that seems to be emphasized is to not use products containing mineral oil or paraffin oil. From what I know, though these oils do get mention as being potential irritants, they are not the top allergens and not cancer causing when applied to the skin as moisturizer. Why have MooGoo chosen to emphasize on paraffin and mineral oil? (Also, the links you’ve shared under ‘Why We Don’t Use Paraffin Oil in Skincare’ are either broken or not directly applicable to moisturizer context.)

Craig Jones: Although everyone has different preferences and some people may choose paraffin oil, I think mostly it sneaks into products because it is poorly understood exactly what it is. I personally think Paraffin Oil is a very poor quality oil to be used in skin care and would not use a product with Paraffin on my skin. Nor would I put it in a product that we make.  Labelled as “soft white paraffin oil/mineral oil/baby oil/paraffin liquidatum” it doesn’t sound particularly offensive. Bu people probably don’t comprehend that this is a flammable petroleum oil that in its raw form, they probably wouldn’t put on their skin.  Properly refined petroleum oil for skin care does have the carcinogenic hydrocarbons removed, that is true. However, in the need to keep the price down (paraffin oil is usually used in cheaper products) I wonder sometimes if there might be a temptation for companies to use cheaper grades of paraffin. Also, the study below here has always concerned me. It has shows tumour growth in UV treated mice that have first had paraffin based moisturisers applied, as compared to no tumour growth in the control cream which was non-paraffin based. It doesn’t prove that paraffin oil can cause tumour growth in humans exposed to UV, but it would concern me. (Study here: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2630214/?tool=pubmed)

Here is story about a study done on paraffin oils and childhood eczema using a paraffin based cream where is generally made eczema worse for kids. (http://www.sciencedaily.com/releases/2010/10/101018074536.htm)

So for the video ( I will have to look for the broken links) we didn’t make any claims that paraffin is a cancer risk as is claimed by a few other websites. All we wanted to do was show people exactly what it was. Paraffin is the base oil for so many pharmacy products because it is so cheap. We get a feedback all the time comparing the price of our products to something like Sorbolene. So we need to explain that although both may look the same, they aren’t the same.

Marcie Mom: I also see that you have a MooGoo Nappy Balm and that they are first tried and tested on your own babies, and friends, staff and even facebook customers! Good to know but I’d like to ask if you send or intend to send your product for clinical trials for independent reporting. I also noted that there are quite a number of oils that you use, can you share a little more about which oil needs to be preserved and processed to the form of a balm and how MooGoo has ensured that you keep the end product safe for use in babies? Do you manufacture all your products in-house?

Craig Jones: All the products we make for ourselves first. The Nappy Balm will soon be registered as a medical device in Australia which includes the evidence for ingredient efficacy.

For the oils we simply chose a list of soothing edible oils. Although people with nut allergies are generally not allergic to nut oils (because the allergy causing protein is removed) we chose to not use Nut Oils in this case so that new mothers weren’t concerned.

This is not a miracle product either. The main thing is that we use edible oils so that the product can be ingested. Most commercial nappy balms are paraffin based. Paraffin Oil can be fatal for children if ingested. It simply works as an edible barrier balm that is also anti-bacterial. A very simple product.

Marcie Mom: Thanks Craig for taking time for an interview with me. I know there’s so much more you’ve to share that can help parents assess the products they’re using. So, I’ll be running the 2nd segment of your interview in two weeks’ time, on 24th July (p.s. to readers of eczemablues.com, I didn’t receive any money from MooGoo for this interview).

Sensitive Skin Product Series – How many ingredients?

When More is not Merrier!

This is a 13-part series focused on understanding and using products for sensitive skin, an important topic given the generous amount of moisturizers that go onto the skin of a child with eczema. Marcie Mom met Laura Verallo Rowell Bertotto, the CEO of VMVGroup, on twitter and learnt that her company is the only hypoallergenic brand that validates its hypoallergenicity. VMV Hypoallergenics is founded in 1979 by Dr. Vermén Verallo-Rowell who is a world renowned dermatologist. Dr. Vermén created the VH Rating System which is the only validated hypoallergenic rating system in the world and is used across all the products at VMV. In this interview, Laura answers Marcie Mom’s questions on understanding how many ingredients a product should have.

Marcie Mom: Given that a child with very sensitive skin/eczema can be allergic to many ingredients, it makes sense that the fewer ingredients, the less likelihood of triggering an allergic reaction. Is there an average number of ingredients a moisturizer is likely to have?

Laura: There is no one average to give because different formulations necessitate different quantities of various things like emulsifiers, stabilizers and so on. For example, a shampoo might normally need to have a longer ingredients list than, say, a lipstick, because the shampoo contains so much water and needs more preservation, whereas a lipstick or concealer is mostly wax and therefore needs less preservation. A good bet is to compare similar products, e.g. two toothpastes. If toothpaste A has 10 ingredients and toothpaste B has 25, then A is probably the safer bet. Of course, toothpaste A could have allergens and toothpaste B could have no allergens…

In a nutshell: hypoallergenicity is a highly complex concept with many, many moving parts and it would be unreasonable to expect any mother or any consumer to master (or even familiarize herself with) all of these myriad issues. As we are mostly “lay” moms who want to care for children with very sensitive skin, it’s not a matter of mastering this complexity or of finding one magic bullet. It’s a matter of choosing products with as many of the good-practices as possible. If I were to summarize the safest best practices into a simple checklist, this would be it:

1)             Look for zero or as few allergens as possible. Your best bets for this are a) a patch test when your child is old enough and b) a VH-Rating.

2)              Avoid the most consistent top allergens: paraben, fragrance, masking fragrance, dyes, “coca”-surfactants

3)            Choose shorter ingredient lists (but check them against #2 above).

4)             Try to opt for brands with real clinical legitimacy. Published studies in well-known medical journals and presented studies in the large medical conventions are a good bet. At least you’ll know that their claims are backed by research that has objectively been considered scientifically valid enough for presentation and publication…so you might at least feel more comfortable trusting their claims.

Marcie Mom: Great checklist! I’m so happy that we’ve understood lots and understand so much better when we read the product label. Our next interview will move on to practical application of the moisturizers!

Sensitive Skin Product Series – Understanding Coconut Oil

 

Table to explain processing of coconut types and of other oils (provided by Dr Verallo-Rowell)

This is a 13-part series focused on understanding and using products for sensitive skin, an important topic given the generous amount of moisturizers that go onto the skin of a child with eczema. Marcie Mom met Laura Verallo Rowell Bertotto, the CEO of VMVGroup, on twitter and learnt that her company is the only hypoallergenic brand that validates its hypoallergenicity. VMV Hypoallergenics is founded in 1979 by Dr. Vermén Verallo-Rowell who is a world renowned dermatologist. Dr. Vermén created the VH Rating System which is the only validated hypoallergenic rating system in the world and is used across all the products at VMV. In this interview, Dr. Verallo-Rowell and Laura answer Marcie Mom’s questions on coconut oil.

Marcie Mom: I read with interest that your products contain USDA-certified organic virgin coconut oil and monolaurin (derived from coconut oil) that is a substitute for paraben. Do all products containing coconut oil have the same antibacterial, antiviral and disinfectant properties that your product have? Could the ‘wrong’ coconut oil actually be an allergen?

Laura: There are currently no reports of reactions to coconut oil but yes, there are different types of coconut oils. Ours is USDA-certified organic because the entire farm is organic…no fertilizers, nothing…and because the method of extracting the oil is organic…nothing is added; we use first and cold-pressed oil…not even heat is used and no chemicals. Some other coconuts are grown on non-organic farms or the oils/other extracts are processed using other chemicals that could be allergenic. Others still are sold with additives like preservatives or flavor or stabilizers or fragrance. Those would definitely increase the likelihood of a reaction.

Virgin coconut oil is well studied to have anti-viral properties and has even shown some success in managing herpetic flareups that are resistant to valacyclovir. Virgin coconut oil should have these properties, but we can only vouch for the one we produce because we control it from seed to bottle, and it is the oil with which all our clinical studies were done.

Monolaurin has a slew of studies as well proving its similarity in efficacy to several broad-spectrum antibiotics, antivirals, disinfectants (even 70% isopropyl alcohol) and antifungals, but without the side effects like increased tolerance to treatment or dryness. I should also point out that our proprietary preservative system that replaces parabens is not just monolaurin…it’s a delicate balance between this and several other ingredients…it’s a big headache, if I’m to be frank :) But such is our mandate :)

Dr. Verallo-Rowell: Yes. No matter how processed, the composition of all fatty acids in the oil removed from the coconut meat is about the same: myristic (15%), lauric acid (46-50%), Capric (6-8%), Caprylic ( 6%). These are all medium chain and saturated.

Could the ‘wrong’ coconut oil actually be an allergen? Yes, because of processing. RBD (primarily a cooking and/or industrial oil) vs. virgin coconut oil. See table above that explains processing of coconut types and of other oils.

Marcie Mom: Thanks! Coconut oil is increasing popular as an ingredient and your information on it is precious to parents when evaluating what product to buy. We’ll learn more about cross-reaction in our next interview.

 

Sensitive Skin Product Series – What Ingredient to Avoid

List of Ingredients that Could Irritate

This is a 13-part series focused on understanding and using products for sensitive skin, an important topic given the generous amount of moisturizers that go onto the skin of a child with eczema. Marcie Mom met Laura Verallo Rowell Bertotto, the CEO of VMVGroup, on twitter and learnt that her company is the only hypoallergenic brand that validates its hypoallergenicity. VMV Hypoallergenics is founded in 1979 by Dr. Vermén Verallo-Rowell who is a world renowned dermatologist. Dr. Vermén created the VH Rating System which is the only validated hypoallergenic rating system in the world and is used across all the products at VMV. In this interview, Dr. Verallo-Rowell and Laura answer Marcie Mom’s questions on which ingredients to possibly avoid.

Marcie Mom: For a parent on a tight budget (also considering long term and frequent use of moisturizers), should he/she start the child on the cheapest lotion/cream available? If not, is there certain baseline to start with, for instance, it must state ‘suitable for infant with eczema’ or not contain ‘perfume’?

Dr. Verallo-Rowell: The answer is no. Many cheap products are strongly/nicely scented to cover up for the natural scent of less-pure cosmetic ingredients versus, for example, pharmaceutical-grade or higher-quality or purer ingredients, which are frequently more expensive. Some cheaper products are dyed with relatively cheap ingredients to add attractiveness in children’s eyes. Cheap or expensive, preservation is also problem, as are added antibiotics. All these are allergens and break down the skin’s natural barrier.

Make function be the basis for your choice. Remember that in different forms of eczemas you pay attention to the skin’s outermost barrier layer: genetic innate barrier dysfunction initiates atopic; allergic or irritant reaction breaks down the barrier in contact; food around the mouth area can physically act on the barrier, and secondarily, bacteria cross damaged barrier in all types of eczemas.

Hence to keep the barrier as intact as possible: Place the least irritating, partially occluding product you can find without any of the above: scents, preservatives, antibiotics, dyes. Mineral oil and pertroleum jelly are long time favorites of us dermatologists. They are cheap and excellent barriers, but they are petrochemical derived. Consider non-preserved, non-adulterated oils. For this my favorite is virgin coconut oil because it needs no preservation and is broken down by lipases of friendly skin bacteria into monoglycerides with antiseptic properties. I have a published paper on VCO vs. Olive oil in Atopic Dermatitis that includes comparison on Staph. Aureus action by both oils.

MarcieMom: Can you list for us some common irritants and list them on a scale of 1-10 (1 being the most likely to cause allergy)? It’ll also be great if you can let us know if there are other common names for these irritants.

1.     Perfume/ Fragrance

Benzyl alcohol (Phenylmethanol / Phenylcarbinol) Natural grape aromatic preserves & scents in “fragrance-free products”
Carvone (d-carvone, d-1-Methyl-4-isopropenyl-6-cyclohexen-2-one Essential oils from dill, caraway seeds, spearmint, orange peel
Cananga odorata(Ylang ylang, Cananga distillates) from the flower
Cinnamic aldehyde (Cinnamaldehyde) from bark camphor, cassia cinnamon trees
Colophonium Rosin (Abietic acid, alcohol, Abitol) A resin from pine trees
Extracts of common plants of the (Astraceae/ Compositae family: yarrow, mountain arnica, German chamomile,  feverfew,  tansy) Botanical additives

2.     Preservatives

Bacitracin  (An Antibiotic )
p-Chloro-M-Xylenol (Chlroxylenol, PCMX)
Clioquinol
Formaldehyde (Formalin, Methaldehyde, Methanal)
Diazolidinyl urea (Germall II) and 

Imidazolidinyl urea (Germal 115, Eukyl K 200)

Dimethylol dihydroxy ethyleneurea (DMDHEU)
DMDM Hydantoin (Glydant)
Quarternium 15 (Dowicil 200)
Methyldibromo glutaronitrile + 2 phenoxyethanol (Eukyl K 400)
Methylchloroisothiazolinone/methylisothiazolinone (MCI/MI Eukyl K100, Kathon CG)

3.     Parabens – Methyl, Ethyl , Propyl, Butyl Paraben.  Please also above in Preservatives

4.     Propylene Glycol – 1,2 Propanediol

5.     Lanolin – Lanolin alcohol, Wool Alcohol

6.     Colorant/Dye

Disperse blue 124/106  Mix (Thiazol-azoyl-p-phenylene diamine derivative dyes)
p-Phenylenediamine

7.     Conventional emulsifiers

Stearamidopropyl dimethylamine  (Amidoamine)
Dimethylaminopropylamine (DMAPA)
Cocamide DEA (Coconut Diethanolamide)
Cocamidopropyl betaine
Oleamidopropyl dimethylamine
Decyl glucoside  from glucose (corn starch) & decanol fatty acid from coconut
Ethylenediamine dihydrochloride (Chlorethamine)

8.     Mineral oils – actually quite skin safe. A favorite among dermatologists.

9.     Paraffin – same as mineral oil.

10.  Sodium Lauryl Sulphate – An Irritant especially when present in higher concentrations. Not too common as an Allergen.

Marcie Mom: Thanks Dr. Verallo-Rowell and Laura. It’s great to finally have a sense of the list of ingredients to avoid and in priority, so that parents can check if the product they buy are at least free of the allergens on the top of the list!

Sensitive Skin Product Series – Understanding Irritant-Free

Allergens to Avoid

This is a 13-part series focused on understanding and using products for sensitive skin, an important topic given the generous amount of moisturizers that go onto the skin of a child with eczema. Marcie Mom met Laura Verallo Rowell Bertotto, the CEO of VMVGroup, on twitter and learnt that her company is the only hypoallergenic brand that validates its hypoallergenicity. VMV Hypoallergenics is founded in 1979 by Dr. Vermén Verallo-Rowell who is a world renowned dermatologist. Dr. Vermén created the VH Rating System which is the only validated hypoallergenic rating system in the world and is used across all the products at VMV. In this interview, Laura answers Marcie Mom’s questions on understanding ingredients that may be potential irritants.

‘Perfume Free’, ‘Propylene Glycol Free’, ‘Paraben Free’, ‘Lanolin Free’, ‘Preservatives Free’, ‘Colorant Free’ – So Many ‘Frees’! Is this too much or too little?
In this post, I’ve consolidated a list of irritants to avoid which include the above and also sodium lauryl sulphate, mineral oils, conventional emulsifiers and paraffin. I’ve also realized that it’s difficult to find a product that excludes all potential irritants so for this interview, we catch up with Laura to understand which are the more allergenic ingredients and how to assess what our child can use.

Marcie Mom: I understand that VMV recommends its customers to perform a patch test, i.e. applying on a small area and observe for few hours to up to 72 hours before gradually increasing usage. Can a child also take a patch test?

Laura: Wow you do your research :) Ok, for ANY cosmetic, doing a provisional patch test before purchasing and/or sampling is always a good idea prior to making a purchase.

The best tool is really a proper patch test done by your dermatologist, but this cannot be done on children. If you have a child with very sensitive skin, allergies and/or eczema, etc., however, as soon as he is old enough to get a full patch test, he should. This is really the best way to determine what, in particular he needs to avoid. And if you’re sensitive, as allergies are often hereditary, your own patch test results may give you a possible idea of what your child might be allergic to as well (this is not a sure thing, however; your child would still benefit from his/her own patch test at the appropriate age).

Making Sense of Irritant-Free

Marcie Mom: Should parents use a product that markets ‘XXX-Free’?

Laura: Yes, a good guide is to look out for what irritant the product is free of. The big problem, however, is that a lot of marketing-speak says “free this” and “free that”, and, unless you’ve really done your homework and have a deep understanding of ingredients and allergens, you may not be able to accurately judge if the ingredient that is absent is even harmful. What I’m trying to say is that “XXX-FREE!” is a powerful marketing phrase on its own, whether or not it has objective merit (e.g. whether or not a product is better for not having a particular ingredient in it).

SLS

Lots of shampoos now, for example, are touting “SLS-free” heavily. The thing is there are two ingredients with these initials: Sodium LauRYL Sulfate and Sodium LaurETH Sulfate. While the former is a well-known irritant, the latter is actually rather harmless, particularly in lower concentrations. So if a product says SLS-Free, you’d need to check which of the two is absent. And, neither is on the allergen lists (again, these lists are compiled from patch tests done on over 20,000 people). Much of the hooplah surrounding SLS/SLES has to do with their environmental impact — which is a valid concern but may not be as relevant as for skin safety.

‘Cancer-Causing’

One more thing to consider. When you read a lot of the posts about “causes cancer”, it’s natural to worry. These claims are serious and you don’t want to take them lightly. However, it is important to remember that many (but not all) of these reports are skewed to be sensational — they may not be balanced. For example, much of the evidence of the carcinogenicity of certain ingredients is determined in laboratory experiments with animals fed the ingredient in very high doses (sometimes the equivalent of the animal’s body weight and the equivalent of a lifetime of consumption at these doses). Many of the same ingredients used in cosmetics are used in minuscule amounts and in molecular sizes that are too large to penetrate to the dermis, much less get to the bloodstream. An example would be parabens: we stopped using them because they are allergens, not because of the cancer panic, because there simply is not enough to go on. More information in this article.

Mineral Oil

Mineral oil is another great example: NOT an allergen. Ask any dermatologist and they’ll tell you mineral oil is a go-to, reliable hydrator even for extremely sensitive skin (there are some reports of comedogenicity but it is otherwise a go-to moisturizer) and for extremely sensitive areas (even the genitalia). Again, most of the concern with this (as well as petroleum jelly, another big dermatologist favorite) is environmental. And again this is a valid argument for the planet, but strictly speaking for skin safety, these ingredients are not allergens and are relied upon regularly by dermatologists for very dry, sensitive skin conditions.

Hypoallergenic

“Hypoallergenic” is not regulated. Many ingredients touted for sensitive skin are actually highly allergenic. Some natural and/or organic ingredients are allergens, too. Yes, definitely, “fragrance-free” is key…but then again, are you confident that you know all the chemical names of all products that are fragrances and masking fragrances or that cross react with/are related to them (e.g. cinnamic alcohol)?

The best guide is really allergen-free. But you have to make sure that the “allergens” to which the brand is referring are those that are proven allergens. The NACDG and ESSCA patch test on over 20,000 people in multiple countries to compile their lists of allergens, and crucially, they update these lists every few years. These lists are, therefore, statistically relevant, consistently updated, and put together by two of the most respected groups of doctors in the world who concentrate on allergens and contact dermatitis — and they are regularly published in peer-reviewed medical journals. This allergen list is what the VH-Rating System uses and, considering we’ve had less than 0.1% reported reactions in 30 years, it’s quite reliable.

Marcie Mom: Thanks! It’s great to understand a little more about some of the ingredients, so that parents can assess if they truly need a product that excludes them. For the next interview, we’ll continue to learn more about choosing products for sensitive skin.

Sensitive Skin Product Series – Understanding Ingredients

Allergens to Avoid

This is a 13-part series focused on understanding and using products for sensitive skin, an important topic given the generous amount of moisturizers that go onto the skin of a child with eczema. Marcie Mom met Laura Verallo Rowell Bertotto, the CEO of VMVGroup, on twitter and learnt that her company is the only hypoallergenic brand that validates its hypoallergenicity. VMV Hypoallergenics is founded in 1979 by Dr. Vermén Verallo-Rowell who is a world renowned dermatologist. Dr. Vermén created the VH Rating System which is the only validated hypoallergenic rating system in the world and is used across all the products at VMV. In this interview, Laura answers Marcie Mom’s questions on understanding the ingredient label.

Product Label – Deciphering the Ingredients

Marcie Mom: Laura, thanks again for continuing to help us make sense of the ingredient label.

Many ingredients sound similar though not identical. Is there some broad classification of ingredients and how to identify what type of ingredient a certain name suggests? Is there a glossary/definition page that you can refer us to?

For instance, do ‘glycerin’, ‘capric triglyceride’, ‘palm glycerides’, ‘caprylyl glycol’, ‘glyceryl stearate SE’, ‘glyceryl laurate’, ‘glycol distearate’, ‘butylene glycol’, ‘glycerylcocoate’ belong to the same classification? And what are they?

Laura: Unfortunately, unless you’re a chemist or decide to devote yourself to the pharmacological sciences, this is almost impossible to master for most consumers. Yes, there are some roots to words that imply certain things. “GLY”, for example, implies a fat; “OSE” implies a sugar. But all the other roots in each word also mean different things and can signify huge differences.

Cocamidoproplyl Betaine

For example: cocamidoproplyl betaine is a surfactant and an allergen. Coconut oil (cocas nucifera) is an oil and is not an allergen. Both have “coca” imbedded in the name. In the former, it is not the coconut element that is the allergen but the substances used to process the coconut extracts (the “amines”) that make the ingredient allergenic.

Butylene Glycol

Another example: butylene glycol (not an allergen) and propylene glycol (allergen)…both have “glycol”, but the former is a humectant and antioxidant (also not an allergen) while the latter is a formaldehyde-releasing preservative and an allergen.

SLS

Yet another: both Sodium LauRYL Sulfate and Sodium LaurETH Sulfate share lots of elements in their nomenclature. But SLS (the former) is far more irritating than the latter (the latter is actually quite safe). I suppose you could try to memorize RYL as “avoid” and ETH as “better”, but again, this does require some effort.

In addition to understanding (and memorizing!) all the possible combinations of different chemical roots, one would also need to memorize which are on the current allergen lists. As the current lists now specify 76 common allergens (and the lists change every so often), mastering the complexity of cosmetic ingredients is really more of a full-time job than something that most consumers can do, even as a hobby. There aren’t even a lot of dermatologists who are extremely familiar with all these ingredients, the allergens, possible cross reactants, etc. Those that specialize in contact dermatitis would have very in-depth knowledge, and this knowledge takes lots of sustained reading and learning. Considering that only a subset of dermatologists who devote themselves to this study would have this knowledge, you can imagine how difficult it would be for a regular consumer.

This complexity is in part why our founding physician created the VH-Number Rating System. If a patient got a patch test, great: at least she’d know what to avoid. But even then, some chemical names are listed in different ways…or there may be cross reactants that aren’t immediately obvious. With a VH-Number, consumers can immediately see if (and how many) known allergens are included, and the allergen is highlighted in the ingredients list for easy identification. 

Marcie Mom: Thanks so much Laura; looks like it’s best to stick to a trusted company for choosing products for our children as you’ve illustrated, it’s near impossible for a mom (plus a stressed one!) to master the ingredients and allergens.

Sensitive Skin Product Series – Understanding Ingredients & Patch Test

Patch Test (picture from www.chemistscorner.com)

This is a 13-part series focused on understanding and using products for sensitive skin, an important topic given the generous amount of moisturizers that go onto the skin of a child with eczema. Marcie Mom met Laura Verallo Rowell Bertotto, the CEO of VMVGroup, on twitter and learnt that her company is the only hypoallergenic brand that validates its hypoallergenicity. VMV Hypoallergenics is founded in 1979 by Dr. Vermén Verallo-Rowell who is a world renowned dermatologist. Dr. Vermén created the VH Rating System which is the only validated hypoallergenic rating system in the world and is used across all the products at VMV. In this interview, Laura answers Marcie Mom’s questions on understanding ingredients and on patch test.

Product Label – Deciphering the Ingredients

I’ve written in this post on how difficult it has been comparing the ingredients across products and make some sense of what they mean. For one, not all products list all their ingredients and even when they do, different companies seem to be giving the same ingredient different names (because they all sound so similar yet not identical!)

Marcie Mom: Laura, thanks again for continuing to help us understand the product label. This interview will focus on getting a broad understanding of labeling ingredients.

i. Is the ‘Ingredient’ list on product packaging Compulsory and Regulated? Does the Ingredient List cover all ingredients? Or can companies pick and choose what they like to reveal?

Laura: In many countries, yes, it is compulsory to list all ingredients, following a specified format, and using only the INCI (International Nomenclature of Cosmetic Ingredients) names of ingredients. A few countries do not require that ingredients be listed, in full or in part, and/or do not have requirements regarding the names used or formatting.

ii. Why is there no percentage (%) beside each ingredient? That way parents can compare and choose the product with the least % of allergen. Also, I read that certain allergen will not trigger a reaction because its concentration is too low in moisturizers but I also read that some products use an exceptionally high concentration of certain irritants. How can consumer find out the concentration of allergen/irritant in a product?

Laura: This is quite a complex question…love it! :)

First, % are not included mostly because of proprietary concerns. A company does not want its exact formulation copied by anyone else.

Second, if a product is a DRUG (prescription or over-the-counter), it does, actually, have to disclose the % of the active ingredient.

Third, an easy way to get an idea of how much of an ingredient is in the formulation is to look at WHERE it is on the ingredients list. Most regulatory bodies require that ingredients be listed from MOST to LEAST.

Fourth: the % of an irritant or allergen is relevant mostly if someone only has irritant reactions to it. Irritant reactions do have a relationship to concentration of ingredient, frequency of exposure, time on skin, etc. For example, you could be using an allergen most of your life and not really react to it or just have mild irritant reactions like dryness. But if you are ALLERGIC to a substance or develop an allergy to it, any % of it for any amount of time on the skin will cause a reaction. Again, this is why a patch test is so important.

iii. Can you explain a little more on patch test?

Patch-Testing before Use

A patch test is a painless procedure where ingredients/substances are put on your back in small dollops and kept on for a few days, with readings by your doctor at intervals like 48 and 72 hours. It can be a little costly upfront, but the amount of time, money and discomfort/skin trauma it can save you (versus random trial and error) over time makes up for that hundredfold. It tells you EXACTLY which ingredients you, in particular, need to avoid. So, for example, you may need to avoid certain dyes in clothing, certain laundry soaps, and certain metals in your cell phone, etc. but may actually be ok using such natural ingredients as tea tree oil…this helps guide you far more specifically. And if you happen to be in the USA and your dermatologist is a member of the American Contact Dermatitis Society, your patch test results can be entered into the CAMP (Contact Allergen Management Program) database…so that instead of just a list of ingredients to avoid, you get a list of brands and product names that you can use.

Not to over-emphasize a point but this is also why the VH-Rating System is so handy. If you have not yet had a patch test, choosing the highest VH-Rating (showing that zero allergens are included in the formulation) can already significantly improve your chances of non-reaction. If you HAVE had a patch test, if an allergen is included in a product, the VH-Rating will alert you to the presence of which allergen in particular is included (for example Vitamin E). If your patch test shows you’re allergic to parabens and not vitamin E, then you probably can still use the product.

Marcie Mom: Thanks so much Laura for your help in helping us understand the big picture on ingredient labeling. In our next interview, we will learn in greater detail about reading ingredients on the label.

Sensitive Skin Product Series – Understanding Suitable for Eczema Children

Eczema on 2 month old baby's face

This is a 13-part series focused on understanding and using products for sensitive skin, an important topic given the generous amount of moisturizers that go onto the skin of a child with eczema. Marcie Mom met Laura Verallo Rowell Bertotto, the CEO of VMVGroup, on twitter and learnt that her company is the only hypoallergenic brand that validates its hypoallergenicity. VMV Hypoallergenics is founded in 1979 by Dr. Vermén Verallo-Rowell who is a world renowned dermatologist. Dr. Vermén created the VH Rating System which is the only validated hypoallergenic rating system in the world and is used across all the products at VMV. In this interview, Dr. Verallo-Rowell and Laura answer Marcie Mom’s questions on understanding the product label.

MarcieMom: Suitable for Eczema Child/Infant – These are the most important keywords for a parent looking for sensitive skin products for his/her child with eczema – how much surer can it be when the product is labelled (and often prominently so) that it can be used for infant with eczema! Can you explain to us what ‘suitable for use for infant’ and ‘suitable for eczema’ really mean? Also, is there a regulatory body that governs the use of such terms on product packaging?

Laura: Again, great question, and not as confusing as it may seem with some simple guidelines (but yes, still not regulated terms so there is definitely self-education needed).

Suitable for infants: Here is the premise we at VMV operate on. Baby skin is formed and functioning from a very young age (neonatal and even younger — in utero by the end of the 1st trimester). But during the first few months of life, immunological functions are still undeveloped. For example, atopic dermatitis (an allergic disease that needs immune-forming cells to make IgE immunoglobulin) is not often seen until after the 3rd month of life. Because infant skin is newer to the world, building up its defenses, and as the surface area of skin is greater in babies (they absorb anything topically applied more than adults), baby skin care should be very safe yet still protect against micro-organisms. This, at VMV, has meant products with as few or ZERO of all known allergens (plus other things that are NOT allergens but known to have irritant responses and other safety issues, like SLS and phthalates) PLUS the inclusion of a very safe antibacterial-antiviral-antifungal-anti-inflammatory in all formulations. We also use coconut oil and its derivatives a lot because many have been found to actually be present in mother’s milk, studied extensively, peer-reviewed and published multiple times.

Suitable for Eczema has similar requirements. Eczema is actually atopic dermatitis. I left the more detailed definition to my mother, Dr. Verallo-Rowell, as this is her forte and I believe you and your readers would appreciate a doctor’s definition:

Dr. Verallo-Rowell: Eczema is actually a more generalized term for any skin eruption characterized by edema within the epidermis and dermis clinically seen as tiny itchy bubbles that ooze and become little bubbles or vesicles, even blisters. Then, exposed to the air, they dry up and become crusts. With chronicity this wet phase may not be as obvious, and becomes replaced more by dry, thickened, very itchy patches and plaques. Atopic dermatitis is the prototype example of this process but it may be seen in other conditions such as allergic and irritant contact or photocontact dermatitis, eczematous drug eruption and secondary reactions to a primary diagnosis.

Laura: Because “eczema” is actually a very general term, a specific diagnosis can be a powerful tool towards consistent and sustained management. A specific diagnosis usually also comes with an identification of the possible triggers for an individual’s flare-ups. Because babies cannot yet be patch tested, however, the alternative is frequent and controlled observation of what seems to cause eruptions (this is also why it is so important to use few products…so it’s easier to observe what the trigger/s might be) and strict prevention.

For the many conditions that can fall under the mantle “eczema”, they all benefit from the same ultra-über safety that we would do for baby products, i.e. ZERO of all known allergens, etc. plus the inclusion of a very safe antibacterial-antiviral-antifungal in all formulations. Why? With eczema, when the skin develops fissures or cracks, this becomes welcoming to opportunistic microorganisms to enter the skin, which can lead to or exacerbate itching and further dryness…which can lead to more cracks (which can lead to more infection) and more scratching (which can spread infection)…more risk of microorganisms, etc. in a vicious cycle. This is why we put the skin-safe but powerful antibacterial-antiviral-antifungal-anti-inflammatory (monolaurin) in all these products.

Marcie Mom: Thanks Dr. Verallo-Rowell and Laura, I think we’ve covered the more common terms which parents of eczema children look out for in labels and discussed whether they are truly meaningful and beneficial. Look forward to learning more from you in our next blog interview.

Sensitive Skin Product Series – Understanding Organic & Non-Comedogenic

Organic Certified

This is a 13-part series focused on understanding and using products for sensitive skin, an important topic given the generous amount of moisturizers that go onto the skin of a child with eczema. Marcie Mom met Laura Verallo Rowell Bertotto, the CEO of VMVGroup, on twitter and learnt that her company is the only hypoallergenic brand that validates its hypoallergenicity. VMV Hypoallergenics is founded in 1979 by Dr. Vermén Verallo-Rowell who is a world renowned dermatologist. Dr. Vermén created the VH Rating System which is the only validated hypoallergenic rating system in the world and is used across all the products at VMV. In this interview, Laura answers Marcie Mom’s questions on understanding the product label.

Terms on Product Label – “Hypoallergenic”, “Natural”, “100% Organic” – What They Really Mean and Do They Mean Well?

Marcie Mom: Today’s learning more about terms like ‘organic’, ‘non-comedogenic’ and ‘pH-balanced’

Organic – This is a term that always baffles me and reading the amount of debate online as to what is organic is even more confusing! Can you explain to us whether the use of ‘organic’ term is regulated?

Laura: Regulation is much clearer for “organic” which requires certification by certain bodies that have earned the right to certify organicity (certain companies authorized by the US Department of Agriculture, for instance). For example, the virgin coconut oil we use is USDA-certified — a seal that has very strict requirements, that necessitates an inspector to travel to our farm and inspect it in person (including how we extract the oil) and a seal which we have to renew (to “re-earn”) regularly.

With the proper certification, “organic” is arguably far more reliable than “natural”.

Marcie Mom: Non-comedogenic I noticed that your products are listed as ‘non-comedogenic’ and ‘non-drying’. Can you explain to us what this mean and also what pH-balanced means?

Laura: Non-comedogenic means will not clog pores…and this is important for compliance. If a product will not cause reactions or offers a very effective clinical therapy…but then causes acne…then people are less likely to use it or may have just created more problems to deal with.

Non-drying is related to allergenicity. Many people who experience dry skin do not realize that they may already be experiencing a mild allergic or irritant reaction. We use this term to alert people to this fact. As well, some non-pore-clogging products achieve pore-friendliness via the inclusion of ingredients that do dry out the skin.

Important note: Many skin conditions, including psoriasis, eczema, acne and aging, are caused by, worsened by, or related to inflammation. The more a product can help reduce inflammation or if it can contain an anti-inflammatory, the better for most skin concerns. Also, the less inflammation to have to fight, the stronger the skin is and the better able to, on its own, ward off infection, reactions and other problems.

pH-balanced is an interesting term because it could mean completely neutral, which may or may not be ideal for a formulation. The skin’s natural pH is actually slightly more acidic (5.5-6.5) than neutral (which is 7). Bar soaps, because of the way they are made, intrinsically tend to have a more basic or higher pH (some going as high as 8 or 9). This can, on its own, be quite denaturing and very drying to skin. Most of our products for very dry, sensitive skin skew towards the skin’s natural pH as much as possible, or slightly lower…we try to avoid the high range as much as possible.

Marcie Mom: Thanks! So, we’ve covered the more common terms in labels and discussed whether they are truly meaningful. In the next interview, we’ll understand more about the term most parents with eczema children look for, i.e. “suitable for eczema/ infant”.

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