Did you know that some sunscreen ingredients are common causes of rashes? There is a particular type of rash called a photoallergic contact dermatitis. This means that the sunscreen ingredients may not on their own trigger a rash such as contact dermatitis but may do so once exposed to light. This sounds a little crazy that some ingredients that you are applying to protect your skin from UV exposure are possible triggers for contact dermatitis when you need them most! This can also have a major impact on those with eczema. Read more...
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What is eczema? What are its symptoms?
Eczema is a common skin condition and can manifest as itchy, irritated skin that can become dry and inflamed. Think of the word “eczema” as a basket term that refers to a state of skin sensitivity but it does not necessarily tell you why your skin is inflamed nor does it tell us the cause.
There are numerous triggers for this type of sensitivity such as allergies, irritation, reactions to temperature changes, excess dryness, genetics, products, sweat, and several other factors. The symptoms include a cycle itching and inflammation that leads to skin breakdown. The skin can appear almost like cracked porcelain with a dry flaky appearance.
Video: Techei
Effects of Fragrance in SPF Products on Eczema-Prone Skin
Discover why fragrance in SPF products can be problematic for eczema sufferers
Fragrances in products are an important topic and in dire need of clarification. Fragrances are ingredients added to products to impart a pleasant odor or smell. The natural ingredients in products, including sunscreen products, have an inherent smell. This smell may or may not be a pleasant one.
If your goal is to have a product without any fragrances, that is without added ingredients used to impart a pleasant odor, then these products will usually be labeled “fragrance-free”. The problem here is that these products may not smell so great. I have evaluated some fragrance-free sunscreens and they can have a really “earthy” smell- not one that I find the slightest bit pleasant.
Some products may be labeled as “unscented”. This term ironically references a product that likely has fragrances added to neutralize the smell or odor of a product to make it less offensive. This makes the term "unscented" a bit misleading for the person seeking a product without fragrance as it may have more fragrances added. The reality is that if you are seeking a product without fragrance then unscented isn’t it.
What I have also come to find in reviewing products is that many products may not add specific traditional fragrances tested in our patch tests such as balsam of Peru and fragrance mix, they may still add several floral, food-derived, and botanical extracts to impart a scent. This again means you are getting scent added to your products.
To confirm that you are allergic specifically to fragrances, it is worth checking with your Dermatologist to consider patch testing. This type of testing can confirm if you have a true allergic contact dermatitis as a cause of your eczema or sensitive skin. If confirmed then you may need to avoid these ingredients to reduce the chances of aggravating your eczema. If you are not specifically allergic to fragrances that you can find on a product label, then it may not be necessary to focus on this ingredient. I have come across patients that thought they were allergic to fragrances only to find out they were actually allergic to a preservative as confirmed by patch testing. If your preference to avoid fragrance is not based on skin sensitivities but perhaps that they affect your sense of smell, contribute to nausea, or some other aspect not directly related to an allergic reaction, choosing an unscented product may be reasonable even though it has added fragrances.
Chemical vs. Physical SPF: Which is Better for Eczema?
Understand the differences between chemical and physical sunscreens when it comes to sensitive skin, including why some chemical sunscreen ingredients can trigger irritation.
Chemical sunscreens work by absorbing light. Once the sunscreen maxes out its ability to absorb light, the rest flows over to your skin. Physical sunblocks block UV by shielding the skin directly. They do not absorb UV, they block it physically.
Here is an ironic fact: some chemical sunscreen ingredients are actually common causes of photoallergic contact dermatitis. This means that sunscreen ingredients may not on their own trigger contact dermatitis but may do so once exposed to light. This sounds a little crazy -- some ingredients that you are applying to protect your skin from UV exposure could be triggering contact dermatitis but only when you are exposed to light! The most common sunscreen ingredients that can trigger reactions are oxybenzone (benzophenone-3), avobenzone, octocrylene, PABA, and cinnamates.
Mineral or physical sunscreens are not common causes of contact allergies.
The Importance of Patch Tests for Eczema Prone Patients
Learn why patch testing is helpful for identifying skin triggers, especially for eczema patients
Patch testing is helpful to pinpoint the true cause of skin reactions or, at the very least, rule out possible triggers. I have performed thousands of patch tests and find that patients and I can often be surprised by the results. When it comes to sunscreens, the potential exists for the reaction to be related to the active ingredients, preservatives, fragrances, and/or dyes. In my experience, reactions to the preservatives tend to be a very common trigger and can require lots of label reading to determine an alternative.
Barrier-Replenishing Ingredients in Sunscreen
Discover ingredients like ceramides and hyaluronic acid to help replenish the skin barrier and possible benefits for eczema-prone skin.
There are two ways to look at the question of seeking barrier-replenishing ingredients.
One way is to focus on ingredients that play a role in hydrating and protecting the skin. This could include ingredients such as ceramides, hyaluronic acid, and even some anti-inflammatory ingredients such as niacinamide.
The other way to seek barrier replenishment is to avoid ingredients that aggravate the skin barrier by triggering inflammation. There are some sunscreens products that may be marketed as anti-aging and include ingredients such as retinols, salicylic acid, and other alpha and beta hydroxy acids. These ingredients have the potential to trigger some chemical exfoliation.
Why SPF and UPF Matter for Eczema
Understand the significance of choosing a sunscreen for eczema-prone skin to help prevent sunburns and minimize eczema flares.
SPF ratings are so poorly understood and very confusing. SPF stands for sun protection factor. This is an FDA-regulated claim where companies test skincare products -- lotions, moisturizers, creams, and sprays-- for how much UV protection is offered. More specifically, SPF tells us how much a product is protecting our skin from experiencing sunburn from UVB exposure. It does not tell us how much UVA is being blocked or absorbed by the product.
Here is the SPF system:
These percentages tell you how much UVB is blocked with ideal use- applying a generous amount of sunscreen. One challenge is that some sunscreen ingredients are not necessarily photostable and they also start to become less effective with sweat, swimming or moisture. Avobenzone, for example, is known for its instability in UV light and often will have other ingredients added to stabilize it in sunscreen formulations.
The FDA has stated that SPF ratings do not inform us of the time of effectiveness of sunscreen products in the sun. The reason is simply because the amount of UV radiation varies widely based on the time of day and location in the world. Although I know there are a lot of sources that attempt to simplify understanding SPF ratings by stating that higher SPFs last longer, this may not be as simple as you think.
Choosing the right SPF is not always about the number, it's about the use. Studies have shown that when people use higher SPF they may tend to spend longer in the sun thinking that they can.
Focus on the ideal use of sun protection through various modalities. Sunscreen is one option for exposed areas. Choose sun protection based on your skin’s needs. If you tend to burn easily, choose higher SPF values. Remember higher SPF values are less aesthetically elegant to apply, especially when you have skin of color. Choosing an SPF of 50 may look obvious when applied and may not be necessary for the added 1.3% UVB blockage it can offer. I tend to recommend an SPF of 30 and reapplication every 2 hours when not sweating or swimming and more frequently if this is the case.
Also remember that SPF tells us nothing about UVA blockage which is what is responsible for photosensitive reactions to hormones, medications, and premature aging of the skin. Higher SPFs will do nothing about this. Looking for Broad Spectrum coverage is helpful. Even better is sun-protective clothing as it blocks both UVA and UVB.
Although sunlight and phototherapy may help in some cases of eczema, it is still important to avoid a sunburn.
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