Categories
Featured Healthy Living Skin

“I’m Allergic To My Partner … & Maybe My Kids!”: Skin Issues From Close Contact

“Connubial or Consort Contact Dermatitis” is thing!

While some skin lesions can be associated with sexual activity (infection, friction, etc.) — which is why it’s so important not to self diagnose! — other types of close contact can cause skin problems.

“Connubial or consort allergic contact dermatitis occurs when the agent causing the dermatitis has not been used by the patient but by his partner or other cohabitants or proxy. Most cases are due to fragrances, cosmetics or topical nonsteroidal anti-inflammatory agents.”1

In other words, Connubial or Consort Contact Dermatitis (also called Contact dermatitis “by proxy”) occurs when you experience contact dermatitis due to something that you’re not using yourself but that is being used by someone you come into close contact with or live with. The most common culprits are the top contact allergens.

Connubial contact dermatitis can occur from contact with your partner if they use a soap or lotion that contains your allergens. It can also occur between parents and children when using products with lots of fragrance (which tends to be common in baby products) or other allergens.

It can even occur when applying a cream meant to provide relief from a skin irritation, as in a 2013 paper published in the journal Cutaneous and Ocular Toxicology (Exuberant connubial allergic contact dermatitis from diphenhydramine) which reported how a woman applying a topical medication for itching, pain and irritations on her husband’s back experienced contact dermatitis herself.

How else can connubial/consort contact dermatitis occur?

• In close contact sports: allergens from skincare products, clothing, laundry soap, even medications can be excreted in sweat. In fact, heat, humidity, and sweat can increase their reactivity. Wrestling or grappling with a partner who is wearing or using things with your allergens could cause a reaction in your skin, even if they are unaffected.

• Contact during sexual activity with lubricants or condoms that have or are made with materials that you are allergic to.

• Chronic skin issues on a certain side of the face or body could indicate a sensitivity to something your partner is using if that side is where you tend to lean on them when cuddling. This could also be from other issues, of course, such as working next to a window facing that side of your face or sleeping on that side (your pillowcase material or laundry soap could be a factor). Your dermatologist, especially if they are a contact dermatitis specialist, can help determine possible triggers.

Other important things to know:

1. Not all skin problems on the genitalia are from sexual activity. Some can be due to your body wash or laundry soap. Others like Molluscum contagiosum can come from fomites (towels and sheets).

2. You should never be embarrassed about seeking out medical care for a skin lesion bothering you on or in the genitalia. This is what dermatologists are for and they have seen it all.

3. Virgin coconut oil and monolaurin are both safe enough for use on the genital areas. But like all oils, VCO should not be used as a lubricant when using latex condoms.

4. If you have a current infection (bacterial, viral, etc.) that is not normally transmitted through sexual activity or other close contact, you could still theoretically pass it on to another person if they have become immunocompromised due to stress, certain medications, or fighting off another illness.

5. Some skin conditions like eczema or psoriasis can seem contagious but are not. You do not get eczema (atopic dermatitis) or psoriasis from contact.

6. Because people can be allergic to what others around them use, choosing products without the top contact allergens — in everything from your haircare, to your body wash, body lotion, skincare, makeup, and laundry soap — can be safer for you and the people closest to you.

It is therefore not a stretch to say: when you choose allergen-free products, you’re not just looking out for yourself; you’re also looking out for others!

REFERENCES:

1. Teixeira V et al. Exuberant connubial allergic contact dermatitis from diphenhydramine. Cutan Ocul Toxicol. 2014 Mar;33(1):82-4. doi: 10.3109/15569527.2013.812106. Epub 2013 Jul 12. PMID: 23848819.

2. Paravina M., Nedeva M., Bajic L. Contact Dermatitis – A review of the literature with the Connubial type in focusActa Medica Medianae 2019;58(4):152-157.

3. McFadden, J. (2014). Proxy Contact Dermatitis, or Contact Dermatitis “by Proxy” (Consort or Connubial Dermatitis). 10.1007/978-3-642-45395-3_10.

4. Ho KK et al. Contact dermatitis: a comparative and translational review of the literature. Vet Dermatol. 2015 Oct;26(5):314-27, e66-7. doi: 10.1111/vde.12229. Epub 2015 Jul 16. PMID: 26184842.


Laura is our “dew”-good CEO at VMV Hypoallergenics and eldest daughter of VMV’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 “usage testing” services). In addition to saving the world’s skin, Laura is passionate about health, inclusion, cultural theory, human rights, happiness, and spreading goodness (like a great cream!)

Categories
Featured Healthy Living Skin

Skin & Food Allergies Are Not The Same Thing

If You Can’t Eat It, You Can Probably Still Use It In A Cream.

“I’m allergic to almonds…can I use a cream with an ingredient extracted from almonds?” “I can’t eat coconuts…that means I can’t use coconut oil, right?”

If you have prick tested positive to something, it is more likely than not that you can still use it on your skin.

The main reason is that, while complex, skin and other allergies involve such different cells, systems, and modalities.

Quick Breakdown

There are 4 types of reactions that we tend to have. Type 1 and Type 4 are most relevant to prick tests and patch tests.

Type 1: asthma, naso-bronchial allergies, pets, dust mites, pollen, and food

  • Is IgE-mediated and involves antibodies.
  • Is what a lot of us think of when we think about an allergic reaction (the trouble breathing (anaphylaxis), puffing up, urticaria, etc.
  • While there can be some delayed responses, always something happens quickly — within 60 minutes. This reaction is very straightforward because it is IgE mediated and IgE exists in the body.
  • Food is included here but is more complicated (see below)

Type 4: contact dermatitis

  • Is non-IgE mediated and does not involve antibodies.
  • It is T-cell mediated.
  • The response is not immediate as with Type 1. It is delayed because there is more of a process. There has to be a sensitization that then triggers a reaction to occur. This can take a week to many weeks.
  • Instead of being IgE-mediated, this is T-cell mediated.

Food Reactions Can Be More Complicated

Food reactions include…

  • IgE-mediated: e.g. strawberries, peanuts
  • Non IgE-mediated: food protein-induced enterocolitis, which is T cell-mediated, does not happen immediately, and is usually outgrown, such as when a baby is allergic to the protein found in cow’s milk.
  • Non-allergic reaction which is metabolic: such as when you don’t have the enzyme needed to break down sugar lactose, i.e., you’re lactose intolerant).
  • Food allergies can be difficult to isolate because there can be many substances at play in one food. This is especially true for drugs. Drugs are made up of so many compounds so it is very difficult to isolate the trigger. This is why drug IgE testing is rare and very hard to distinguish. On the other hand, an allergy to a drug with skin manifestations can be patch tested.
  • Other food reactions include:
    • Adverse reaction (non-immune mediated)
    • Toxic (puffer fish toxin)
    • Conditions like Irritable Bowel Syndrome, which is not an allergy but has the same symptoms.

Where It Gets More Complex for Skin: Atopic Dermatitis

Atopic dermatitis is a different type of allergy with many theories still being explored. Inheritance plays a factor. One theory is regarding the presence of over-reactors — in which case, an over-reaction to food may also occur. And contact dermatitis is frequently a factor.

There is also “atopic march”: if you had eczema as child, you could be more likely to have asthma and naso-bronchial allergies as an adult.

For more on atopic dermatitis (eczema), check out What Is Eczema.

What To Know If You Have Skin & Food Allergies:

1. A prick test is for IgE, involves antibodies, and can be more complicated. Even if you prick test positive to shellfish, for example, your allergist needs to correlate the findings with your history to determine if you really cannot eat shellfish.

2. A patch test is very straightforward: If you patch test positive to something, contact with it will be a problem.

3. If your prick test is positive for something — unless you ALSO patch test positive to it — you can probably use it on your skin because the modalities and systems are so different. For example, if you prick test positive for almonds, the chances are very high that you can use a product on your skin with an ingredient extracted from almonds.

3. If you patch test and prick test positive to something, you need to avoid it in food and in your skin. For example, if you patch and prick test positive to nickel, you’ll react to it when touching it and if it is in your food.

Which Test To Get, and From Which Doctor?

For a patch test, see a dermatologist. For a prick test, see an allergist.

Some allergists do patch testing, too. But if you have a long history of stubborn skin reactions, we’d suggest seeing a dermatologist who is a contact dermatitis specialist for your patch testing. They are…specialists! They would have more patch test tray options, can really help identify what you need to avoid, and can identify other possible skin conditions that may also need to be managed. If you also have non-skin allergies, your contact dermatitis specialist can work closely with your allergist.

How to find such a doctor?

  • In the USA: search contactderm.org. You can search by zip code and members of the American Contact Dermatitis Society also use CAMP (the Contact Allergen Management Program) to show you not just the ingredients and substances you need to avoid but brands and products that you can use (where you’ll see VMV Hypoallergenics a lot!)
  • In the Philippines: PM VMV Skin Research Centre + Clinics, where patch testing is a specialty.
  • In other countries: ask your official dermatological society about local contact dermatitis experts who offer patch testing.

How Else VMV Hypoallergenics Can Help?

Ask us to customize recommendations for you based on your patch test results and even possible cross reactants.

Otherwise, use the VH-Rating to shop safely for VMV products! Check out this helpful video on how it works.

At VMV, we make it easy to be guided by your patch test.

1) We practice allergen ommision

As our basis for what to omit, we refer to studies by independent groups of doctors who specialize in contact dermatitis, such as the North American Contact Dermatitis Group and European Surveillance System on Contact Allergies. They regularly publish top contact allergens based on thousands of patch tests done in multiple countries.

2) We do our own patch testing…

…not just of the final formulation but also of each ingredient, raw material, and applicators (and we do allergen reviews of packaging, too).

3) Our VH-Rating System shows how many of the top contact allergens are NOT in a formulation.

If an allergen is included, the VH-Rating is lower and marked by an asterisk which corresponds to the ingredients list — you’ll see the allergen clearly marked with the asterisk and underlined, too. If they’re not allergens that you patch tested positive to, you can still use the product.

The VH-Rating System has been so effective that a clinical study published in a leading contact dermatitis journal showed less than 0.1% reactions reported in over 30 years.

4) We manufacture our own products.

We can ensure that our formulations are not mixed, stored, or handled in containers used for formulations with allergens, or otherwise contaminated by allergens..

PLEASE FOLLOW THE RECOMMENDATIONS OF YOUR OB-GYN AND PEDIATRICIAN.

Data regarding the effects (positive or negative) of topical skin treatments on fetal or infant development at this point may be inconclusive; but for anything taken orally, you should be conscientious and always consult your doctor beforehand. You’ll be seeing your gynecologist soon and regularly, then your child’s pediatrician. These visits, more than anything, will help you best monitor your baby’s healthy development. This information should not be considered medical advice. Particularly if you have a medical condition, before you change anything in your skincare or other practices related to pregnancy or nursing, ask your doctor.


Laura is our “dew”-good CEO at VMV Hypoallergenics and eldest daughter of VMV’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 “usage testing” services). In addition to saving the world’s skin, Laura is passionate about health, inclusion, cultural theory, human rights, happiness, and spreading goodness (like a great cream!)

Categories
Featured Skin

What Is The Validated Hypoallergenic Rating System (VH-Rating System)?

“Hypoallergenic” can be an ambiguous term. It is regulated in some FDAs, but not all. When regulated, certain evidence is normally required to justify the claim but requirements can differ. Our founding dermatologist-dermatopathologist wanted a more objective, consistent, and clear way to prove what “hypoallergenic” meant in formulations.

VMV Hypoallergenics was the first to validate what it meant by “hypoallergenic” for its products with a “grading” system: the VALIDATED HYPOALLERGENIC RATING System, or VH-Rating System, created in the late 1980s (VMV was founded in 1979).

What Is The VH-Rating System?

It works a bit like an SPF in that it is a clear, immediately visible “grade” given to a formulation. While an SPF shows the product’s tested protection factor against UVB rays, the VH-Number shows how many top contact allergens are NOT in a formulation. In both cases, the higher the number, the better the “grade.”

The VH-Rating System uses published contact allergen lists of the North American Contact Dermatitis Group and European Surveillance System on Contact Allergies — based on thousands of patch tests conducted in multiple countries — as independent references.

The VH-Rating System was the first and is still the only hypoallergenic rating system in the world. A study on it published in Dermatitis, the journal of the American Contact Dermatitis Society, concludes:

“The VH Rating System is shown to objectively validated the hypoallergenics cosmetics claim.”

Verallo-Rowell VM. The validated hypoallergenic cosmetics rating system: its 30-year evolution and effect on the prevalence of cosmetic reactions. Dermatitis. 2011 Mar-Apr;22(2):80-97. PMID: 21504693.

The same study shows that VMV products had less than 0.1% reactions reported in over 30 years.

How It Works:

Check out this handy video in our YouTube Channel: Validated Hypoallergenic – The VH Rating System

Very simply, the higher the number, the more allergens are NOT in the formulation.

Every product has a VH-Rating on its label followed by a slash and the total number of current top contact allergens. The higher the VH-Rating, the more allergens are not included in the formulation.

In case an allergen is present, the VH-Rating will be lower than the total number of current top contact allergens. An asterisk will also be seen that corresponds to the allergen in the ingredient list (which will also be underlined) for quick identification.

Breaking Down the Elements

  • VH stands for Validated Hypoallergenic.
    • The product has been tested specifically for hypoallergenicity.
    • At VMV, this includes patch testing each raw material, ingredient, applicator, and final formulation.
  • -# (the minus sign followed by a number)
    • Shows how many allergens are ABSENT from the formulation.
  • /# (slash followed by a number)
    • Means “over this current total of top allergens.”
    • This shows the total count of the current top allergens.

A VH-Rating of VH-109/109 would be read as: “Validated Hypoallergenic MINUS 109 over 109.”

A rating of VH-108*/109 would be read as “Validated Hypoallergenic MINUS 108 over 109.” The asterisk alerts you to check the ingredients list for its counterpart, which would be the allergen present in the formulation.

Examples of VH-Ratings on products:

VH -109/109

The highest (current) VH-Rating: VH-109/109
  • Validated Hypoallergenic minus all 109 common allergens.

VH -108*/109

A lower VH-Rating: VH-108/109. Note the asterisk.
The asterisk from the VH-Rating corresponds to the present allergen in the Ingredients List … which is also underlined so you can’t miss it! If it’s not one of your allergens, you can still use the product.
  • Validated Hypoallergenic minus 108 of 109 allergens.
  • Allergens present in the formulation are identified with an asterisk and underlined in the ingredients list.
  • In this example, if you’re allergic to parabens, fragrance, or dyes but not to vitamin E (a great antioxidant), you can still use this oil-free moisturizer.

Need More Help?

Ask us to customize recommendations for you based on your patch test results and even possible cross reactants.

Where to get a patch test?

  • In the USA: search contactderm.org. You can search by zip code and members of the American Contact Dermatitis Society also use CAMP (the Contact Allergen Management Program) to show you not just the ingredients and substances you need to avoid but brands and products that you can use (where you’ll see VMV Hypoallergenics a lot!)
  • In the Philippines: PM VMV Skin Research Centre + Clinics, where patch testing is a specialty.
  • In other countries: ask your official dermatological society about local contact dermatitis experts who offer patch testing.

Haven’t had a patch test but have a history of very sensitive skin? Choose products with the highest VH-Rating!


Our team of “dew gooders” at VMV Hypoallergenics regularly shares “skinsider” tips! Follow us on Instagram for more of their hacks, “skintel” and tutorials!

Categories
Family Blog Featured Skin

What Skincare Is Safe To Use While Pregnant & Nursing?

Q: I’m pregnant or am nursing. Can I still use my favorite VMV Hypoallergenics®products?

A: There are no conclusive studies that show that typical cosmetics can affect fetal or infant development. But it is understandable to be extra cautious. Every person (and baby!) is an individual so make sure to check with your obstetrician and pediatrician before following any of the following suggestions.

Best Practices:

• Most topically-applied products have a molecular size that is too large to penetrate the epidermis, much less the dermis. This makes it highly unlikely for most cosmetics to make it to your bloodstream, uterus, and fetus. Because cosmetics aren’t ingested, this makes it also unlikely for ingredients to make it to your breast milk.

• There are exceptions like topical steroids which can penetrate the dermis. If your dermatologist prescribes a topical steroids, make sure they know that you are pregnant or nursing and follow their instructions. Other products that are not recommended at all are those that contain retinoic acid and salicylic acid. This is especially true of oral medications.

• To be extra safe, at least until the 3rd trimester but ideally for the entire pregnancy, do not use skin care products with active ingredients that are not washed off quickly. Continue reading for our list of products to pause and products you can continue.

• Because hormones can cause skin to go a little nuts (dryness, acne, darkening, stretch marks, etc.) we suggest focusing on prevention: no allergens, irritants, or comedogens. We also suggest choosing formulations that are the least stressful on skin.

• When nursing, something to keep in mind regarding skincare is that, when feeding or carrying, baby’s skin comes into contact with whatever you use on your skin. If you notice redness or other irritations on baby’s skin, check your own products for allergens or irritants. The same can occur with airborne allergens like bleaches and fragrances.

Simple REGIMEN:

This simple regimen can help address some of the more common skin concerns during pregnancy and nursing. Many of them can be shared when baby is born, too!

PREVENTION:

STEP 1: CLEANSE

STEP 2: FOR BUMPS

STEP 3: MOISTURIZE + BARRIER REPAIR

STEP 4: PROTECT + PREVENT HYPERPIGMENTATION

Products to PAUSE:

Following the suggestion to not use skincare with active ingredients that are not washed off quickly, these are the specific VMV products that we would suggest pausing during pregnancy:

Products to PROCEED WITH:

These are the specific VMV products that we can suggest continuing during pregnancy — with the guidance of your OB-GYN at all times, of course:

Additional Information on
Pregnancy/Lactation and Active Ingredients

While there are no conclusive clinical studies showing that the typical active ingredients found in cosmetics, especially at the concentrations used in most cosmetics, can (positively or negatively) affect fetal development or breast milk when applied on the skin, research is always progressing. Your OB-GYN (obstetrician-gynecologist) and pediatrician would be your best resources regarding the latest studies available and how they apply to you and your baby in particular.Some information that we can share as accurate as of this writing:

• Barring exceptions that do penetrate the dermis such as topical steroids, there are no conclusive studies showing positive or negative effects on fetal development or milk content from topically applied products.

• Historically, the active ingredients that have caused the most concern when taken internally are retinoic acid and salicylic acid, not glycolic acid, kojic acid, or mandelic acid. Retinoic acid is teratogenic (it affects growing cells, which blastocysts are). However, the concentrations used in cosmetics are so small that it is still considered unlikely that enough of it can penetrate to cause any damage. Still, retinoic acid is, by far, the active ingredient that causes the most red flags for pregnant women and it probably should be avoided altogether regardless of the concentration.

• The percentage of actives in most cosmetics is usually very low. We use concentrations that are proven to be effective, but even these concentrations are quite controlled. Many of our active toners, for example, contain about 2.5% of the active ingredient in a 120mL solution. Even if the active ingredient could penetrate the bloodstream (unlikely due to the relatively large molecular size) and make it to the fetus (even more unlikely), the percentage of the active ingredient that would get this far during each individual application is minuscule. This is because the ingredient:
…is present in low concentrations;
…is further diluted in a solution of much greater volume; and
…is applied in small amounts on the skin (and, again, because the molecular size makes penetration past the dermis unlikely).

For example: 2.5% of an active ingredient mixed in a 120mL solution of a toner means 3g of the active in the solution. Let’s assume that the toner is finished in 30 days. To estimate, dividing 3g by 30 days results in around 0.1g of the active ingredient getting to the skin per application. Because of the molecular size of the active, much of this 0.1g cannot penetrate beyond the dermis into the bloodstream, and even less could therefore possibly make it to the fetus.

This is NOT a recommendation to use active ingredients during your pregnancy — as we stated at the start of this article, we follow the safer recommendation to discontinue the use of active ingredients during pregnancy and nursing. We follow this guideline as an extra precaution because while studies are inconclusive, research is always revealing new discoveries. Avoiding active ingredients that are not immediately washed off provides an added degree of safety.

PLEASE FOLLOW THE RECOMMENDATIONS OF YOUR OB-GYN AND PEDIATRICIAN.

Data regarding the effects (positive or negative) of topical skin treatments on fetal or infant development at this point may be inconclusive; but for anything taken orally, you should be conscientious and always consult your doctor beforehand. You’ll be seeing your gynecologist soon and regularly, then your child’s pediatrician. These visits, more than anything, will help you best monitor your baby’s healthy development. This information should not be considered medical advice. Particularly if you have a medical condition, before you change anything in your skincare or other practices related to pregnancy or nursing, ask your doctor.


Laura is our “dew”-good CEO at VMV Hypoallergenics and eldest daughter of VMV’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 “usage testing” services). In addition to saving the world’s skin, Laura is passionate about health, inclusion, cultural theory, human rights, happiness, and spreading goodness (like a great cream!)

Categories
Featured Healthy Living

Put Virgin Coconut Oil In Your Coffee!

It’s a faster, simpler way to “bullet coffee” that gives you the same energy boost with more benefits for your skin, body, heart, and brain!

Eat less:

Virgin coconut oil is high in calories but they’re healthy calories. It has excellent satiety, so that it may help you consume less throughout the day by making you feel full, longer.

Help your immune system:

There are many published studies on the antimicrobial (antibacterial, antiviral, and anti fungal) benefits of VCO, lauric acid, and other coconut derivatives. Check out this study review for some of them.

Get more energy:

Get more kick from your coffee. VCO is rich in medium-chain triglycerides and, instead of being stored as fat, its fatty acids are processed by the liver into energy. This could also…

Increase your metabolic rate…

…which helps your body burn fat more quickly.

Other health benefits

Our bodies’ cell walls (including those of our skin) are made up of lipids. VCO helps strengthen those cell walls. It’s also cholesterol-free and great for heart health. Other studies show promise for brain health, too. And VCO is a great natural laxative.

How to?

Getting all the magic of VCO in your morning coffee is super easy. Add a tablespoon of Know-It-Oil or Oil’s well to your coffee (along with coconut sugar or your choice of sweetener) and blend until mixture turns a light color. Or, pour the VCO directly into your cup — there will be a film of oil on top but it’s the same goodness and yumminess (and less cleanup)!

This information should not be considered medical advice. Particularly if you have a medical condition, before you change anything in your diet, ask your doctor.

Laura is our “dew”-good CEO at VMV Hypoallergenics and eldest daughter of VMV’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 “usage testing” services). In addition to saving the world’s skin, Laura is passionate about health, inclusion, cultural theory, human rights, happiness, and spreading goodness (like a great cream!)

Categories
Featured Skin

“Skintimate” Problems: Skin Issues Related to Underwear, Sex & Other Things That Might Embarrass You (But Shouldn’t)

Skin problems can cause embarrassment. This can be especially true for skin problems affecting the “nether regions” — areas of the body that so many of us are taught to think of as shameful, not to be spoken of, or at least extremely private. Of course, they aren’t shameful and we should all know more about skin problems that appear on the genitals, or that are related to sex or our undergarments. Furthermore, we shouldn’t be shy about consulting a dermatologist to make sure that we get an accurate diagnosis and address the problem properly.

Darkening and other Skin Problems in the Groin, Stomach, and Bra Areas

Elastics, dyes, chemical processing (bleaching), scratchy fabrics, and preservatives in fabric can cause itching, rashes and, over time, darkening around the groin, scrotum, buttocks, bra area, and stomach. But it’s not just underwear that can cause these problems. Seats and lower back cushions with leather, rubber, vinyl, and other allergens can also be at fault.

While a rash, itching, or discomfort may bring you to your dermatologist, an asymptomatic condition called pigmented contact dermatitis (PCD) — a faint to mild and progressive darkening that is frequently considered “just part of aging” — might be missed. PCD can be seen around the groin, in between the buttocks, in the genital and scrotal areas, on the nipple and surrounding areola, under the breast, and/or on the stomach. It’s often missed as a type of contact dermatitis because it doesn’t start out as a rash or itching…it darkens gradually over time. While strong bleaches (some with steroids) can work to lighten the hyperpigmentation, the darkening will recur without proper prevention. Patch testing easily proves the (+) and relevant chemicals that cause the reactions.

In addition to getting a patch test so that you can practice more accurate prevention, good practices include choosing underwear that is made with elastic-free, organic (bleach and dye-free) cotton like those from Cottonique. Choose chairs with seats and lower-back surfaces that are not made of rubber or leather, or dyed. If this isn’t possible, place a barrier between you and the surface. Try a white (or, even better, uncolored) cotton towel.

Wash underwear and the barrier you use on your seat in Fawn & Launder or diluted Superwash. If you are sensitive to chlorine which is often present in tap water, rinse these items with distilled water.

Diapers

Anyone, of any age, who uses diapers can develop irritations and/or allergies on the areas of contact, especially because of the extended time of contact and in an enclosed, often humid environment. Many allergens and irritants go into the materials of diapers themselves, so try to look for unbleached options. Or consider cloth diapers or underwear with built-in pads. Pure organic virgin coconut oil (VCO) like Know-It-Oil is a great option as it cleans well without roughness, provides antimicrobial protection, and also moisturizes the area to help prevent diaper rash. Adding a purely mineral barrier might also help prevent irritations from chafing or contact with elastics.

Diseases That Can Involve the Genitals…

…include viral warts and herpes lesions (which are infectious and spread faster in ano-genital skin). Other more infectious diseases include chlamydia (the most common STI in the world), gonorrhea, syphillis, and HIV. Use a condom when having sex but get a patch test as you might be allergic to some materials commonly used in condoms. Note that not all these skin lesions are sexually transmitted. Toilet paper can cause skin problems and molluscum contagiosum can be transmitted via towels and sheets.

Don’t be shy: if you see or feel lesions in the genital areas, set a consultation with your dermatologist or gynecologist.

Genital Skincare

Irritations and abrasions on or around the anus and other genitals can be helped by Boo-Boo Balm.

Know-It-Oil can also be inserted to soothe and reduce inflammation: put some into a needless syringe. Store it in the refrigerator for a few minutes. When the VCO is a cold “butter,” insert the syringe into the vagina or anus and push the plunger. The oil is quickly absorbed and does not tend to leak — if you’d like more precautions, do this before going to sleep and place a towel between you and the bed. Important: Consult your gynecologist. There are no studies on inserting VCO into the genitalia at this time. There seems to be some discussion in the medical community about whether VCO is preventive of yeast infections or has the potential to disrupt the native flora of the vagina (since it is antibacterial and antifungal) because VCO innately only treats non-commensal microbes. There are a number of well-respected hospitals (Sloan Kettering) and published doctors who do recommend using virgin coconut oil as a lube or moisturizer. But because your doctor knows your particular history best, check with them. If your doctor does give you the go-ahead, make sure that the oil you insert is pure, organic, cold-pressed VCO (not coconut oil with additives, grown with pesticides, or handled with less sanitary methods).

When using lube, look for for fragrance- and preservative-free options. VCO can also be used as a lube, but not with latex condoms as latex is broken down by oils (of any kind).

Sanitary napkins with fragrance, dyes, and preservatives are common causes of itching, irritations, and allergies. While harder to find, there are unscented and unbleached options. Feminine washes and douches are unnecessary and potentially harmful: risks include skin issues as well as offsetting the important and delicate balance of microbiota in the area.

Wash with a gentle, allergen-free liquid soap like Clark Wash instead. Pure organic virgin coconut oil like Know-It-Oil can be used for cleansing and/or barrier repair of chronically irritated and inflamed skin.

Hyperhidrosis (Sweating a LOT)

Excessive sweating that is visible and even drip from the skin may be a condition called hyperhidrosis (if it is accompanied by a bad odor, it might be bromhidrosis — see below). The sweating can be localized on the underarms, palms of the hands and soles of the feet, or generalized, affecting larger areas of the body or the whole body. All the typical things that trigger sweating (such as anxiety, heat, exercise, spicy food) worsen sweating but with hyperhidrosis, sweating can occur without triggers and even in the cold.

Hyperhidrosis can be caused by thyroid problems, menopause, diabetes, obesity; some cancers or neurological damage; or could be related to other underlying conditions. Your doctor can help you investigate the cause further. Even if unrelated to another health condition, hyperhidrosis can be frustrating. It can cause visible sweat stains and ruin fabrics. It can cause discomfort with simple social interactions like shaking hands. If severe, the sweating can cause keyboards and other electronic equipment to malfunction. And an unpleasant odor can develop.

Use a strong antiperspirant like Essence Skin-Saving Antiperspirant or Illuminants+ Axillight Treatment Antiperspirant on all affected areas. Botox® injections can stop the production of sweat in the area for several months. Consult your dermatologist for options.

Bromhidrosis (“Bad Smell”)

This perceived “bad smell” mostly occurs in the axillary or underarm area (if it is apocrine bromhidrosis). It can also be from other parts of the body (eccrine bromhidrosis). Apocrine and eccrine refer to the two types of (sweat) glands that we have.

Eccrine glands are most numerous on the palms of the hand and soles of the feet but are everywhere on the body. When the body’s temperature increases, they produce sweat that is normally odorless, more dilute, and watery. It can also begin to smell due to bacteria, some foods and medications, or alcohol.

Apocrine glands are located in the groin, breasts, and underarms and produce a thicker sweat that contains pheromones. Apocrine sweat begins without smell, with odor developing as bacteria break down the sweat.

All humans have a natural, healthy colonization of bacteria and other microorganisms that coexist in a complex, sophisticated, functional balance. Sometimes, when this balance is thrown off, one microorganism can begin to dominate and cause problems.

Odor is caused when bacteria break down sweat resulting in fatty acids and ammonia. In bromhidrosis, a higher level of bacteria break down the sweat in the apocrine areas (the most common type of bromhidrosis is in the armpits), resulting in a stronger or foul-smelling odor. If hyperhidrosis  is also a concern, it needs to be addressed as well for the bromhidrosis to be managed.

Management of bromhidrosis includes…

  • The same sweat control with Essence or Illuminants+ Antiperspirants mentioned in hyperhidrosis, above.
  • Practicing proper hygiene (wash the areas at least twice a day) with…
  • Unscented products such as Essence Superwash. While it may seem counterintuitive, a common cause of bromhidrosis is the scent of sweat interacting with perfumes in products.
  • Following antiperspirant with Id Monolaurin Gel or Kid Gloves for additional sweat control as well as antibacterial care. Id Gel and Kid Gloves can be reapplied throughout the day, too.
  • Removing hair regularly to help prevent the accumulation of bacteria and sweat on hair shafts (particularly armpit hair).

Depilation or Hair Removal

Laser hair removal is a great option but — especially if you have brown skin — comes with the risk of hyperpigmentations. Make sure to see a specialist familiar with laser procedures on brown skin. Brown skin can include paler mixed skin as well. And note that laser hair removal might not not work for individuals with very light hair coloring. For this procedure, it’s clear that a specialist is important.

Waxing and sugaring are also worth considering, but hair growth will recur. Particularly when waxing (because of the heat and tearing), consider using an anti-inflammatory like Red Better Calm-The-Heck-Down Balm and ice afterwards.

Caring for Someone Who Needs to Spend Several Hours In Bed or Otherwise Not Moving Regularly

VCO is an excellent option for the daily washing of the perineal area, and can be applied at every diaper change to prevent rashes, sensitivity, and infection. This, plus regular massaging of the areas with VCO can also help prevent bed sores.

This information should not be considered medical advice. For skin problems, and certainly for those affecting sensitive areas of the body such as the genitals or that may be related to sexual activity, see your doctor.

Laura is our “dew”-good CEO at VMV Hypoallergenics and eldest daughter of VMV’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 “usage testing” services). In addition to saving the world’s skin, Laura is passionate about health, inclusion, cultural theory, human rights, happiness, and spreading goodness (like a great cream!)

Categories
Featured Skin

6 Truths About Acne That May Surprise You

Which 5 statements about ACNE are TRUE?

Find clues in VMV Hypoallergenics’s weekly livestreams and IGTV!

  • ? Acne is an inflammation of the follicle.
  • ? Skin conditions like keratosis pilaris, pityrosporum folliculitis, ingrown hair, and others can be confused for acne.
  • ? Acne means your skin is dirty.
  • ? Oily skin is something that needs to be fixed.
  • ? Things that cause acne include pore-cloggers; substances that irritate the pore including allergens, disinfectants and PPEs; inflammatory food; poor sleep; stress; hormones; some medications, bacteria, fungi, mites, genes.
  • ? Because “Comedogens” are tested and graded consistently, you can generally trust ratings that you see on the internet.
  • ? “Comedogens” are more accurately determined by human skin tests, not Rabbit Ear Assays which are old and inconsistent.
  • ? Acne only affects teens and people with oily skin.
  • ? Because so many things can cause acne, and some skin conditions can look like acne but aren’t, you should see a dermatologist for a proper diagnosis and treatment plan.
  • ? Antibiotics and other medications to manage acne are *never* necessary.
  • ? Coconut oil, stearic acid, and stearyl alcohol are not comedogenic.

 ANSWERS: ?????? are TRUE.

TRUE: ? Acne is an inflammation of the follicle.

Acne usually starts as a comedone (plugged hair follicle). Sebum production follows, then an overgrowth of a microbe in the follicle (innate bacteria, fungi, or mites), which leads to more inflammation and the formation of papules, pustules, and/or cysts.

TRUE: ? Skin conditions like keratosis pilaris, pityrosporum folliculitis, ingrown hair, and others can be confused for acne.

Many bumps and lesions can be confused for acne, which is why it’s so important to get an accurate diagnosis from a dermatologist.

TRUE: ? Things that cause acne include pore-cloggers; substances that irritate the pore including allergens, disinfectants and PPEs; inflammatory food; poor sleep; stress; hormones; some medications, bacteria, fungi, mites, genes.

Acne has LOTS of possible causes. And unless you identify it or them accurately, you might be treating the wrong thing.

TRUE: ? “Comedogens” are more accurately determined by human skin tests, not Rabbit Ear Assays which are old and inconsistent.

A surprising number of ingredients flagged as “comedogens” online aren’t because many websites use results of old, outdated, inaccurate Rabbit Ear Assays as their reference. Plus, “comedogens” only clog the hair follicle to cause comedones. “Acnegens” do the same thing AND cause irritation and inflammation. For acne prevention, you need non-comedogenic (based on newer, more accurate human controlled trials) as well as the absence of top contact irritants and allergens to prevent the irritation that eventually leads to inflammation and acne.

TRUE: ? Because so many things can cause acne, and some skin conditions can look like acne but aren’t, you should see a dermatologist for a proper diagnosis and treatment plan.

Definitely. Your dermatologist will take a more complete history and possibly ask for tests or even a cross-consultation with another specialist. Because acne is inflammatory, what will help are the classic anti-inflammatory things you should be doing anyway: no junk food, lots of fresh veggies and fruit, proper sleep, and stress management. But which topical products will work for your acne, and if you need an oral medication, is best determined by your dermatologist.

TRUE: ? Coconut oil, stearic acid, and stearyl alcohol are not comedogenic.

Based on those more reliable Human Controlled Trials, none of these ingredients are comedogenic or acnegenic.

For more, check out Lots Of Comedogenic Ingredients Aren’t Actually Comedogenic, and What You Really Need To Prevent Acne.


Laura is our “dew”-good CEO at VMV Hypoallergenics and eldest daughter of VMV’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 “usage testing” services). In addition to saving the world’s skin, Laura is passionate about health, inclusion, cultural theory, human rights, happiness, and spreading goodness (like a great cream!)

Categories
Featured Skin

Lots Of Comedogenic Ingredients Aren’t Actually Comedogenic, and What You Really Need To Prevent Acne

“Don’t use virgin coconut oil! Or stearic acid! They’re so comedogenic!”
         … are they, though?

And is “non-comedogenic” alone the one magic, major thing to prevent acne? The internet is a wonderful source of good information…but also outdated information, information without context, incomplete information, and wrong information. Comedogenicity, for example, has had a complex history with conflicting results and different testing methods. Yet many sites that list comedogenic ingredients don’t show the sources of the studies and how the studies have held up over time. And it seems that comedones are only half the story. To really help keep acne at bay, we need “hypoallergenic” and “anti-inflammatory” as much as “non-comedogenic.”

To help “unclog” some of the confusion, we asked dermatologist and dermatopathologist Dr. Vermén Verallo-Rowell to explain: what do “comedogenic” and “acnegenic” mean, and what studies should we be trusting?

What we learned…

See Dr. Verallo-Rowell’s original summary below. These are 3 of the most eye-opening things that we learned.

1. Non-comedogenic isn’t all that you need to prevent acne. Look for: non-comedogenic, no contact allergens, no irritants, and anti-inflammatory.

First, let’s clarify what’s what…

Comedones and comedogenic:

“Comedone” is the medical term for a plugged hair follicle. Hormones, other inflammatory stress triggers, as well cosmetics and skincare and/or their ingredients can form comedones. When they’re closed, they’re whiteheads. When they’re open, they’re blackheads. They might be visible or not (micro-comedone).

What clogs the follicle — the product itself and/or its ingredient(s) — is a comedogen(s).

Acne and acnegenic:

Acne is caused by inflammation. There can be many triggers, from an inflammatory diet, hormones, a medical condition, and certain drugs. A cosmetic product or its ingredients can also be a trigger — here, the product/ingredients may cause an irritant contact dermatitis that also becomes inflamed. Acne starts as a comedone (clogged hair follicle). Sebum production follows, then an overgrowth of a microbe in the follicle (innate bacteria, fungi, or mites), which leads to more inflammation and the formation of papules, pustules, and/or cysts.

What clogs the follicle but also causes irritation and possibly inflammation — the product itself and/or its ingredient(s) — is an acnegen(s).

What should I be looking for?

Comedogens (which clog the follicle) are not necessarily acnegens (which clog then irritate the follicle, and cause inflammation); and acnegens are not necessarily comedogens

A product that says “non-comedogenic” should have done tests on the ingredient and final product — and/or is relying on studies already done on the same ingredient — to prove that it does not clog pores. “Non-acnegenic” may be the better term to look for if you’re trying to prevent acne in addition to clogged pores but many FDAs prevent the use of this term for cosmetic products (both “acne” and “inflammation” are restricted to drugs). The best thing would be to look for products that:

• Say “non-comedogenic”;
• Have zero of the top contact allergens and irritants; and
• Are anti-inflammatory.

Remember that comedogens clog pores. Acnegens both clogs pores and cause irritation and inflammation. A non-comedogenic product with anti-inflammatories and without allergens or irritants should fit the bill. Just make sure that the brand relies on Human Controlled Use Tests or similar studies on people to determine comedogenicity and/or acnegenicity because…

2. Most of the studies used to determine “comedogenicity” are old and inconsistent or inaccurate.

Part of the confusion lies in that the most commonly cited studies for comedogenicity are old, done on rabbit ears (Rabbit Ear Assays; “REA”), and are less reliable. Just ten years after some of the earliest studies that were considered the gold standard for comedogenicity, the same team of doctors, using a human skin model in lieu of the Rabbit Ear Assay, saw that the results of their initial animal (and later human) studies were incongruent.

To try to resolve the difference, in 1989, the American Academy of Dermatology held the Symposium on Comedogenicity to standardize testing methods. To clarify findings, especially if positive in REAs, it was recommended that “the product should be adequately tested in humans before general use.” Results from tests on humans were considered the defining results.

The next wave of influential studies began in 2006 with Draelos et al. One study concluded that finished cosmetics with ingredients shown to be comedogenic in Rabbit Ear Assays are not necessarily comedogenic when tested on human skin. More recent studies use updated methodology that measure oil production and tackle inflammatory follicular targets. These seem to more accurately identity what ingredients or products are comedogenic and acnegenic.

Draelos’s results, the results from tests on human skin, as well as newer methodologies are what we use in our research center and when formulating VMV Hypoallergenics products.

The newer methodologies have many advantages: they are more accurate, they don’t need bunnies, they are easy to perform on more subjects for greater statistical significance, and they can be done with more types of ingredients, finished products, and other materials. Importantly, unlike REAs which were incongruent themselves and incongruent when compared to human tests, these newer methods are more consistent and are accurately reproducible. And, in case you were wondering, these show virgin coconut oil as not comedogenic. Virgin coconut oil is also not acnegenic.

3. What is causing your acne may not be what you think.

The easiest thing to blame is the last product you used or a new product you’re trying. But acne (especially adult acne) is multi-factorial: it can have many possible causes. Some causes include certain cosmetic products, and using too many cosmetic products, but also hormones, certain medical conditions, disinfectants, some medication, lack of sleep, halogens (fluoride, chloride, iodide, etc.), and inflammatory food (red meats and byproducts, highly processed foods, junk food, too much carbs and dairy, “white” food like white rice and bread, pre-packaged drinks, vegetable oils, etc.).

A product that produces a reaction quickly might be acnegenic: it clogs the pore but also causes irritation (remember, acne in this case is actually a type of irritant contact dermatitis of the follicle) and inflammation. On the other hand, a product that is comedogenic would take time (sometimes weeks) to show a reaction because more applications are needed for the erring ingredient/s to build up and cause clogging.

If you’re convinced that a product that you used is the problem because you noticed new acne soon after using it, maybe the product is acnegenic: it contains both comedogens but also allergens and irritants that have irritated the pore and caused inflammation. If the lesions developed over time, it might be due to the comedogens in your most recent product or in your other products that have had enough time to build up and clog your pores. Or it could be a change in lifestyle (more stress, lack of sleep, worse food), new medication, a development in hormones, or even a condition that just looks like acne but isn’t. This is why your best bet is to see a dermatologist for a comprehensive history, tests, and a proper diagnosis.

For guidance, a lot of people search online and stumble upon “comedogenicity tables” on acne websites. Most of the tables are adapted from the Kligman Rabbit Ear Assay studies and Fulton collation of these studies. As a review of medical literature shows that these are incongruent at best: what is consistent is the inconsistency of results between Rabbit Ear Assays and human skin studies.

This well established incongruence between REAs and human studies, along with the difficulty in reproducing the results of REAs, led to the official AAD Symposium Consensus Statement saying that human skin tests are the determining results. We therefore rely on human skin tests with newer methodologies (like Human Controlled Use Tests) and not on older Rabbit Ear Assays that have been proven wrong or proven to be difficult to reproduce with the same results.

Summary by Vermén M. Verallo-Rowell, MD, FPDS, FAAD, FASDP, FADA

The concept of acnegenic and comedogenic to describe ingredients individually, and in skin care and cosmetic products, has been based on animal and human test protocols. The results are varied and standards not well defined for manufacturers or by regulatory bodies. Hence the confusion for the users of these products and the meaning and use of these terms. 

Acnegenic products induce comedones plus inflamed papules, pustules, and cysts. The cause of acnegenicity is follicular irritation. It is a variant of irritant contact dermatitis with a more pronounced follicular component. As such, acne lesions appear quite quickly after application, while comedones may take weeks to develop. Therefore, comedogenic substances are not necessarily acnegenic, and the reverse is also true.(1)

Comedogenicity is the potential of a cosmetic or of its components to form acne-like plugged hair follicles that, when closed, are called whiteheads and, when open, are called blackheads. The medical term for both is a comedone. Chloracne, a form of comedonal acne was first seen among factory workers through the 1940s. Using the Rabbit Ear Assay (REA), chloracne was shown to be due to chlorinated hydrocarbons.(2) Kligman in 1970 used the REA to rate the comedogenicity of human sebum on a scale of 0 (no potential) to 3 (severe potential).(3) In 1972 Kligman and Mills next linked REA comedogenicity ratings of human sebum and cosmetic ingredients to low-grade acne which they called “cosmetic acne” in the cheeks of 22-25 year old post-adolescent young women.(4) 

Ten years later, Mills and Kligman continued to do comedogenicity studies on the same chemicals, but used a human skin model in lieu of the rabbit ear. Surprisingly, the results of their initial animal, and later human, studies were incongruent.(5)

To try to resolve the difference, the American Academy of Dermatology in 1989 held the Symposium on Comedogenicity to standardize testing methods. They came up with the following consensus statement: “If the animal model does not show evidence of comedogenesis, the test material under consideration is unlikely to be comedogenic in human skin. One plus (+) positive reactions are also unlikely to cause reactions in humans. Two (++) or three (+++) responses require sound scientific judgment. Reformulation should be considered, or the product should be adequately tested in humans before general use.”(6)

These findings lead to a study in 2006 by Draelos on six individuals with prominent follicular orifices and the ability to form comedones on the upper aspect of the back which served as the test sites. Using the technique of Marks and Dawber, 0.2 to 0.5 mL of 7 cosmetics with at least 2 ingredients reported to be comedogenic in the REA assays, a positive, and a negative control were applied, kept covered for 48 hours, opened, and re-applied 3 times weekly for 4 weeks. Cyanoacrylate follicular biopsies at baseline and at the end of the study counted the ratio of follicles to microcomedones per square inch. Like Kligman, Draelos’ results were likewise “incongruous”. The study concludes that finished cosmetics with ingredients shown to be comedogenic in rabbit ear testing, are not necessarily comedogenic when tested on human skin.(7)

In recent years, dermatologists have noted the rise of cases of adult acne defined as acne in men or women 25 years and older. Unlike adolescent acne which occurs from hormonal surges in adolescence(8), adult acne is multifactorial. The factors include hormones from stress-related fluctuating hormones of fast-paced modern lifestyles; polycystic ovarian syndrome; and discontinuing birth control pills. Commonly used drugs and chemicals such as antidepressants, cough medicines, corticosteroids including those in inhalers; pollutants like particulates, chlorines and dioxins in our environment, and in our food and drinks are others. Lastly, the increasing number of chemicals in cosmetics and cosmeceuticals are frequent suspect causes.(9,10) Quality of life among adolescents to adults with acne have been shown to be as serious as in those with diseases considered to be dire such as CVD, diabetes, and cancer.(11-13)

More recent studies are now used to characterize sebum production, and inflammatory follicular targets that may be useful to more accurately characterize what ingredients or products are indeed comedogenic and acnegenic.(14,15 ) 

A study by Catambay, Villanueva and Verallo-Rowell in 2016 modified the Draelos human comedogenicity assay (DHSA). The study again proved that although there were some similarities of REA and DHSA ratings in 3 oils, the 5 others had different readings. Similar were DHSA (and REA) – comedogenic Olive and Almond; DHSA (and REA) – non-comedogenic Castor. Dissimilar were DHSA non-comedogenic Coconut, Avocado and Grapeseed (REA comedogenic); DHSA non-comedogenic sunflower and safflower (REA mildly comedogenic) oils. Notable is coconut which, despite years of being listed as comedogenic (in REA ratings), was shown  non-comedogenic by DHSA, Table 1. This confirms what has been seen in clinics where VCO, for regular application not just on the face, but also all over the body, is a non-comedogenic moisturizer and antiseptic oil. The study utilized a new methodology with many advantages: accurately reproducible, easy to perform, cost effective, can be done on a larger number of test materials (ingredients, finished products), on a bigger subject size for greater statistical significance of results, and “no animal testing” for cosmetic ingredients and cosmetic products.(17) 

Consumers tend to immediately blame cosmetics for their adult acne and look for self-help guidance to the comedogenicity tables found in the internet (acne websites) or even in dermatology literature. Most of the tables are adapted from the Kligman (0-3) ratings and Fulton who collated the REA studies and rated comedogenicity and also irritancy as (0 to 5). All are based on REA assays.

References:

  1. Draelos ZD. Atlas of Cosmetic Dermatology. Philadelphia, Pennsylvania: Churchill Livingstone, 2000, pp. 25-29. 
  2. Moses M, Lilis R, Crow KD, et al. (1984). Health status of workers with past exposure to 2,3,7,8-tetrachlorodibenzo-p-dioxin in the manufacture of 2,4,5-trichlorophenoxyacetic acid: comparison of findings with and without chloracne. Am. J. Ind. Med. 5 (3): 161–82. doi:10.1002/ajim.4700050303. PMID   6142642
  3. Kligman A.M., Wheatley V.R., Mills O.H. Comedogenicity of Human Sebum. Arch Dermatol 1970 Sep;102(3):267-75.PMID: 4247928
  4. Kligman AM, Mills OH. Acne cosmetica. Arch Dermatol. 1972;106:893-897
  5. Mills OH, Kligman AM. Human model for assessing comedogenic substances. Arch Dermatol. 1982;116:903-905.
  6. Consensus Statement, American Academy of Dermatology Invitational Symposium on Comedogenicity. J Am Acad Dermatol. 1989;20:272-277.
  7. Draelos ZD, DiNardo JC. A re-evaluation of the comedogenicity concept. J Am Acad Dermatol. 2006;54:507-512.
  8. Smithard A, Glazebrook C, Williams HC. Acne prevalence, knowledge about acne and psychological morbidity in mid-adolescence: a community-based study. Br J Dermatol. 2001;145:274-279.
  9. H. P. M. Gollnick H.,P.,M. Review: From new findings in acne pathogenesis to new approaches in treatment. 07 June 2015 https://doi.org/10.1111/jdv.13186
  10. Verallo-Rowell V.M. Chapter 7. Role of diet and environment in skin ageing. In:Ageing and Longevity Medical Webinars Handbook. Genuino RF, Genjuino LS, Arquiza MC, eds.Manila, Philippines: Mu Sigma PhiSoririty Inc. June 2020.  
  11. Barnes, LE, Levender,MM, Fleischer Jr, AB, Feldman, S.R. Review Quality of Life Measures for Acne Patients. Dermatol Clin 2012 Apr;30(2):293-300, ix. doi: 10.1016/j.det.2011.11.001
  12. Mallon E, Newton JN, Klassen A, Stewart-Brown SL, Ryan TJ, Finlay AY. The quality of life in acne: a comparison with general medical conditions using generic questionnaires. Br J Dermatol. 1999;140:672-676.
  13. Lasek RJ, Chren MM. Acne vulgaris and the quality of life of adult dermatology patients. Arch Dermatol. 1998;134:454-458. 
  14. Campos P.,M.,B.,G.,  Melo, M.,O.,Mercurio, D.,G. Use of Advanced Imaging Techniques for the Characterization of Oily Skin. 2019 Mar 26;10:254. doi: 10.3389/fphys.2019.00254. eCollection 2019.
  15. Yoon JY, Kwon HH, Min SU, et al. Epigallocatechin-3-gallate improves acne in humans by modulating intracellular molecular targets and inhibiting P. acnes. J Invest Dermatol. 2013;133:429-440.
  16. M. Jackson Edward, F. M. T. Robillard Norman The controlled use test in a cosmetic product safety substantiation program.September 2008Cutaneous and Ocular Toxicology 1(2):117-132OI: 10.3109/15569528209051517
  17. Catambay N., Villanueva J., Verallo-Rowell VM. Comedogencity of virgin coconut (VCO) and other cosmetic oils using a modified Draelos protocol: a randomized double blind controlled trial. Poster presentation at the American Contact Dermatitis Society, 2016 Annual Meeting.
  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
Categories
Beauty Featured Skin

Curly Hair & Silicones…What’s Really Bad (and Good!)

Curly hair does require special care. While there are lots of great resources online for important daily maintenance and styling tips — using a silk pillowcase, air drying or using a microfiber towel or T-shirt, etc. — we thought we’d add some information from a dermatological and formulation angle and address one ingredient in particular that has been flagged as “bad” for curly hair: silicones.

Is Silicone “Bad” For Curly Hair?

Several curly hair bloggers recommend no silicones in hair products. The bad rating seems to be based on the idea that silicones are not water soluble and therefore build up in curly hair. This is stated to be a concern for curly hair in particular because, as it is not washed daily, the silicones become saturated and weigh down the hair’s natural curls. When this happens, one then needs a “clarifying” shampoo to fully wash away the silicone buildup, and clarifying shampoos are too drying for curly hair.

This assumes two things: 1) something false about silicones (which we tackle further below), and 2) something true about many clarifying shampoos (they can indeed be too drying for curly hair…but there is more to this as well).

Diving Into Silicones

1) Allergenicity: Silicones are not allergens. This is notable because silicones are everywhere. The risk of allergenicity increases significantly when an ingredient is very common. Nickel, for example, is the top contact allergen and part of the reason why is its ubiquity (it’s found in almost every metal). Despite silicones being widely used in many products, the reports of contact allergies to them are extremely rare, and they are not in published allergen lists (these lists are based on patch tests done on almost 30,000 individuals). Silicone’s hypoallergenciity is important for sensitive skins and scalps, and can help reduce stress on the hair shaft, which is fundamental to curly hair care.

2) Anti-Inflammatory: In addition to not being allergens, silicones are normally well tolerated. Peer-reviewed published medical literature shows that dimethicone-based anti-acne regimens significantly had less erythema and dryness and could be used as a counter-irritant in formulations known to cause erythema and irritation; dimethicone added to sunscreens resulted in less irritation in patients with rosacea who tend to experience more irritation to common topical preparations; and silicones do not show comedogenic or irritant properties. Silicones, therefore, also have several benefits for the skin and scalp, including helping to lessen inflammation.

3) Environmental Concerns: In the case of nanoparticles, the concern is the potential buildup of silicones within the body. Nanoparticles (and this is a concern not just for silicone but for any ingredient in nanoparticle form) are very small molecules and there is a debate about their ability to penetrate beyond the skin to potentially cause harm inside the body. While there is still no definitive study or conclusion, we at VMV Hypoallergenics have chosen not use nanoparticles in any of our formulations. We have made this decision partly because of this concern but also because of another basic rule of hypoallergenicity: the smaller the particle size, the more an ingredient penetrates the skin, and the higher the risk of an allergic reaction. The particle size of silicones (certainly the ones we use) are large at 60 microns. The particle size that is inhaled and gets into the lungs and vessels is <10 microns.

4) Silicones and curly hair: It is highly unlikely that silicones cause buildup. Silicones tend to evaporate quickly (almost as quickly as alcohol), making buildup unlikely. They seem beneficial for curly hair as they provide additional slide, making detangling less risky (preventing the risk of breakage). Possibly more damaging to curly hair are strong detergents and other harsh ingredients, allergens, and irritants that tend to dry out hair, e.g. fragrance, dyes, amido-amine sulfates (e.g. cocamide-dea, cocamidopropyl, etc.) parabens, and formaldehyde-releasing preservatives. These do tend to be present in clarifying shampoos…but not all. If you have curly hair and happen to need a clarifying shampoo because of another reason (like styling product buildup), there are options like Superwash that are allergen- and irritant-free, and that are non-drying.

In summary, because silicones evaporate almost as quickly as alcohol, it is unlikely that they’d build up in curly hair, even with infrequent shampooing…which also makes the need for a clarifying shampoo unlikely.

Dryness

Preventing dryness is fundamental to curly hair care. Dry hair is generally a result of physical injury to the hair shaft. Some common culprits include harsh shampoos such as some anti-dandruff shampoos; frequent hair color stripping and/or dyeing; or regular hair curling, heating or straightening treatments. Very gentle care is required to reduce the stress on stretched hair shafts (the same applies to broken cuticles).

A regularly prescribed technique by our founding dermatopathologist who cares for more extreme cases is:

  • Apply plain petroleum jelly or The Big, Brave Boo-Boo Balm before shampooing to provide a barrier that protects breaks in the hair shaft.
  • Shampoo hair with a very gentle shampoo such as Essence Clark Wash which is free of ingredients — such as dyes, fragrance, and preservatives — that can potentially break down hair.
  • Use a rich but non-irritating conditioner and virgin coconut oil for repair.

For an at-home deep hydration treatment, try this:

  • Shampoo and condition your hair. As much as possible, do not dry.
  • While your hair is wet, comb Know-It-Oil or Oil’s Well virgin coconut oil through your hair and cling wrap it.
  • Rinse after 30-60 minutes.
  • Let air dry.

Read more about how hypoallergenic helps dry hair and dry scalp. And try this for a great (hypoallergenic) hair pomade!


Laura is our “dew”-good CEO at VMV Hypoallergenics and eldest daughter of VMV’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 “usage testing” services). In addition to saving the world’s skin, Laura is passionate about health, inclusion, cultural theory, human rights, happiness, and spreading goodness (like a great cream!)

Categories
Allergen, Not An Allergen Featured

NOVEL CORONAVIRUS: Allergen or Not An Allergen?

Not An Allergen

NOVEL CORONAVIRUS (SARS-CoV-2)

Please note that this page is a summary of what we currently know about novel coronavirus, COVID-19, and skin concerns. As of the time of this writing, skin lesions were beginning to be described in COVID-19. Avoiding rashes and other skin problems from the irritants and contact allergens described below is important as they may be mistaken for the skin lesions of COVID-19. Because the virus is new and the understanding of it is evolving rapidly, this page may quickly become outdated. Refer to trusted sources such as the World Health Organization, Centers for Disease Control and Prevention, and your country’s department of health for up-to-date information about COVID-19.

Novel coronavirus caused a global pandemic, fear and uncertainty, economic instability, sickness, and death…but it is not a contact allergen. While it would never be on patch test trays, COVID-19 does teach us a few important things about how a pandemic can affect the skin and especially sensitive skins.

The virus is not dermatotropic (a virus that affects or is attracted to the skin) but its contagiousness has meant a necessary increase in more aggressive personal hygiene and disinfection, and an increase in contact with personal protective equipment (PPEs). Many people can suffer irritation and/or contact dermatitis due to the harm that alcohol, detergents and disinfectants can cause the hydro-lipid mantle of the skin. But it is health front liners who bear the brunt of skin issues. According to one study in Clinics and Dermatology, some of the skin concerns suffered by healthcare workers include “Pressure injury, contact dermatitis, itch, pressure urticaria, and exacerbation of pre-existing skin diseases, including seborrheic dermatitis and acne.” The most common skin complications seen are contact reactions — redness, burning, itching, barrier problems, scaling, and more — from the extended wear of PPEs:

  • Extended wear of gloves can lead to redness and other reactions due to contact dermatitis (especially to rubber or latex gloves) or the sustained exposure to the sweaty environment that the occlusion creates (the gloves create a sealed environment).
  • Hand washing is a concern for everyone but more so for front liners who wash their hands well over ten times a day.
  • Extended wear of goggles and masks in particular (especially with the heat and sweat of exertion and stress) can cause swelling, burning, itching, urticaria, contact dermatitis, and even acne.
  • Head covers and other occlusive equipment can trigger flare-ups of seborrheic dermatitis, folliculitis, and itching.
  • Heat and sweat can cause pressure urticaria. This is not an allergy but a form of physical urticaria.

Dermatologists may need to care for people hoping to prevent infection as well as health front liners who may develop skin complications due to their efforts to stay safe and care for others. Some possible ways to prevent or alleviate symptoms could be to prioritize allergen-free, irritant-free, and non-comedogenic products.

Cleanser:

Hair and body washes like Superwash have the added benefit of cleansing hands, hair, scalp, and body both gently (allergen-free) and thoroughly (contains acceptable concentrations of coconut-derived SLS, which is antimicrobial).

Facial Cleanser:

Now is the time for the gentlest options to offset the friction, occlusion, and allergen-exposure from prolonged use of PPEs.

Moisturizer and Barrier-Protection for Hands:

Apply emollients and barrier protective creams liberally onto hands following hand washing and before wearing PPE equipment.

Skin Calmers:

The Big, Brave Boo-Boo Balm and Red Better Calm-The-Heck-Down Balm provide non-steroidal quick relief and non-irritating disinfection for itching, redness, and lacerations. While steroids may occasionally be necessary, they are contact allergens and prolonged steroid use can worsen the skin and cause other health issues.

Disinfection Techniques with Moisturizing, Film-forming, Barrier-Protective Alternatives:

See another disinfection technique using the products listed above. Based on a review of clinical studies on virgin coconut oil and monolaurin as effective antivirals, antibacterials and antifungals, this technique could give damaged skin some relief and time to heal.

Other Skin Concerns:

Dermatology patients with auto-immune skin disorders with chronic inflammation such as psoriasis, lupus, atopic dermatitis, etc. may also require additional care. Many of these conditions are treated with biologicals which are immune suppressive. Check with your dermatologist on the latest recommendations regarding whether the administration of these biologics needs to be delayed.

It is important to emphasize that, to our knowledge as of this writing, monolaurin has not been tested on SARS-CoV-2 specifically (neither has alcohol). This information is compelling but needs validation on this particular virus. The available evidence seems to suggest similar efficacy to alcohol in destroying enveloped viruses and some coronaviruses. Follow your doctor’s instructions, and rely on trusted sources such as the World Health Organization, Centers for Disease Control and Prevention, and your country’s department of health. For a study review of VCO, monolaurin and other coconut oil derivatives as antivirals, antibacterials and antifungals, click here.

If you have a history of sensitive skin, don’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:

On the prevalence of skin allergies, see Skin Allergies Are More Common Than Ever and One In Four Is Allergic to Common Skin Care And Cosmetic Ingredients.

To learn more about the VH-Rating System and hypoallergenicity, click here.

Main References: 

Regularly published reports on the most common allergens by the North American Contact Dermatitis Group and European Surveillance System on Contact Allergies (based on over 28,000 patch test results, combined), plus other studies. Remember, we are all individuals — 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 basis but it is always best to get a patch test yourself.

1. 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.

2. W Uter et al. The European Baseline Series in 10 European Countries, 2005/2006–Results of the European Surveillance System on Contact Allergies (ESSCA). Contact Dermatitis 61 (1), 31-38.7 2009.

3. 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.

4. 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.

5. Ruby Pawankar et al. World Health Organization. White Book on Allergy 2011-2012 Executive Summary.

6. 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.

7. 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.

8. 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. 

9. 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.

10. Kei EF et al. Role of the gut microbiota in defining human health. Expert Rev Anti Infect Ther. 2010 Apr; 8(4): 435–454.

11. Thavagnanam S et al. A meta-analysis of the association between Caesarean section and childhood asthma. Clin Exp Allergy. 2008;38(4):629–633.

12. 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.

13. 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.

14. Bogdanov I, Darlenski R, Hristakieva E, Manuelyan K. The rash that presents as a vesiculobullous eruption. Clin Dermatol. 2020;38(1):19–34. doi:10.1016/j.clindermatol.2019.10.012.

15. Darlenski R, Tsankov, N. Covid-19 pandemic and the skin – What should dermatologists know? Clin Dermatol. 2020 Mar 24. doi: 10.1016/j.clindermatol.2020.03.012 [Epub ahead of print]

Want more great information on contact dermatitis? Check out the American Contact Dermatitis SocietyDermnet New Zealand, and your country’s contact dermatitis association.


Laura is our “dew”-good CEO at VMV Hypoallergenics and eldest daughter of VMV’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 “usage testing” services). In addition to saving the world’s skin, Laura is passionate about health, inclusion, cultural theory, human rights, happiness, and spreading goodness (like a great cream!)