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Fragrances, Perfumes, Preservatives, And Acne

By Megan Griffith

Reviewed for medical accuracy by Dr. Jaggi Rao,
MD, FRCPC Double board-certified dermatologist

Over and over on this site, we warn you about the dangers of fragrances, perfumes, and preservatives in skincare products. If you have sensitive skin, fragrances, perfumes, and preservatives can cause you problems a lot faster than acne breakouts, and they aren’t easy to overcome. Some of the most harmful substances are chemicals you probably never imagined appear in skincare products.  Here are the five that are the most likely to cause a skin reaction.

Skin Care Products
Many skin care products include fragrances, preservatives and other ingredients that can cause skin reactions.

1. Formaldehyde isn’t just used to preserve corpses. It is also used to preserve many skincare products. If you are sensitive to formaldehyde, you are most likely to break out when you get a double whammy of formaldehyde from your skincare product1 and naturally occurring formaldehyde in food. Cured ham, maple syrup, pickled herring, dried cod, caviar, coffee, and shiitake mushrooms all release natural formaldehyde. Small amounts of formaldehyde are released when your body metabolizes aspartame (Nutrasweet). And formaldehyde is also released by the skincare ingredient quaternium-15.

2. We warn you about lots of botanical ingredients, ranging from andrographis to zizyphus fruit. The single most irritant botanical ingredient, however, is a pungent herb derivative known as balsam of Tolu, or Tolu balsam. The big problem with this ingredient is that it can trigger cross sensitivities. If you develop an allergy to the balsam of Tolu2, you will also be allergic to cinnamon oil, lemon oil, orange peel, oil of cloves, benzoin, and propolis. An allergy you develop when you use one product may make you allergic to dozens more.

3. Millions of people are allergic to nickel. There’s probably no more troublesome trigger for eczema than nickel used in ear clips and the studs for body piercings. Nonetheless, a wide range of skincare products uses nickel sulfate3 as a preservative. (The products we recommend on this site do not.)

4. Neomycin isn’t just an antibiotic used as a skin cream. It’s also a preservative in some acne care formulas made in China. If you’re allergic to the4 antibiotic, you’ll be allergic to the acne skincare product, too.

5. Some seemingly safe ingredients can cause a condition known as protein contact dermatitis. These are usually food ingredients that don’t cause a food allergy, because they break down during digestion, but do cause a skin reaction. The scratch tests you get at the allergist’s office won’t detect them. Common culprits include soy5, peach, tomato powder, chrysanthemum, and natural latex.

The problem with these ingredients is that they cause skin reactions that most people and their doctors would naturally assume are caused by anything but a skin care product. Fortunately, all of these skincare product ingredients are easy to avoid (except in products made in China) if you just know you need to be on the lookout for them.

How to Know If You Are Sensitive to Fragrances, Perfumes, and Preservatives

Here are ten signs you may have a problem with fragrances, perfumes, and preservatives.

1. Earrings make your ears itch unless the clasp is made with 14-karat gold.

Sensitivity to earrings, piercings, and clip-on jewelry is a tell-tale sign of nickel allergy. Another sign of nickel allergy is sensitivity to cell phones. The numbers on the cell phone keypad are usually printed in nickel. Hairdressers, cashiers, metal workers, caterers, and housekeepers are especially like to have nickel allergies, due to frequent exposure. If you develop a nickel allergy through repeated exposure to the metal in your work you will be especially sensitive to acne products that use nickel sulfate as a preservative.

2. Hair dyes and temporary tattoos make you break out.

The offending ingredient in hair dyes6 and temporary tattoos that can cause the skin to break out is a chemical known as p-phenylenediamine or PPD. This ingredient occasionally shows up in tinted acne creams (again, not in any products recommended on this site) and in makeup used to cover acne blemishes. It’s kind of unusual to be allergic to PPD. About 4% of people in the US and Europe are allergic to the chemical, but about 6% of people elsewhere in the world.

3. Aftershave, cologne, deodorants, or soap make you sneeze or break out.

With aftershave, cologne, deodorant, and soap, the irritant ingredient is usually a fragrance. Chances are that there is just one fragrance that causes you special problems, but because there are over 4,000 different fragrances that are added to cosmetic products and the US Food and Drug Administration do not require manufacturers to list them by name on the label, you will never be able to find out exactly which product causes you difficulty. That’s why we usually recommend acne care products that are fragrance-free. Acne care products containing fragrances are most likely to cause problems on recently shaved or broken skin.

4. You are allergic to gentamicin or tobramycin.

If you are allergic to either7 of the aminoglycoside antibiotics gentamicin or tobramycin, you are probably also allergic to neomycin. You need to avoid any acne care products that contain even traces of neomycin, and it’s especially important that you do not use them underneath a bandage.

5. You are allergic to benzocaine.

Acne products that promise pain relief sometimes contain benzocaine. If you’re allergic to benzocaine, it may still be safe for the doctor or dentist to give you lidocaine injections for prevention of pain during office procedures, but be sure to let them know.

6. Eating peppery or highly seasoned foods makes you cry.

Foods that contain the chemical capsaicin usually trigger a reaction in the vagus nerve that causes the eyes to tear and the mouth to water. Capsaicin also accelerates digestion, although regular eaters of hot peppers may not be aware of this effect. If you are unusually sensitive to hot peppers, you may also be unusually sensitive to irritant ingredients in skincare products for acne.

7. The products your doctor gives you for breakouts make you breakout.

While corticosteroids are useful for treating skin allergies and for shrinking pimples, it’s possible to become allergic8 to them. If you use a topical steroid cream for acne and it makes you break out, be sure to let your doctor know, so you won’t be prescribed stronger steroids that might cause an even worse reaction.

8. People ask you if you have been out in the sun, even when you haven’t.

If your skin is naturally sensitive, it may have allergies that don’t cause itching or irritation, but sometimes looks like sunburn. If you have this type of skin, odds are high that fragrances, perfumes, and preservatives will only make things worse.

9. You get red in the face when you are angry or embarrassed.

Blushing is a common response to feeling angry or embarrassed, but some people are more prone to blushing than others. If your skin gets red and blotchy at even the most minor embarrassment, or if your blushing is so severe to be almost hive-like, your skin may be naturally sensitive, and there’s a good chance fragrances, perfumes, and preservatives will also bother your skin.

10. You get red in the face when you drink alcohol.

Both this form of flushing and emotional blushing tend to be more common in people who have rosacea, which is also made worse by fragrances, perfumes, and preservatives. If your acne sometimes looks more like a rash, you may actually have rosacea, not acne, and should talk to your dermatologist.

References:

  1. Flyvholm M.A., Menné T. Allergic contact dermatitis from formaldehyde. A case study focussing on sources of formaldehyde exposure. Contact Dermatitis. 1992;27(1):27-36.
  2. Bhate K., Landeck L., Gonzalez E., Neumann K., Schalock P.C. Genital contact dermatitis: a retrospective analysis. Dermatitis. 2010;21(6):317-20.
  3. Torres F., das Graças M., Melo M., Tosti A. Management of contact dermatitis due to nickel allergy: an update. Clinical, Cosmetic, and Investigational Dermatology. 2009;2:39-48.
  4. Cohen P.R. Follicular contact dermatitis revisited: A review emphasizing neomycin-associated follicular contact dermatitis. World Journal of Clinical Cases. 2014;2(12):815-21.
  5. Jarmila C., Květuše E., Karel E., Jaroslava V., Josef B. Soy Allergy in Patients Suffering from Atopic Dermatitis. Indian Journal of Dermatology. 2013;58(4):325.
  6. Mukkanna K.S., Stone N.M., Ingram J.R. Para-phenylenediamine allergy: current perspectives on diagnosis and management. Journal of Asthma and Allergy. 2017;10:9-15.
  7. Sánchez-Borges M., Thong B., Blanca M., Ensina L.F., González-Díaz S., Greenberger P.A., Jares E., Jee Y.K., Kase-Tanno L., Khan D., Park J.W., Pichler W., Romano A., Jaén M.J. Hypersensitivity reactions to non beta-lactam antimicrobial agents, a statement of the WAO special committee on drug allergy. The World Allergy Organization Journal. 2013;6(1):18.
  8. Kamm G.L., Hagmeyer K.O. Allergic-type reactions to corticosteroids. The Annals of pharmacotherapy. 1999;33(4):451-60.
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