Not An Allergen … but (surprise!) an irritant!

Water

Water is life. We all need it to survive and it makes up a lot of our bodies. It’s also cleansing and healing … and not a top contact allergen. In fact, it’s used to rinse off allergens that we come into contact with. But, as is true for many substances, too much of it can be an irritant and otherwise harmful to skin!

Too much cleansing of the skin is not a good thing in part because of the excessive exposure to allergens that may be present in the cleaning product but also due to over-exposure to the water itself. While it’s unlikely to develop an allergic reaction to water, an irritant reaction can occur.

Our normal exposure to water on the skin is usually not a problem. Being immersed too long in water, however, or a significant increase in hand washing (as was necessary during the pandemic) can elicit an irritant reaction.

In addition to an irritant reaction, too long and/or too much water can negatively affect the skin’s barrier. The barrier layer is often described as the skin’s brick and mortar. The “bricks” are mainly proteins and water in what’s called their “NMF” (Natural Moisturizing Factor). The “mortar” (the “stuff” in the middle of the bricks) is lipid-rich ā€” why the use of oils can help repair barrier deficiency. If you stay too long in water, NMFs can get washed off and contribute to barrier deficiency. Watch this helpful video in our YouTube channel for more about the skin’s important barrier layer.

The risk of a reaction is higher if the water you use for bathing and hand washing contains stronger irritants like fluorides and chlorides ā€” normal additives to the water supply in many countries.

Irritant and allergic reactions are not the same. Unlike a true allergy, when you lessen the exposure to the irritant you should be able to continue using it again at lower levels of exposure. If you’ve had a patch test and are avoiding your allergens meticulously but your skin reactions are continuing, your doctor might ask you to use mineral or distilled water to cleanse for a time to rule out irritants in your water supply from being factors. A helpful trick is to apply a purely physical mineral (inorganic) barrier product (like Stay-On-Point!) or sunscreen like Armada Baby or Post-Procedure and/or petroleum jelly or Boo-Boo Balm prior to water exposure to minimize contact. Another possibility is to cleanse with pure, organic virgin coconut oil like Know-It-Oil or Oil’s Well (which also helps repair a compromised barrier layer) until the skin normalizes.

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If you have a history of sensitive skinā€¦

ā€¦donā€™t guess! Random trial and error can cause more damage. Ask your dermatologist about a patch test.

To shop our selection of hypoallergenic products, visit vmvhypoallergenics.com. Need help? Ask us in the comments section below, or for more privacy (such as when asking us to customize recommendations for you based on your patch test results) contact us by email, or drop us a private message on Facebook.

For more:

Main References: 

Regularly published reportsĀ on the most common allergens by theĀ North American Contact Dermatitis GroupĀ andĀ European Surveillance System on Contact AllergiesĀ (based on over 28,000 patch test results, combined), plus other studies.Ā Remember, we are all individuals ā€” just because an ingredient is not on the most common allergen lists does not mean you cannot be sensitive to it, or that it will not become an allergen. These references, being based on so many patch test results, are a good basisĀ but it is always best to get a patch test yourself.

  1. DeKoven JG, Silverberg JI, Warshaw EM, Atwater AR, et al. North American Contact Dermatitis Group Patch Test Results: 2017-2018. Dermatitis. 2021 Mar-Apr 01;32(2):111-123.
  2. DeKoven JG, Warshaw EM, Zug KA, et al. North American Contact Dermatitis Group Patch Test Results: 2015-2016. Dermatitis. 2018 Nov/Dec;29(6):297-309.
  3. DeKoven JG, Warshaw EM, Belsito DV, et al. North American Contact Dermatitis Group Patch Test Results 2013-2014. Dermatitis. 2017 Jan/Feb;28(1):33-46.
  4. Warshaw, E.M., Maibach, H.I., Taylor, J.S., et al. North American contact dermatitis group patch test results: 2011-2012. Dermatitis. 2015; 26: 49-59.
  5. W Uter et al. The European Baseline Series in 10 European Countries, 2005/2006ā€“Results of the European Surveillance System on Contact Allergies (ESSCA). Contact Dermatitis 61 (1), 31-38.7 2009.
  6. Wetter, DA et al. Results of patch testing to personal care product allergens in a standard series and a supplemental cosmetic series: An analysis of 945 patients from the Mayo Clinic Contact Dermatitis Group, 2000-2007. J Am Acad Dermatol. 2010 Nov;63(5):789-98.
  7. Warshaw EM, Buonomo M, DeKoven JG, et al. Importance of Supplemental Patch Testing Beyond a Screening Series for Patients With Dermatitis: The North American Contact Dermatitis Group Experience. JAMA Dermatol. 2021 Dec 1;157(12):1456-1465.
  8. Verallo-Rowell VM. The validated hypoallergenic cosmetics rating system: its 30-year evolution and effect on the prevalence of cosmetic reactions. Dermatitis 2011 Apr; 22(2):80-97.
  9. Ruby Pawankar et al. World Health Organization. White Book on Allergy 2011-2012 Executive Summary.
  10. Misery L et al. Sensitive skin in the American population: prevalence, clinical data, and role of the dermatologist. Int J Dermatol. 2011 Aug;50(8):961-7.
  11. Warshaw EM1, Maibach HI, Taylor JS, Sasseville D, DeKoven JG, Zirwas MJ, Fransway AF, Mathias CG, Zug KA, DeLeo VA, Fowler JF Jr, Marks JG, Pratt MD, Storrs FJ, Belsito DV. North American contact dermatitis group patch test results: 2011-2012.Dermatitis. 2015 Jan-Feb;26(1):49-59.
  12. Warshaw, E et al. Allergic patch test reactions associated with cosmetics: Retrospective analysis of cross-sectional data from the North American Contact Dermatitis Group, 2001-2004. J AmAcadDermatol 2009;60:23-38.
  13. Foliaki S et al. Antibiotic use in infancy and symptoms of asthma, rhinoconjunctivitis, and eczema in children 6 and 7 years old: International Study of Asthma and Allergies in Childhood Phase III. J Allergy Clin Immunol. 2009 Nov;124(5):982-9.
  14. Kei EF et al. Role of the gut microbiota in defining human health. Expert Rev Anti Infect Ther. 2010 Apr; 8(4): 435ā€“454.
  15. Thavagnanam S et al. A meta-analysis of the association between Caesarean section and childhood asthma. Clin Exp Allergy. 2008;38(4):629ā€“633.
  16. Marks JG, Belsito DV, DeLeo VA, et al. North American Contact Dermatitis Group patch-test results, 1998 to 2000. Am J Contact Dermat. 2003;14(2):59-62.
  17. Warshaw EM, Belsito DV, Taylor JS, et al. North American Contact Dermatitis Group patch test results: 2009 to 2010. Dermatitis. 2013;24(2):50-99.
  18. Verallo-Rowell V. M, Katalbas S.S. & Pangasinan J. P. Natural (Mineral, Vegetable, Coconut, Essential) Oils and Contact Dermatitis. Curr Allergy Asthma Rep 16,51 (2016) . https://doi.org/10.1007/s11882-016-0630-9.
  19. Park G, Oh DS, Lee MG, Lee CE, Kim YU. 6-Shogaol, an active compound of ginger, alleviates allergic dermatitis-like skin lesions via cytokine inhibition by activating the Nrf2 pathway. Toxicol Appl Pharmacol. 2016 Nov 1;310:51-59. doi: 10.1016/j.taap.2016.08.019. Epub 2016 Aug 22. PMID: 27562088.
  20. de Groot AC. Monographs in Contact Allergy, Volume II ā€“ Fragrances and Essential Oils. Boca Raton, FL: CRC Press Taylor & Francis Group; 2019.
  21. De Groot AC. Monographs in Contact Allergy Volume I. Non-Fragrance Allergens in Cosmetics (Part I and Part 2). Boca Raton, Fl, USA: CRC Press Taylor and Francis Group, 2018.
  22. Zhu TH, Suresh R, Warshaw E, et al. The Medical Necessity of Comprehensive Patch Testing. Dermatitis. 2018 May/Jun;29(3):107-111.

Want more great information on contact dermatitis? Check out the American Contact Dermatitis SocietyDermnet New Zealand, the Contact Dermatitis Institute, and your countryā€™s contact dermatitis association.


Laura is our ā€œdewā€-good CEO at VMV Hypoallergenics and eldest daughter of VMVā€™s founding dermatologist-dermatopathologist. She has two children, Madison and Gavin, and works at VMV with her sister CC and husband Juan Pablo (Madison and Gavin frequently volunteer their ā€œusage testingā€ services). In addition to saving the worldā€™s skin, Laura is passionate about health, inclusion, cultural theory, human rights, happiness, and spreading (like a VMV cream!) goodness!

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