If you live with a chronic skin condition such as eczema or dermatitis, you’ll recognise the frustration of getting home with a lovely new moisturiser for your poor dry skin, slathering it on and then...OUCH! The stinging starts up and you wish you hadn’t bothered.
Whether an emollient is prescribed by your GP or bought over the counter, it can contain ingredients that actually aggravate your eczema rather than calm it down. So what should you be looking out for and what should you avoid?
Here’s five common ingredients in your eczema cream that might be doing you more harm than good.
We’ve heard a lot about foaming agent Sodium Lauryl Sulfate - and its partners-in-crime, Sodium Laureth Sulfate (SLES) and Ammonium Laureth Sulfate (ALS) - in shampoos, body washes and facial cleansers, to the point where cosmetics advertise themselves as SLS-free, but who’d have thought it would turn up in emollients prescribed for eczema as well?!
SLS is a known irritant that damages the skin barrier, and is definitely not recommended for topical use, especially not on the skin of itchy children. Look out for it in aqueous creams and avoid!
Almost every moisturiser contains fragrance of one kind or another, but perfume (or parfum) is highly likely to irritate sensitive skin, even if it’s described as ‘natural’. It’s not generally included in prescribed products but do look out for it in moisturisers, cleansers, creams and lotions if you’re buying over-the-counter, and that includes moisturisers targeted at sensitive types!
Parabens, such as butyl paraben, methy paraben, propyl paraben, and ethyl paraben, are used as preservatives and are known to accumulate in the skin and cause irritation. They’re incredibly common in leave-on cosmetics and emollients and while they generally don’t cause a problem to normal skin, the problem lies when they’re used in emollients meant to soften and hydrate sensitive skin. This is because it will be skin with a compromised barrier function that’s most likely to react to them. Always check that your emollient is paraben-free!
Like parabens, lanolin is a very commonly used ingredient in moisturising creams, including eczema-specific emollients. It softens the skin and creates a barrier against moisture loss, and usually it’s tolerated pretty well. However some people - ie those with eczema - are sensitive to lanolin (and to sheeps wool, from which lanolin is derived) and should avoid it. As with parabens, what might be fine for the general population is not OK for those whose skin is already sensitive.
Paraffin is one of the main ingredients in conventional emollients, whether prescribed or not. Like lanolin, it does the job of softening rough or cracked skin and protecting it from moisture loss by providing a fine barrier over the epidermis. The problem with paraffin is not that it’s a by-product of the petrochemical industry (although that certainly does not endear it to the ecologically-minded!) or even that it can cause irritation (because it’s generally, though not always, well tolerated) but that it can be dangerous in other ways. Bandages and clothes soaked in paraffin-based creams are highly flammable and have actually been linked to hundreds of fire deaths, so many experts are suggesting ditching it in emollients. Paraffin is also not great when ingested and can cause vomiting or nausea.
What about other ingredients, the ones with long complicated Chemistry lesson names?!
Propylene glycol? Cetyl alcohol? Hydroxybenzoates? Sodium Hydroxide? Dimethicone? Phenoxyethanol? Polyethylene glycol (PEG)? Synthetic urea? Well, some of these are classified as safe for use topically, but may not be tolerated by everyone. Some, like Phenoxyethanol, are well known skin irritants and should definitely be avoided. Sodium Hydroxide, for example, is better known as caustic soda and yet is used in one of the UK’s most popular emollient creams. Some are classified as potential environmental toxins or not safe to be ingested. Many synthetic ingredients can cause damage to the skin barrier by stripping away the skin’s natural oils.
Some, on the other hand, like Glyceryl Caprylate, look like they’re paint strippers but turn out to be gentle, coconut-derived fatty acids. And others, like some essential oils, seem lovely and natural but can cause inflammation and irritation to even robust skin!
It’s all highly confusing! Our advice would be to educate yourself on what does and does not work for you and your very particular skin. If you know that your skin barrier function is impaired, that even mild cosmetic products bring you out in hives, that your skin is delicate and needs extra tender care, then it might be best to avoid anything you don’t know for sure won’t damage it further, even if it’s included in an emollient specially meant for eczema. And always, ALWAYS, do a patch test.
To blow our own trumpet for a while, you can be sure that our Skin Salvation ointment does not contain ANY of these potentially problematic ingredients! The balm is safe to use on babies from 6 weeks, on those with very sensitive skin, even on broken skin.
We’re very proud of the awesome statistic that 99% of people* said that Skin Salvation did not sting on application! Given how sensitive our customers are, that’s really rather a brilliant achievement.
*In a survey of over 500 people
This article is not written by medical professionals, it is based on opinion and publicly available information. For medical advice please contact your healthcare professional.