“Hypoallergenic” Moisturizers Could Still Have Allergens


Because moisturizer use is an important part for the prevention and treatment of numerous dermatologic conditions, patients frequently request product recommendations from dermatologists. A recent study, published online in JAMA Dermatology, was designed to determine the product performance characteristics and ingredients of popular moisturizers.

The cohort study involved publicly available data of the top 100 best-selling whole-body moisturizing products at 3 major online retailers (Amazon, Target, and Walmart). Exclusions included products marketed for use on a specific body part (eg, face, hands, eyelids).

Pairwise comparisons of median price per ounce on the basis of marketing claims (eg, dermatologist recommended, fragrance free, hypoallergenic) and presence of ingredients represented in the North American Contact Dermatitis Group (NACDG) series were conducted using Wilcoxon rank sum tests. The effect of vehicle type (eg, ointment, lotion, cream, butter) was assessed using the Kruskal-Wallis test. Cross-reactors and botanicals for fragrances were derived from the American Contact Dermatitis Society’s Contact Allergen Management Program database.

One hundred and seventy-four best-selling moisturizer products were identified, constituting 109,713 reviews as of August 2016. The median price per ounce was $0.59 with a wide range. The most popular vehicles were lotions (102 [59%]), followed by creams (22 [13%]), oils (21 [12%]), butters (14 [8%]), and ointments (3 [2%]). Only 12% (n = 21) of best-selling moisturizer products were free of NACDG allergens. The 3 most common allergens were fragrance mix (n = 87), paraben mix (n = 75), and tocopherol (n = 74). 

Products with the claim “dermatologist recommended” had higher median price per ounce ($0.79) than products without the claim ($0.59). Products with the claim “phthalate free” had higher median price per ounce ($1.38) than products without the claim ($0.59). Lotions (median, $0.49) were statistically less expensive per ounce than butters (median, $1.20), creams (median, $0.80), and oils (median, $1.30). 

For products with a claim of “fragrance free,” 18 (45%) had at least 1 fragrance cross-reactor or botanical ingredient. Products without any ingredients in the NACDG (median, $0.83) were not statistically more expensive per ounce than products with 1 or more allergens (median, $0.60).

Best-selling moisturizers vary widely by price and product characteristics. Given the lack of readily available comparison data on moisturizer efficacy, dermatologists should balance consumer preference, price, and allergenicity in their recommendations, the researchers concluded. 



Xu S, Kwa M, Lohman ME, Evers-Meltzer R, Silverberg JI. Consumer preferences, product characteristics, and potentially allergenic ingredients in best-selling moisturizers [published online September 6, 2017]. JAMA Dermatol. doi:10.1001/jamadermatol.2017.3046