• Sarah Schafer, MD

Sjogren's, skin health, and cosmetics

Updated: Nov 16

By Rebecca (Bexi) Lobo, PhD, Guest blogger



Living with Sjogren’s has taught me that skin care is health care. For decades my painful, dry, sensitive skin and eczema were my most visible symptoms of Sjogren’s, and to find relief, I learned everything I could about skin care. Frustrated with the never-ending cycle of skincare products that never worked, I decided to take matters into my own hands, and I radically changed how I cared for my skin. I stopped using products with ingredients that created the illusion of healthy skin without supporting skin health, e.g., dimethicone and cyclopentasiloxane, which artificially and temporarily make your skin feel smooth and soft. Instead, I fed my skin from the outside in. I used whole foods to create skincare products that nourished, supported, and repaired my skin’s function. If you saw me now, you would never believe I had dry, sensitive skin, and eczema for all those years. I now help people who are experiencing similar struggles with their skin find relief. I am uniquely suited to do this because I earned a BS in Chemistry and a PhD in Nutritional Biology and, through my own journey to healthy skin, I’ve learned a lot about skin health, the cosmetics industry in the US, and how cosmetics are made and marketed. Learn more about my story here.

Your skin is your largest organ. It makes vitamin D, allows you to sense touch and temperature, and is a physical barrier that protects your body from the environment. A mix of bacteria, fungi and viruses that help to fend off invading species and communicate with immune cells lives on your skin (incorrectly, but colloquially, called your skin microbiome) and is important for your health and well-being (A).


What you put on your body (makeup, lotions, sunscreens, perfumes, etc.) not only changes your skin microbiome (A), but frequently ends up in your body. This is why it is important to know what you are putting on your skin and how it affects your health in both the short term and, more importantly, the long term.


Just like the lining of your gut, your skin is selectively porous. When healthy and working appropriately, it allows certain substances in and keeps others out. However, just like your gut, sometimes, the barrier function can be impaired and stuff that should stay out gets in which can cause health problems. With dry skin, barrier function is impaired and stuff that should stay out, such as chemicals, pollen, microbes, and dust, get in, triggering your skin’s most protective response, inflammation. Life is already stressful, and nobody needs the added stress of inflammation caused by what you put on your skin, especially not those of us living with Sjogren’s.


Here’s what you need to know about cosmetics in the US, so you can take better care of your skin and, therefore, your health.

  1. Anyone can put anything in a jar and legally sell it as a cosmetic, and they frequently do (B). Unlike drugs, cosmetics do not have to go through rigorous testing and clinical trials and be FDA-approved before being sold to you.

  2. Unlike drugs, the FDA isn’t legally responsible for making sure your cosmetics are safe (B). Cosmetics manufacturers are solely legally responsible for allegedly ensuring the safety and proper labeling of their own cosmetics.

  3. Cosmetics manufacturers aren’t always qualified and do not always ensure the safety of their products before they get onto your skin and into your body. If you use sunscreen, you may have been applying benzene (a carcinogen) to your skin for the last three years. In July 2021, Johnson & Johnson recalled specific Neutrogena and Aveeno Aerosol Sunscreen products, because they contained benzene, a carcinogen (C). This July, Edgewell Personal Care Company voluntarily recalled batches of their Banana Boat Hair and Scalp Sunscreen Spray SPF 30, because they, too, contained benzene. As Edgewell Personal Care Company states in its recall announcement, “Exposure to benzene can occur by inhalation, orally, and through the skin and it potentially can result in cancers including leukemia and blood cancer of the bone marrow and blood disorders which can be life threatening.” Learn more about the Edgewell recall here.

  4. Manufacturers can legally sell drugs as cosmetics because the FDA defines drugs and cosmetics based on their intended, rather than their actual, effects on your body. Any cosmetics containing broad spectrum SPF 15 (including sunscreen) are legally both drugs and cosmetics, because their intended use is both to prevent skin cancer and make your skin look and feel nice. Most anti-aging products are marketed and sold as cosmetics, but are functionally drugs and cosmetics, or just drugs masquerading as cosmetics. As the FDA admits, “Firms sometimes violate the law by marketing a cosmetic with a drug claim or by marketing a drug as if it were a cosmetic, without adhering to requirements for drugs.”(D). Read more here.

  5. Most cosmetics are formulated to superficially and temporarily address a symptom, not the root cause. You must keep using the product to get relief. The cycle is addictive and destructive, a never-ending quest to look young and flawless, no matter what it takes, reinforced by the beauty industry and society at large. Read more here.

  6. The FDA cannot order a recall of a hazardous cosmetic, it can only request that the manufacturer recall the cosmetic and notify the public. Meanwhile, the hazardous cosmetic can continue to be legally sold (E). Read more here.


Skincare products are a subset of cosmetics. My next post will outline what factors to consider when choosing skincare products for healthy skin.

Questions? Please contact Rebecca (Bexi) Lobo at her website, Bexi’s Bespoke Revitalisation.


References

A. Skin microbiome

B. Cosmetics are FDA-regulated, not FDA-approved.

C. FDA recall of J&J sunscreens

D. FDA definitions of a drug vs. a cosmetic

E. FDA policy for recalling cosmetics


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