Basic information about allergies
For cosmeticians and clients an incompatibility reaction is always aggravating. Allergies have increased over recent years. A large part of the cosmetics industry and their products are not completely blameless in this adverse development, because according to our findings too many allergenic ingredients are contained in cosmetic products. Therefore a particular responsibility rests with cosmeticians as an important link between the industry and the end-user, to use their expertise to critically scrutinise products to ensure that they are the safest possible products for them and their clients. Scrupulous professional cosmeticians should know the background of allergic reactions in order to avoid them as far as possible and be able to advise their clients accordingly.
As a matter of principle, any substance which the organism regards as foreign can trigger an allergic reaction. The more foreign the substance is to the immune system, the greater the likelihood of such a defensive reaction in the organism. Conversely, an allergic reaction in the skin is more unlikely when the ingredients in cosmetics are more like the substances which are native to the body. Epidemiological investigations have clearly shown which ingredients in cosmetic products most frequently trigger allergies and which are compatible with the skin. Medical textbooks and academic articles on dermatology state that perfume and chemical preservatives are amongst the worst allergens and unfortunately the most commonly used substances in cosmetics. When these substances are carried into the skin and break through the horny layer’s protective barrier, the exacerbated allergies caused by cosmetics are no longer surprising. Please note that that one can be completely unaware of the first stage of a skin allergy (the so-called sensitisation). Even when your skin ostensibly seems to tolerate a product with perfume and chemical preservatives, the allergic process (the so-called sensitisation phase) could have already begun in the immune system. We all know of the phenomenon where a product is tolerated for a long time by the skin and then all of sudden it is no longer tolerated. This phenomenon can seem astounding to the layman, but for experts on allergies this is hardly surprising. The sensitization phase, the time it takes the body to react to an allergen with an allergic reaction, can take days, weeks, months or even years. If you regularly apply a cream which contains perfume and/or chemical preservatives to a client’s skin and it seems initially to be compatible, as a matter of fact, it could have started the development of an allergy a long time ago!
The dermatological journal “Der Hautarzt” (The Skin Doctor) published an article in 2003 called “Kontaktsensibilisierungen auf Externa” (Contact sensitization to external agents) by the authors Dr. S. M. Erdmann and Dr. H. F. Merk from the Aachen University skin clinic. Here are some important citations from the article:
“Especially skincare products, due to their frequent use and broad distribution, are a great cause of sensitization. Perfumes and preservatives, especially in cosmetic products, are a common trigger for contact allergies world-wide.”
“It has to be put on record that to date no microbiologically satisfactory preservative has been found that is guaranteed not to trigger a sensitization process (neither for topical dermatics nor for cosmetic products).”
(Topical dermatics = medicinal prescriptions for the acute treatment of the skin)
Which are the most common preservatives identified by INCI which one comes across in cosmetics?
Methylparaben, ethylparaben, Butylparaben, Propylparaben, Sodium Benzoate, Potassium Sorbate, Triclosan, Imidazolidinyl Urea, Diazolidinyl Urea, Chlorhexidin, Methylisothiazolinon, Dibromodicyanobutan, Sorbic Acid, Benzoic Acid, DMDM Hydantoin, Polyaminopropyl Biguanide, Phenoxyethanol, Chlormethylisothiazolinon, 2-Bromo-2-Nitropropane-1,3-Diol (Bronopol), Quaternium 15, Iodpropinylbutylcarbamat.
Sometimes marketers would like to make the presence of chemical preservatives appear better by selling products with the instruction that they contain “only natural preservatives”. They are however assiduously tight-lipped about the fact that “natural preservatives” are no different from “chemical preservatives”.
Note: Natural = chemical (synthesised)
There are in fact miniscule traces of the most commonly used chemical preservatives such as parabens, potassium sorbate, sodium benzoate etc. in nature, but they are chemically synthesised for the cosmetics industry in factories on an industrial scale. This is a good example of the fact that when it comes to allergy hazards it is immaterial whether the substance comes from nature or not. What is much more important is whether or not the immune system considers the substance to be foreign or native to the body.
To achieve the best possible compatibility for the most people it is obvious that the most common allergens should be excluded from cosmetic products! But it requires particular effort in research to get products to smell good or neutral without the use of perfume and to make them durable without the use of preservatives. The Dr. Baumann SkinIdent research team has been successful in getting not only creams but also liposomes to smell good without adding perfume and to be long-lasting without chemical preservatives.
Please note that in the evaluation of the compatibility of cosmetic products that it depends on every individual ingredient, because a product can be incompatible if it contains even one single allergenic ingredient. One can also compare this to a chain, which is strong except for on weak link. Although the chain seems strong, it is only as strong as its weakest link. In the same way, a product with many good ingredients and one incompatible substance can trigger an allergy.
Often advertisers indicate that products are “dermatologically tested”, “clinically tested” etc. But what do these tests reveal? These advertising messages do not disclose what the results of the tests were. Even when the products are found to be incompatible, they are still dermatologically tested! For example it has been found that products are advertised as “dermatologically tested” and “hypo-allergenic” even though the products contain chemical preservatives and have not been tested for allergies! Besides, a single test is not enough to determine whether or not sensitization is caused by a product and its ingredients, as many repeated tests must be carried out over months and years.
With Dr. Baumann SkinIdent products which contain no perfume and no chemical preservatives you can be assured of being safe from incompatibility reactions. Even in this case one is never 100% safe, as even otherwise compatible active ingredients can cause a reaction in a person with an exceptional disposition towards allergies. If in an exceptional case a reaction develops from a Dr. Baumann SkinIdent product, you can explain this to your client, and refer her to one of the various other Dr. Baumann SkinIdent products that are usually compatible, and thus keep the relationship of trust with your client intact. Dr. Baumann SkinIdent products are characterised by good compatibility. The people who have difficulties in finding a compatible skin cream are amongst the most loyal customers of Dr. Baumann SkinIdent.
The new SkinIdent series offers optimal security against allergic skin reactions caused by cosmetics. It is easy to understand why when one takes a concentrated look at the anatomy and physiology of the skin:
The skin (cutis) consists of the epidermis and the dermis (corium). Including the sub cutis (subcutaneous fatty tissue) in the skin is anatomically incorrect. The cutis and sub cutis together make up the integumentum commune. The skin is approximately 1,75 m2, and is the largest “immune organ” of the body. In the epidermis we find keratinocytes and the immune cells called Langerhans cells. In the dermis there are lymphocytes, mast cells (mastocytes), monocytes and macrophages. The job of the immune system is to recognise and attack foreign bodies in order to protect the integrity and individuality of the organism. The premise behind this is the differentiation between “self” and “other”. This makes it possible to recognise foreign bodies (antigens) e.g. bacteria and viruses and for the immune system’s special defence mechanisms to render them harmless.
If the skin’s natural barrier (stratum corneum) is breached by foreign allergens, they comes into contact with the immune cells of the epidermis, the Langerhans cells. These use their dendritic appendages to form a network in the epidermis, take up the antigens or allergens and process them. The Langerhans cells then present the processed antigen to the lymphocytes which causes them to activate and proliferate. Therefore the Langerhans cells are also known as “antigen-presenting cells”. The lymphocytes then migrate to the area where the antigens have invaded and release inflammatory substances, which is when the typical signs of inflammation in the skin can be seen. (Example: allergic contact dermatitis).
An immunological tolerance towards tissues and substances which are native to the skin is vital; otherwise the body would destroy itself. As rare diseases, autoimmune diseases often develop into very severe and deadly progressive forms. The tolerance towards substances which are native to the skin exists since embryonic development and is accomplished through complicated interwoven, yet unknown, mechanisms.
The immunological defence against pathogens is essential for the body’s survival. Hypersensitivity reactions in the form of allergies harm the organism and relevant organs considerably. “Approximately 80% of all allergies happen in the skin and surrounding mucous membranes”.“Eczema is the most common skin disease, with a 20% prevalence world-wide”. “Allergic contact eczema is the most common type of eczema”. (from the textbook “Dermatology” by Dr. Jung).
Allergies also pose a considerable problem. The frequency of allergies in industrialised countries is on the rise. Therefore knowledge about allergies and their prevention is of great importance, particularly to cosmeticians.
Other than the immune defence against pathogens, the first contact with allergens within the framework of allergy development remains clinically silent. In other words: When the skin first comes in contact with a substance, no allergy can develop in the skin. A complicated chain of metabolic processes – the so-called sensitization process - must take place in the body before an allergy can appear. One knows that the process of sensitization takes at least 5 days, and more often weeks, months, years or even decades. When one sees how many complex metabolic mechanisms and cells are involved it becomes easy to understand why it takes so long for allergies to arise. If you have an immediate allergic reaction to a substance it means that you have previously had contact with this substance and a process of sensitization has already occurred. In the following paragraphs the sequence of sensitization and the triggering of allergic reactions are described. For further information please refer to relevant dermatological and allergological reference books.
The sensitization phase: Haptens (foreign, low-molecular molecules such as preservatives, fragrance etc.) attach themselves to carriers in the skin such as protein molecules to become full antigens. These antigens are taken up by the Langerhans cells, processed and presented (antigen-presentation) to the T-lymphocytes (special immune cells). The Langerhans cells also release the chemical signal (cytokine) Interleukin-1 which activates the proliferation of T-lymphocytes in the regional lymph nodes. These specifically sensitised lymphocytes arrive in the skin and the rest of the body, so that the progress of sensitization is engaged in the whole organism. The sensitization normally remains in existence throughout your life!
The sensitization phase (according to “Dermatology” by Dr. Jung) depends on:
- the duration and intensity of the contact with the allergen
- The sensitising power of the allergen
- The barrier function of the skin
- Probably a genetic predisposition
Thereafter begins the activation phase: By this phase the body is already sensitized, but no skin allergies are in evidence. These only become noticeable when the sensitized organism comes into contact with the same antigen it was sensitized against. The concentration of allergens plays no role in this. Even the smallest quantities can trigger an allergic reaction. On renewed contact between the sensitized T-lymphocytes and the allergen (which previously initiated the sensitization) lymphokines are discharged (which are chemical messengers). These lymphokines attract so-called mononuclear phagocytes (macrophages) with the purpose of eliminating the allergen. From the various inflammatory cells a so-called mediator substance is discharged which results in the clinical inflammation.
A clinical picture of acute contact dermatitis
All of the indications of active inflammation are visible: redness, swelling, blisters which burst and weep, dry out, form scabs and drop off as flakes. There is violent itchiness.
A clinical picture of chronic contact eczema
Rough thickening (lichenification) of the skin, callusing (hyperkeratosis) and deep cracks in the skin characterise this condition.
The distribution phenomenon
If the allergens are not removed, the inflammation can spread from the area of reaction to healthy surrounding areas and other areas which are in contact. In extreme cases the entire surface of the body can become inflamed (erythrodermy).
To abstain from and avoid contact with allergy-inducing substances and cortisone treatment are the choices for medical-dermatological therapy.
Prevention – the most import challenge for a cosmetics institute
Lately the question has been asked, whether it is sensible on medical grounds and justifiable on ethical grounds to allow an allergy to develop through the use of known allergens in order for it to be medically treated afterwards. Is it not more sensible and in people’s best interest to avoid known allergy triggers in cosmetics, what are sensible strategies to prevent allergies from cosmetics?
Very good strategies:
- The products consist of as many ingredients as possible which are native or endemic to the skin.
- All other foreign substances used as ingredients are very compatible according to dermatological classification.
- The most common allergy triggers such as fragrance and preservatives etc. should not be included.
- Practical realization: The classic DR. BAUMANN range with the exception of a few individual products which contain essential oil.
- The products consist exclusively of ingredients and vitamins which are native or endemic to the skin, because under normal conditions the immune system does not work against the body.
- Practical realization: The SkinIdent range.