Cosmeceuticals are Not Regulated by the FDA
"The cosmeceutical sector is a multi-billion dollar industry, yet it is largely unregulated," notes Tan. Unlike medicines, cosmeceuticals, which she explains are over-the-counter products that claim both cosmetic and therapeutic effects, are not regulated by the Food and Drug Administration. "Although high- quality brands usually test for safety, they do not have to undergo testing to ensure the claims they make regarding efficacy are accurate," reveals Tan. "Unfortunately, many creams and products do not live to up to the hype."
"Clean" Can Mean a Lot of Things
Just because something is clean, organic, or natural, doesn't mean you can't sensitivity to the product," reminds Tan. "The FDA has a very loose definition of what 'natural' means, and there is no agency that regulates the use of those terms.
Natural Doesn't Mean Good for Your Skin
Not all naturally-occurring ingredients are good for your health or your skin," warns Tan. "Remember that poison ivy and arsenic are natural, but we do not rub these things on our skin." Additionally, Tan reminds us that these umbrella terms do not mean hypoallergenic. "Poison ivy is natural, yet causes severe allergic contact dermatitis in people," describes Tan. "The terms 'toxic-free' and 'non-toxic' are also unregulated buzzwords to think about."
Harmful Ingredients May be Lurking
"Many times if you look at the ingredient list, there are other preservatives and ingredients in a formula that are definitely not organic or natural," says Tan. "While many medications commercially available did start out as natural remedies—for example, aspirin—relying on the 'clean', 'organic,' or 'natural' labels does not ensure efficacy or safety."
Beware of Essential Oils
"Black salve is one of the most dangerous products I have seen out there," she warns. "This is marketed as a 'natural' anti-cancer medication and I have seen patients use this product in place of seeing a doctor." Tan explains that this can lead to delay in the diagnosis of skin cancer, such as melanoma, and lead to complications. "There is no evidence that this product works and it does not 'draw out cancer,'" she laments.
Tan continues: "I am not a hater of essential oils, but essential oils are not a cure-all and are not a substitute for a physician if there is an ongoing issue. Many health claims associated with essential oils are controversial and not substantiated by science. "There are small-scale studies that show essential oils can help with stress, anxiety, insomnia, and may have anti-inflammatory and anti-microbial properties." However, Tan notes that these products can still cause rashes and irritation.
Your Go-To Products Can Change
"Often when I see patients," tan says, "they have introduced many new factors into their skincare regimen and it is hard to parse out which product is giving them a reaction." She advises to only introduce one new product at a time, and give it one to two weeks. If you develop a reaction, then to skip out on the product. Unlike an anaphylactic response to peanuts, most allergies to topical products can occur over time.
"Just because you have been using the same face cream for five years does not mean you cannot develop an allergy to it," says Tan. "To add to the complexity, manufacturers routinely change the preservatives and ingredients in products over time as certain fads come into play—think paraben-free, propylene glycol- free, or fragrance-free." When you take something out, something else may go back in to ensure the stability of a product. "If you continue to experience a rash and cannot figure out what may be causing it, I would recommend seeing a board-certified dermatologist who can do patch testing to figure out which ingredient may be the culprit," Tan adds.
Go Back to Basics
Just because a product doesn't have the buzz words or pretty packaging does not mean it is not good for your skin. If you're having a bad reaction, it's best to go back to the basics. Tan's favorite example is plain petroleum jelly. "I have had many patients come in with reactions to various lipsticks and lip balms and I counsel them to cut those all out and use plain petroleum jelly," recounts Tan. "It does not have any preservatives or fragrances and is a great emollient." She says the next question she gets is, "Isn't petroleum bad for you?" But, according to Tan, white petroleum jelly, like Vaseline, is not related to unrefined petrochemicals that can have cancer-causing effects. "Petroleum jelly actually has great uses in the medical field because of its inert properties and ability to help soothe and help with wound healing." Tan recommends using hypoallergenic products that minimize preservatives and are fragrance-free.
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