Volume 38, Issue 1, Pages 24-25 (January 2007)

LESLIE S. BAUMANN, M.D.

DR. BAUMANN is director of cosmetic dermatology at the University of Miami. To respond to this column, or to suggest topics for future columns, write to Dr. Baumann at our editorial offices via e-mail at This e-mail address is being protected from spambots. You need JavaScript enabled to view it .

The term “organic” can be traced back to 1940. J.I. Rodale, who founded the Rodale book and magazine publishing company with the modest publication Organic Farming and Gardening, coined the expression (Anonymous. March 1998. “If You Care About Organic Food… Act Now!” Organic Gardening, pp. 22–25). From then until 1992, when the U.S. Department of Agriculture approved the Organic Label and its accompanying standards, “organic” applied mostly to agricultural foods and practices.

Today, government standards apply only to organic food and topical products. However, even clothing and pet food are available in organic varieties. Organic milk now is far and away the most popular organic product (Severson, K. Nov. 9, 2005. “An Organic Cash Cow.” New York Times, p. 1).

Organic plants are never grown with commercial pesticides or hormones, because of concerns about human health and environmental impact. Although research has yet to prove that organics are healthier than nonorganic products, evidence has been uncovered that indicates why exposure to certain substances in nonorganic products could be harmful. For example, a recent study showed that exposure to a compound derived from pesticides may be associated with male infertility, as it lowered circulating testosterone levels in adult men (Meeker, J.D., Ryan, L., Barr, D.B., Hauser, R.; 2006. “Exposure to Nonpersistent Pesticides and Male Reproductive Hormones.” Epidemiology 17:61–8).

Other studies have shown that pesticides in the soil, water, and air are harmful to wildlife. Environmentally conscious consumers take these considerations into account in their product selections.

Organic Skin and Body Products

Between 1998 and 2004, the use of “natural” and “organic” skin and body products rose by 51%, according to Packaged Facts/Market-Research.com. Because there were no rules about which skin care products could be called “organic” or “natural,” the use of such labels caused confusion.

For example, prior to regulation, a product could call itself organic even if it was composed of 90% water (a so-called organic ingredient), with no other organic active ingredients.

To correct this misleading situation, the U.S. Department of Agriculture, at the request of numerous manufacturers of natural and organic topical products, enacted new organic standards for skin and body care products in August 2005. Consumers can now purchase skin, body, and hair products with the Organic Seal. A product that contains at least 95% organic ingredients can be legally labeled as “organic.” A product that contains 75%–94% organic ingredients can be labeled as “made with organic ingredients.”

The Rules of Organic Production

In organic farming of crops intended for either food or topical products, farmers avoid the use of synthetic pesticides, hormones, and chemical products, and do not plant genetically modified crops.

Organic farming also follows traditional agricultural practices that enrich the soil, use resources in an environmentally sound manner, and treat livestock humanely.

Specifically, a grower of organic ingredients must meet these baseline criteria (courtesy of the Organic Consumers' Association) for the products to be certified as organic:

1. Abstain from the application of prohibited materials (including synthetic fertilizers, pesticides, and sewage sludge) for 3 years prior to certification and then continuously throughout the term of their organic license.

2. Prohibit the use of irradiation and of genetically modified organisms.

3. Employ positive soil building, conservation, manure management, and crop rotation practices.

4. Avoid contamination during the processing of organic products.

5. Keep records of all operations.

Topical Products

While there are no long-term studies documenting the effects of topical organic products or ingredients, consumers of organic products are typically as interested in what products do not contain as in what they do contain. The organic label assures consumers that the key cleansing and conditioning ingredients are derived from organically grown plants rather than conventionally grown plants, synthetic chemicals, or petroleum byproducts.

Topical organic products also exclude or minimize any ingredients that could be considered potentially harmful to people, animals, waterways, or the environment.

The Precautionary Principle

Sometimes certain ingredients are excluded from products on the basis of research. In other cases, exclusions are based on the “precautionary principle,” which holds that until the cumulative impacts of and exposures to a broad range of ingredients can be fully assessed, it is best to err on the side of caution and limit use.

For example, although many chemical ingredients used in cosmetics are widely considered safe, some safety factors have not been fully studied. It is virtually impossible to assess the cumulative effects of repeated exposures from multiple sources. This consideration is important because consumers, especially women, use several skin, hair, and beauty products daily. The ingredients in these products could potentially interact or lead to a higher combined rate of exposure than is usually assessed by studying the safety of a single ingredient in the laboratory.

Furthermore, to accurately establish the baseline of the chemical exposures people can safely tolerate, it would be necessary to account for all chemical exposures from food, urban smog, industrial waste, and other sources.

Obviously, the costs of testing for such exposures are too high for individuals and are not part of routine tests at this time. This makes it hard for each of us to assess our particular health risks. Consequently, many consumers who choose organic foods and topical products prefer to limit chemical exposure as a precaution. People with allergies and illnesses may also choose to be more cautious.

Synthetic Ingredient Cautions

While not all widely used synthetic ingredients are considered problematic, certain ones have been targeted for special concern. For example, the parabens (alkyl esters of p-hydroxybenzoic acid) are used as preservatives in many cosmetics and in skin, hair, and body care products, and sometimes produce allergic reactions (Gilman, A.G., Goodman, L., and Gilman, A., eds. 1980. Goodman and Gilman's The Pharmacological Basis of Therapeutics, 6th ed. New York: Macmillan, p. 969. Sax, N.I. 1975. Dangerous Properties of Industrial Materials, 4th ed. New York: Van Nostrand Reinhold, p. 929).

Parabens can be absorbed via the skin and travel into the bloodstream and other tissues. One controversial study has even found high concentrations of parabens in breast cancer tissue (Vince, G. Jan. 12, 2004. “Cosmetic Chemicals Found in Breast Tumors,” NewScientist.com 12:24). Products containing parabens should be avoided by most people who know they are allergic to them. (This can be determined by patch testing.)

There are no convincing data that parabens are harmful to those not allergic to them, but nevertheless, many choose to avoid products containing this ingredient.

Toluene, which is found in many brands of nail polish, has been associated with detrimental effects on males in utero. Consequently, major companies like Revlon and L'Oreal, as well as manufacturers of natural and organic products, have taken steps to eliminate toluene from their nail polishes. Toluene can also cause a skin rash, typically on the eyelids, in people who use toluene-containing nail polishes.

Several other ingredients also warrant cautionary notes, but it is important to know that even organic products can cause problems.

Natural, Organic Ingredient Cautions

It is important to note that a product that is touted as “natural” is not necessarily organic. The product may contain aloe, vitamin E, or other natural ingredients, but it may also contain chemicals intended to act as preservatives or to improve its texture. Only products that are truly organic are legally permitted to include the Organic Seal.

That said, problems can, of course, be associated with ingredients that are natural, or organic.

For example, many natural and organic brands contain fragrances and essential oils that can cause dermatitis. Oil of bergamot and balsam of Peru are both highly allergenic, so even an organic product containing them could irritate sensitive individuals. Organic products containing strong essential oils like peppermint or rosemary can also irritate or inflame sensitive skin. Chamomile, generally considered a gentle and soothing herb, induces allergies in some people (who may also tend to be allergic to wheat). Coconut oil, a popular organic ingredient, can cause acne. And allergies can develop to many essential oils and botanicals.

Furthermore, conventional products, as well as some natural ones, contain a “perfume mix” to mask their odor. Components of the perfume mix are rarely listed on the product label because each company uses its own proprietary blend. Even a product listed as 95% organic could contain a perfume mix that might induce allergic reactions in some people.

In addition, because companies were not able to label their products as organic until recently, there have not been enough clinical research trials on the organic products on the market. In fact, I will stick my neck out and say that most of the American organic brands use the label just for marketing purposes and have no proof that their products are efficacious. The organic sunscreens I have seen in the United States are atrocious!

Skin Type and Product Choice

Although some patients may express preferences regarding the selection among organic, natural, and conventional products, such considerations should be superseded by identifying a patient's skin type and making corresponding product recommendations.

For example, an organic body lotion containing whole soy oil could be suitable for a patient with nonpigmented skin. But for a patient with pigmented skin, the same product could exacerbate the tendency to melasma and pigmentation. For such people, a nonorganic product is recommended. That is, for a patient with pigmented skin to obtain the benefits of soy, fractionated soy (also known as “active soy”), which has been processed to remove the pigment-inducing estrogenic components, is a preferable option. Active soy is contained in several Neutrogena products and in Aveeno's Positively Radiant line.

As another example, a patient with dry, wrinkled skin could benefit from using green tea formulations, of which several product options are organic.

Conversely, a patient who strictly uses organic products and who has oily, wrinkle-prone skin would benefit from using retinoids, even though they are not organic.

Is Organic Better?

There is no question that many natural ingredients have proven benefits when used topically. Green tea is an example. However, does it matter whether the green tea is organic?

In my opinion, the form and concentration of the ingredient are more important than whether or not the ingredient is organic.

In the case of green tea, we know that the epigallocatechin-3-gallate form is the strongest.

When green tea is included in skin care products in a high enough concentration to be effective, it turns the product brown, as seen in Topix's green tea-containing product Replenix. Replenix does not carry the organic label, but it is my understanding that it has higher levels of green tea than the organic products on the market.
What About Synthetic Products?
return to Article Outline

Often, it is only the chemical ingredients, such as retinoids, that confer a desired benefit, and no analogous organic products are available.

I love retinoids! I'll never give them up, and why should people who choose to be cautious and avoid nonorganic products miss out?

It is important for us to guide our patients in making decisions and explain to them the benefits of nonorganic products such as retinoids.

A person using retinoids can supplement them with a natural product like Jurlique Herbal Recovery Gel, thereby enhancing exposure to beneficial ingredients while limiting the use of synthetic ingredients to only the ones needed.

Jurlique is a great example of a company that, while not currently certified as “organic,” strives to manufacture a pure product line, which is especially beneficial to people with sensitive skin. Jurlique products come from Australia, a country that has long embraced the idea of organic or natural products.

Aesop, another skin care line from Australia, has a large following of customers who prefer organics. Some users of Aesop's products told me that they did not agree with my views on retinoids and were rude when I spoke to them, but Aesop's products are great, so why not combine them with retinoids, which have been proved to help acne and wrinkles?

What Next?

With the proper time and attention, most patients/consumers can find the right blend of products for their particular skin type. As a practitioner, it is best to give top priority to skin type when making recommendations, while trying to honor a patient's preferences.

Now that companies are allowed to label their products as organic, these products may become more sophisticated. In fact, I hope that the companies will research their products and look at whether they are efficacious and safe.

It is important to tell patients about the advantages and disadvantages of any products that you recommend. If a certain ingredient is good for a patient, and it is in an organic product, I recommend it. If a patient needs a particular ingredient that cannot be found in an organic product, I recommend broadening the patient's scope to include the conventional product that will best meet his or her needs.

In summary, my philosophy is, “If the ingredient is right for your skin type, and it is found in a sufficient form and concentration in the product, then why not choose natural or organic?” However, there are few well-researched natural products on the market, and there are even fewer, if any, well-researched organic products at this time.

I drink organic milk. I am ready to switch from some of the products I now recommend and start recommending organic skin care products instead. I am just waiting for someone to show me convincing evidence that they work!

PII: S0037-6337(06)71797-1

doi:10.1016/S0037-6337(06)71797-1

© 2007 Elsevier Inc. All rights reserved.