Medical Technology

The majority of hand soaps contain allergens.

NEW YORK (Reuters Health) – A new analysis of 160 hand sanitizers found that 71% contain at least one allergen listed by the North American Contact Dermatitis Group (NACDG).

“There are many products out there with an ideal formulation from a medical perspective (compliant with CDC guidelines and devoid of any common irritant or allergens), but it is very challenging for lay people to identify these products because ingredient labels are hard to interpret, and marketing claims are so commonly misleading,” Dr. Carina Woodruff, associate director of the Contact Dermatitis Unit at the University of California, San Francisco, told Reuters Health by email.

“For example, many well-intentioned and thoughtful consumers opt for ‘natural products,’ unwittingly exposing themselves to highly sensitizing fragrances/botanical extracts and increasing their risk of irritant or allergic reactions. I believe our study points to a need for more regulatory oversight of personal product packaging,” Dr. Woodruff said.

She and her colleagues analyzed 160 highly reviewed hand sanitizers sold online in May 2021 by Walmart, Target, Amazon, Walgreens and CVS. Their findings appear in the Journal of the American Academy of Dermatology.

All of the sanitizers had correctly labeled their active ingredients, such as isopropyl or ethyl alcohol. Another correctly labeled property was “moisturizing,” as every sanitizer that claimed to moisturize indeed contained a humectant, according to the researchers.

Most products, however, contained at least one allergen listed in the NACDG 2017-2018 standard series, including 70% of the sanitizers labeled “hypoallergenic.”

Tocopherol, or vitamin E, was the most common allergen, appearing in 73 products. Tocopherol has low allergenic potential with a sensitization rate of 0.7%, the researchers write. But 60% of the products examined contain ingredients with a sensitization rate of 1% or higher.

“Fragrance chemicals were among the most common potential allergens in the products we reviewed and as a class, they have a high sensitization rate, so recommending fragrance-free sanitizers makes a lot of sense,” Dr. Woodruff said.

However, nearly 40% of products labeled “fragrance free” actually contained a fragrance or cross-reactor listed in the American Contact Dermatitis Society’s Contact Allergen Management Program database.

Other items on labels can be misleading, as well.

“The phrases ‘dermatologist recommended’ and ‘hypoallergenic’ are essentially marketing terms that have no relationship to any regulatory authority,” said Dr. Joel DeKoven, associate professor of dermatology at the University of Toronto, in Canada, who was not involved in the research.

“Labels like ‘no parabens, sulfates, phthalates or dyes’ have no bearing on whether the product contains common allergens that could cause a skin reaction in sensitized consumers,” he told Reuters Health by email.

To guide patients and dermatologists, Dr. Woodruff and Dr. Nina Botto, a co-author of the paper who is also a dermatologist at UCSF, recommend ten hand sanitizers: SupplyAID, Hello Bello, Wave Gel, SanitizeRx, Hydra Pearl, Suave, Adam’s Pipette and Avagard D.

Their criteria were included meeting recommendations from the Centers for Disease Control and Prevention (CDC) for active ingredients, low cost, high customer reviews, no NACDG allergens and containing emollients.

The study had no funding, and the researchers declare no conflicts of interest.

SOURCE: Journal of the American Academy of Dermatology, online November 24, 2021.

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