I was inspired to do this research study after diagnosing a patient (with help of patch testing) with an allergy to her La Mer ($345) moisturizer. Her allergy was due to a preservative called methylisothiazolinone (MI), which was found in the La Mer cream. This preservative has since been banned in Europe in leave on products, but has not been banned in the US yet. I see many allergies to this preservative, mainly from skin care and hair care products. I couldn’t help but wonder: “Do more expensive moisturizers have a higher chance of causing an allergic reaction than less expensive ones?”
The relationship between cosmetics exposure and onset of allergic contact dermatitis (ACD) has been well documented for more than 50 years, with 3.7% of the population estimated to be sensitized to a cosmetic ingredient and 10% of the population experiencing general side effects from cosmetics. In 2006, the market value of the cosmetics industry was estimated to be around $48 billion in the US, with a per capita spending of $161 in the EU. With 21% of the market value in the US specific to skin care, the economic value of skin care products, such as moisturizers, as well as its significance in individual spending is undeniable.
Though there are studies examining the frequency of allergenic ingredients in consumer products, none have examined the allergenicity of products in terms of economic value. Therefore, in this study, we evaluated the potentially allergenic components of moisturizers that are ubiquitous to the public based on price, by presenting a comprehensive analysis of the ingredients present in moisturizers available online at the largest retail drugstore corporation in the United States, CVS Health. In this cross-sectional study, ingredients found in 50 expensive and 50 inexpensive moisturizers were matched with sensitizers within the core allergen series published by the Allergic Contact Dermatitis Society (ACDS) and North American Contact Dermatitis Group (NACDG).
The most to least common potential allergens in the expensive moisturizers were: fragrances (88%), preservatives (80%), tocopherols (58%), botanicals (40%), emulsifiers (38%), acrylates (14%), and other (8%).. Most to least common for the inexpensive moisturizers were: preservatives (88%), fragrances (62%), tocopherols (60%), botanicals (56%), emulsifiers (36%), acrylates (6%), other (2%) (Table 3). The expensive products had significantly higher rates (88% vs. 62%) of fragrances than the inexpensive products.
This data may provide clinicians with the information to determine possible allergen exposure in patients due to their moisturizers, suggest affordable yet less allergenic alternatives, and educate patients on the use of costly moisturizers that may be as allergenic, if not more, than inexpensive options.