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Can Your Shampoo Worsen Your Rosacea?
In normal use, shampoo spreads well beyond the hair.
Most patients are aware of the deleterious potential of skin care, sunscreens and makeup, however certain ingredients found in shampoo (and other hair care products) are also irritants best avoided in the pursuit of minimizing the symptoms of rosacea.
Shampoo can affect your entire face.
If redness and irritation are particularly prevalent around the hair line, forehead or temples, hair care products are a likely culprit and you have identified a potential means of reducing your rosacea.
How Does Shampoo Affect Rosacea?
In the process of rinsing shampoo will inevitably come in contact with the facial skin.
Tilting the head back while rinsing will lessen the amount of shampoo which contacts the face, however the majority of shampoos contain ingredients intended to remain on the hair after rinsing.
Whatever remains on your hair can migrate to the skin.
If you have a long fringe contact with the forehead will occur constantly.
I believe this is the most prevalent cause of hair care-related skin irritation in rosacea patients.
Perspiration, such as from exercising, can also lead to residual shampoo ingredients running down onto facial skin.
Shampoo chemicals can also migrate through bedding (passing from hair to pillow case to face).
Your shampoo might be making your hair look great at the expense of your skin.
Affecting the eyes, ocular rosacea can also be worsened by brief contact with some shampoo ingredients, even if they don't enter the eyes.
Shampoo Ingredients of Concern
Shampoos contain an almost endless array of ingredients which may or may not be irritating depending on the individual.
The main irritants to rosacea are sulphates (for example sodium laureth sulphate and sodium lauryl sulphate) which are ubiquitous and silicones (for example dimethicone, cyclopentasiloxane, polysiloxane and other chemicals ending in "cone").
Pantene and Other Silicone Shampoos
Silicone is used to smooth hair. It is the primary active ingredient responsible for the original success of Pantene products. Silicones coat the hair (and skin) with great tenacity.
Formulas for curly and frizzy hair contain higher concentrations of silicones and varieties of silicones which are heavier and more resilient to removal than formulas for finer or "normal" hair.
Some hairdressers are of the opinion that regular use of silicone-based shampoos leads to so much silicone being deposited on the hair that colouring becomes difficult and that complete removal of the silicone can take 2-3 weeks of using silicone-free shampoo.
Some of the silicones found in hair products have been shown to offer protective benefits to skin, however others create irritating friction. If you have ever developed bumps or acne on your scalp after using a silicone-based hair smoothing serum, this is why. Over the day the silicone can make its way from the hair shafts onto the scalp.
I believe the silicones in shampoos may be irritating because they trap other ingredients, particularly the sulphates, preventing them from rinsing away.
This isn't an issue on the hair shaft but can wreak havoc on reactive facial skin.
2- (or more) in-1 Shampoos such as Pert
These have fallen out of favour due to their mediocrity, however some patients, particularly men, still use them.
Products like Pert contain sulphates, silicones and pore-clogging conditioners.
All-in-one shampoo, face and body-washes, such as those made by Dove and Nivea For Men have especially stripping formulas and sometimes contain peppermint and black pepper, which are strong irritants in rosacea.
Other Rosacea Irritants in Shampoos
Less commonly found but still irritating are isopropyl myristate, petrolatum, mineral and coconut oils.
Fragrances, colouring and preservatives are of lesser concern in shampoos, although they should be avoided in skin care products where possible.
More Suitable Shampooing in Rosacea
J.F. Lazartigue Pure Botanical Shampoo is an example of a formula free of sulphates, silicones, volatile fragrance, paraben and phenoxyethanol preservatives. We highly recommend it to our rosacea patients who show signs of hair care-related skin irritation.
Ideally, you would use a shampoo free of sulphates and silicones for at least some of the week.
These are becoming more popular, however finding sulphate and silicone-free shampoos which still perform well is difficult.
If you have one which you recommend or would like to suggest, we would appreciating you letting us know by posting on our Facebook Wall:
J.F. Lazartigue Essential Orange Oil Botanical Shampoo is the only product I know of to contain strictly genuine alternative hair-cleansing ingredients — and nothing else — apart from an orange extract which appears to be used as a preservative and very mild fragrance. This product is suitable for all types of hair and produces a healthy shine, however will not repair any damage due to processing.
Leonor Greyl products products contain only the least aggressive of sulphates (no sodium laureth or sodium lauryl sulphate), alternative cleansing agents and are entirely free of silicones.
If you use heavy, oil-based styling products, which are also associated with skin irritation, a sulphate-free shampoo may not remove these easily.
I suggest switching to lighter or water-soluble hair care products, or taking extra time to apply sulphate-free shampoos twice (two distinct applications and rinses per wash) and massaging them into the hair more thoroughly.
Soothing Skin — Ideal Cleansing
Another solution is to cleanse the skin after shampooing. However as the rosacea cleansers provide some additional benefits by being allowed to sit on the skin for a short period of time, rather than being washed off immediately, many patients prefer to apply cleanser before getting into the shower.
Some of the silicones used in shampoos are not water-soluble and therefore do not remove with water-soluble cleaners. The method of double-cleansing described here makes use of both an oil-soluble and water-soluble cleanser and can regularly remove oil-soluble silicone and other shampoo and hair care residues from the skin. It is worth trying 1-2x/week or more often.
This is a good compromise between giving up on shampoos you depend on and helping reduce your skin's tendency to become red, irritated and flushed.
Removing Residues To Assist Ocular Rosacea Treatment
The hygiene and integrity of the skin around the eyes, including the eyelids, is important in the management of ocular rosacea.
The Ocular Rosacea Conditioning Cleanser can be used in the second step as a water-soluble cleanser.
Protecting Skin — Establishing An Ideal Skin Barrier
If sulphates and other irritants can't substantially penetrate your skin they are much less of a concern in your shampoo.
An ideally-functioning skin barrier resists compromise by most problematic substances, almost to the point of being inherently waterproof.
The process and conditions by which to establish a healthy skin barrier are detailed in Repair Your Skin's Barrier To Treat Redness and Flushing and involves the daily use of a facial cleanser with the properties of one of the rosacea cleansers (such as the Rosacea Anti-Inflammatory Foaming Cleanser) and a barrier-repair product, such as Rosacea Treatment Fluid, in place of moisturizer.
Let Us Know About Your Shampoo Experiences
As of November 2013 ~300 rosacea patients are now following the contents of our Facebook Wall.
If you have a story to tell about how a shampoo, or hair care in general, has worsened or assisted the treatment of your rosacea, please let us know!
Everyone would appreciate hearing about this mostly ignored but still very important aspect of ideal rosacea treatment.
Further References and Product Information
Variation in barrier impairment and inflammation of human skin as determined by sodium lauryl sulphate penetration rate — "We found that variation in the barrier impairment and inflammation of human skin depends on the SLS penetration rate." — Coronel Institute for Occupational and Environmental Health, AmCOGG, Academic Medical Centre, University of Amsterdam.
Increased permeability for polyethylene glycols through skin compromised by sodium lauryl sulphate — "A defective skin barrier will facilitate absorption of other chemicals and local skin effects." — Coronel Institute of Occupational Health, Academic Medical Center, Universiteit van Amsterdam.
J. F. Lazartigue — Pure Botanical Shampoo —"100% botanical base, this shampoo's cleansing agents are extracted from Oat, Apple, and Babassu Walnut (from a Carribean and Brazilian tree). This shampoo is paraben-free and chemical preservatives-free." (jflazartigue.com).
Leonor Greyl — "The Leonor Greyl Difference" — details products free of sodium laureth sulphate, silicones and parabens (leonorgreyl.com).
Pantene Aqua-Light — "Created to rinse clean quickly, leaving zero heavy residue for a weightless finish." (pantene.com).
Pantene Ice Shine (pantene.com).
Sodium lauryl sulfate (SLS) induced irritant contact dermatitis: a correlation study between ceramides and in vivo parameters of irritation — "Our findings suggest that low levels of these ceramides may determine a proclivity to SLS-induced irritant contact dermatitis." — Department of Dermatology, University of Modena, Italy.
Ananthapadmanabhan, K. P., Moore, D. J., Subramanyan, K., Misra, M. and Meyer, F. (2004), Cleansing without compromise: the impact of cleansers on the skin barrier and the technology of mild cleansing. Dermatologic Therapy, 17:16—25.
Contact Dermatitis. 1995 Oct; 33(4):217-25. Surfactants and experimental irritant contact dermatitis. Effendy I, Maibach HI.
Percutaneous penetration of sodium lauryl sulphate is increased in uninvolved skin of patients with atopic dermatitis compared with control subjects — Coronel Institute of Occupational Health, Academic Medical Center, Universiteit van Amsterdam.
Food Chem Toxicol. 2007 May; 45(5):747-58. Epub 2006 Nov 3. Comparative studies on the ocular and dermal irritation potential of surfactants. Mehling.
Rosacea Treatment Clinic has no association with any of the hair care brands mentioned.
Author: Peter Wilson.
Reviewed: Wednesday, February 19, 2014.
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