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Many moisturizers marked ‘fragrance free’ or ‘hypoallergenic’ are not, study finds

The study offers a cautionary tale for consumers, particularly individuals with eczema, psoriasis, or other skin conditions.

Cosmetic manufacturers are not required to list every chemical in their products if the chemical is a fragrance. But fragrances can be allergens.

Many popular over-the-counter moisturizers are inaccurately labeled “fragrance-free” and “hypoallergenic,” according to a study published online Wednesday in the journal JAMA Dermatology.

Those misleadingly marked products include ones stamped “dermatologist-recommended,” which, as the study also found, tend to come with a higher price tag.

The study offers a cautionary tale for consumers, particularly individuals with eczema, psoriasis, or other skin conditions, for it underscores the limited authority that the Food and Drug Administration (FDA) has over what goes into cosmetic products — and on those products’ labels.

Federal law does not require that the ingredients in cosmetic products — other than color additives — have FDA approval before they go on store shelves, although the agency can take action against a company that misbrands a product.

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Cosmetic manufacturers are also not required to list every chemical in their products if the chemical is a fragrance. But fragrances can be allergens. 

Study details

For the current study, researchers at Northwestern University did a detailed analysis of the ingredients in 174 of the best-selling moisturizing products (lotions, creams, butters and ointments) sold by Target, Walmart and Amazon. Sales of cosmetic and personal care products at those three retailers represent more than half of the $164 billion that consumers spend on such products annually, according to background information in the study.

Part of that analysis included assessing the proportion of moisturizers that had one or more ingredients that are included as allergens in the North American Contact Dermatitis Group (NACDG) patch test.

Of the products labeled “fragrance free,” 45 percent (18 of 40) had at least one fragrance or botanical cross-reactor ingredient. (A cross-reactor is a substance that the body’s immune system interprets as being the same as another allergen.) Of the products labeled “hypoallergenic,” 83 percent (15 of 18) had at least one NACDG-listed ingredient.

In fact, 88 percent of all the moisturizers in the study (153 of 159) had had least one allergen among their ingredients. Forty-three percent (75) had three to four allergens, and 13 percent (24) had five or more.

Price made no difference. Moisturizers without any NACDG-listed ingredients were not any more expensive than those with the potential allergens.

Nor did the label “dermatologist recommended” make a difference. Ninety-five percent of such products had at least one ingredient on the NACDG list. Those products were more expensive, however — about 20 cents more per ounce, on average.

The researchers found the “dermatologist recommended” label to be meaningless.

“We looked into what it means to be ‘dermatologist-recommended,’ and it doesn’t mean much because it could be three dermatologists recommending it or 1,000,” said Dr. Steve Xu, the study’s lead author and a dermatologist at Northwestern University, in a released statement.

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The “all natural” label on a moisturizer is also misleading. One of the “all natural” products in the study had the highest number of NACDG-listed ingredients — 8.

Consumers are on their own

Almost 85 million people in the United States are seen annually by a physician for some kind of skin disease or condition, according to a report released earlier this year by the American Academy of Dermatology. One survey found that 45 percent of Americans report having “sensitive skin” — skin that reacts to external factors (cosmetics, wind, temperature) with redness, irritation, itching or pain.

The American Academy of Dermatology recommends that patients with skin conditions use moisturizing products that are free of additives, fragrances and perfumes.

As this study shows, however, consumers cannot rely on labels to help them find those products.

FMI: You’ll find the study on the JAMA Dermatology website.

UPDATE: As the study is behind a paywall, here are what it found to be the five most affordable moisturizers without ingredients on the NACDG list: Ivory raw unrefined shea butter, Vaseline original petroleum jelly, Smellgood African shea butter, Home Health castor oil and NOW Foods apricot kernal oil.