Emollients from the pharmacy - a help or a threat to patients with eczema?

Xerosis is one of the most common problems of patients with atopic eczema, it is also relatively common in allergic and irritant contact eczema. Moreover, patients with atopic diathesis in a broad sense complain more often of dry skin. As a rule, these patients are administered with emollient preparations that moisturize, soften and smoothen the skin, as well as keep water in the epidermis, supplement lipids of skin's upper layers and protect from external harmful agents. However, emollients just as most other cosmetics, may contain "problematic" ingredients, including sensitizers. The objective of this study was to analyse compositions of emollients available from pharmacies, with the focus on the occurrence of active substances, as well as of ingredients whose use in cosmetics is either subject to restrictions or banned. Material and methods: Emollients offered by Internet pharmacies were analyzed with special attention paid to occurrence of active and "problematic" ingredients as defined by the European directives. Results: We identified 177 cosmetics that contained in total 522 different ingredients, including 181 active substances and 49 "problematic" ingredients (mainly preservatives and fragrances). The active ingredients that were most frequently used in the emollients were liquid paraffin (46%), triglycerides of caprylic and capric acid (33%), cetearyl alcohol and allatoin (each 27%). Methylparaben (38%), phenoxyethanol (36%) and propylparaben (33%) were the most common "problematic" ingredients of the emollients. Conclusions: The vast majority of emollients available from pharmacies contain ingredients with sensitizing potential that are subject to restrictions of use in cosmetics on account of the risk to human health. Lack of correlation between the numbers of active and "problematic" ingredients occurring in the analysed products indicates on the possibility of creating safer emollients while maintaining effectiveness.

Key words: emollients, active ingredients, "problematic" ingredients, consumer safety, contact allergy.

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Dermatitis and eczema diagnosis and treatment in Krakow (Cracow), Poland