There are many additives in most lotions, often ingredients such as steroids, petrolatum and parabens.
What are these ingredients really and why are they and scent mixes added to so many skin care products?
What makes a really great paraben-free eczema cream.
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Topical steroids are creams, ointments and lotions that contain corticosteroid medications.
Applied directly to the skin, they work by reducing inflammation, similar to the naturally produced hormone cortisone.
They are often used with moisturizers for treating eczema and are generally grouped into four categories depending on their strength; mild, moderately potent, potent, and very potent.
For example, hydrocortisone cream 1% is a mild topical steroid.
The greater the potency of the steroid, the more effect it has on reducing the inflammation but the greater the risk of side effects occurring.
Creams are usually best for treating moist or weeping areas of the skin.
Ointments, because they are thicker than a lotion, are preferred for treatment of areas that are dry or thickened.
Lotions are usually recommended for areas that are hairy, such as the scalp.
As a rule, a course of topical steroid is used when one or more patches of eczema flare at the same time.
The aim of the treatment is to stop the flare-up and then stop the steroid treatment.
In most cases the lowest-strength topical steroid that will clear the flare-up will be given.
If within 3-7 days there is no improvement then a stronger dose can be given.
If the flare-up is severe, a stronger dose may be given from the start. The frequency and intensity of flare-ups vary per person.
After you finish the topical steroid you should continue to use a moisturizer daily to prevent future flare-ups.
If using a moisturizer in combination with a steroid, the moisturizer should be applied first.
Apply the moisturizer, wait 10-15 minutes for it to be absorbed (the skin should be moist or slightly tacky but not slippery) and then apply the topical steroid.
Short doses of topical steroids (fewer than four weeks) are usually safe and cause no side effects.
However, problems may develop if they are used for long periods or if short courses of strong steroids are repeated often.
Side-effects from topical steroids can be either localized or systemic.
Localized means affecting only that specific area of skin, systemic meaning the whole body is affected.
Make sure that you are using the proper dosage of any topical steroid, neither too much or too little.
Localized side-effects of topical steroids:
-Stinging or burning when applying the treatment is common but often improves as you become accustomed to the treatment.
-Thinning of the skin happens more often when a high dose topical solution is used under an airtight dressing.
With normal use, skin thinning is less likely and may reverse once the therapy is stopped if it does occur.
-With long-term use the skin may develop permanent stretch marks, bruising, discoloration or spidery blood vessels.
-Topical steroids may trigger or worsen other skin disorders such as acne, rosacea or perioral dermatitis.
-Skin discoloration, usually more noticeable with dark skin tones, may occur.
-Excessive hair growth may occur on the treatment area.
-Skin irritation can add to existing concern.
Systemic side-effects of topical steroids:
-Some topical steroids can pass through the skin into the bloodstream the amount is usually small, unless it is a strong dose used over a large area of skin.
In children who need frequent topical steroid treatments it can affect growth, so their growth should be monitored closely.
-Fluids may accumulate in the legs.
-High blood pressure may be aggravated.
-Bone damage may result due to thinning of the bones.
-Topical steroids may complicate Cushing’s syndrome which is a rare condition caused by high levels of cortisol in the blood. Symptoms may include fast weight gain, skin thinning and mood changes.
Petrolatum or petroleum jelly is derived from petroleum and is often used in personal care products as a moisturizing agent.
When properly refined, petrolatum has no known health concerns.
However, petrolatum is often not refined with strict protocols for purity, so it can be contaminated with toxic chemicals called polycyclic aromatic hydrocarbons (PAHs).
Petrolatum is a byproduct of petroleum refining. It has a melting point close to body temperature so it softens upon application to skin and forms a water-repellant film over the area.
The goal is to create a barrier preventing the evaporation of the skin’s natural moisture.
It is odorless, colorless and has an inherently long shelf life, making it a popular choice for an ingredient in many skin care products.
As mentioned, if petrolatum isn’t properly refined there is a concern of contamination with PAHs, which can cause cancer.
A study found that women with high levels of PAH-DNA combinations had a 50% higher risk of breast cancer.
There is really no way to know if or how the petrolatum is refined unless you call the company and do some major research as the US has no requirements on refinement.
A couple of other things to keep in mind when it comes to petroleum in skin care products is that the body does not properly metabolize petroleum.
What that means is that once it enters your body it doesn’t very easily leave.
Instead of petroleum related products you may want to try coconut oil, jojoba oil, vitamin E, shea butter or cocoa butter.
Epiphany Therapeutics offers petrolatum-free Remedias Calming Moisture Therapy, a light lotion that quickly improves the symptoms of red, irritated skin with no residue, or unpleasant scents.
Parabens are synthetic preservatives used in cosmetics and personal care products such as deodorants, moisturizers and shampoos.
They allow skin care products to stay in your cabinet without spoiling for months or even years; however, they also enter the body through your skin when you use the products.
Parabens mimic hormones in the body and can disturb functions of the endocrine system.
Estrogen, and synthetic chemicals that act like estrogen, play a role in stimulating the division of breast cells and affect other hormones that stimulate breast cell division.
Your body does not easily break down manmade estrogen and this synthetic hormone can accumulate in fat cells, including breast tissue.
A study examined the presence of parabens in tumors but did not fully determine that they were the cause of the tumors.
Still, is it really worth the risk? The ability of parabens to mimic other hormones makes them endocrine disruptors.
The endocrine system releases hormones into the bloodstream and is involved in a number of functions related to reproduction, waste elimination, digestion and metabolism.
Parabens may lead to early puberty in adolescents. Endocrinologists have observed the average age of puberty decreasing in the past several decades.
Parabens have also been shown to adversely affect the male reproductive system.
These are a lot of awful side effects for an additive to cause.
Research has established that fragrance in skin care products is one of the main causes of negative skin reactions.
This tends to prove true for all skin types, not just sensitive or redness prone skin.
Many people assume that because they show no signs of irritation from scented products that these issues don’t apply to them.
However, often the skin doesn’t show signs until later.
Think about it like sun damage. Sun damage begins the minute your unprotected skin is exposed to sunlight, but the damage is cumulative.
Yet other than tanning and temporary sunburn, you see no damage on the surface of your skin until years later.
Some natural ingredients have a pleasant fragrance and cause no damage, such as: melon, vanilla, almond, mango, coconut, cocoa butter and cucumber.
Often a man made fragrance is added to cover the unpleasant scents of additives in the product.
Many beneficial skin care ingredients have natural fragrance, but distinguishing between the beneficial natural and the man made fragrances can be very difficult.
Epiphany Therapeutics calming moisture therapy lotion has no unpleasant or unnatural scents.
It’s worth it to really look into your products before using them.
You want to make sure that they do not include steroids, petrolatum, parabens or scents.
About the Authors
William Goolsbee has spent his career in Life Sciences including leading roles in drug development in immunology and genetic medicine. Recent senior positions include Chairman of the Board at Sarepta Therapeutics and Founder and CEO at Metrodora Therapeutics.
Dr. Gil Price
Gil Price M.D. is the Chief Medical Officer at the Propharma Group, where he provides medical supervision for all clinical trials. He previously served as the Chief Executive Officer of Drug Safety Solutions, where he oversaw safety monitoring for drugs in clinical development. Dr. Price also served as the Director of Clinical Development at Medimmune Oncology and Director of Medical Affairs at Glaxo.