Impact of Cosmetics and Cleansers in Atopic Dermatitis—How to Advise Patients.

Marcelino, J., Giménez-Arnau, A.M.  Curr Treat Options Allergy 11, 62–76 (2024). https://doi.org/10.1007/s40521-024-00360-1

Abstract

Purpose of Review

Atopic dermatitis (AD) or eczema is a frequent chronic inflammatory skin disease. Taking care of the eczematous skin is important to reduce the inflammation and return it to a healthier looking nourished skin. Beyond recommending topical anti-inflammatory drugs and the use of emollients, recommendations on the correct use of other everyday skin products, as cleansers or make-up products, are lacking.

Recent Findings

Potential allergens that can be found in cleansers and make-up removers

The dry, itchy, and inflamed eczematous skin causes anxiety, poor self-image, low self-esteem, decreased social skills, and an overall decrease in a patients’ quality of life. The use of make-up has been shown to ameliorate these impacts. Knowledge on the components of cosmetic products can help suit the products to an eczematous skin.

Existing data identifies agents more likely to cause allergic contact dermatitis and shows how to identify cosmetics that follow the principles of “hurdle technology,” how rubbing during cleansing is a significant and previously unrecognized exacerbation factor, and how cleansers interact with eczematous skin. An adequate choice of all these products allows a patient to enjoy its benefits, while preserving a healthier skin.

Summary

Guiding healthcare professionals on the composition of the cosmetics used, avoiding products with high allergenic properties, identifying products that follow the principles of “hurdle technology,” and educating patients on the appropriate use of make-up and cleansing products have a positive impact on the care of atopic dermatitis and should be part of a holistic approach to a patient.

Key messages

- Adverse reactions to cosmetics can come from allergic sensitization or irritant stimuli (like the rubbing associated with washing the skin).

- Optimizing the composition of the cosmetics used is essential. Ideally, the patients should distinguish the multiple components of a cosmetic, identifying potential risks.

- Avoid products with high allergenic properties, like fragrances or preservatives. Select products which follow the principles of “hurdle technology”: sterile cosmetic technology, good manufacturing practices, appropriate packaging, emulsion form, water activity, and pH control.

- Appropriate use of make-up is important for better care and quality of life of AD patients. Guidance on their use and appropriate cleansing products and techniques are essential to prevent exacerbations.

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