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).
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.
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.
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” 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.
2015 update: Selection of moisturizer – try to see how to put a few basic principles of moisturizer selection in practice
2016 update: Surfactant skincare series that covers ingredients that have been studied to irritate eczema skin, such as CAPB
2018 update: The current list of prohibited ingredients by FDA are 1,4-dioxane, and 10 other ingredients: Bithionol, Chlorofluorocarbon propellants, Chloroform, Halogenated salicylanilides (di-, tri-, metabromsalan and tetrachlorosalicylanilide), Hexachlorophene (HCP concentration in a cosmetic may not exceed 0.1 percent, and it may not be used in cosmetics that are applied to mucous membranes, such as the lips), mercury compounds, methylene chloride, prohibited cattle materials, Vinyl chloride and Zirconium-containing complexes.