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Laundry Detergent | Is this really the cause of your rash?

Updated: Jun 24, 2023

Laundry detergents are products that many people place at the top of their list when they developed rashes or sensitivities of their skin. Ironically, they are not routinely the cause. Read more...
 

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Why do Dermatologists need to understand laundry detergent?



Laundry detergents are products that many people place at the top of their list when they developed rashes or sensitivities of their skin. Ironically, they are not routinely the cause. To really understand why this is the case and what to look for in a detergent if you suspect it's the cause of your symptoms, it helps to review the components of laundry detergents.




Video: Techei


What is in a laundry detergent?



In general, laundry detergents will contain ingredients focused on surfactants, enzymes, chelating agents, brightening agents, fragrances, colorants, and a miscellaneous category of ingredients focused on color protectants and regulating the foam in the wash.



Cleansing agents are known as surfactants. Surfactants are polar particles where one end ‘likes’ various components of ‘dirt’ or soil in fabrics and one end ‘likes’ water. The end that ‘likes’ soil attaches itself to the oil on the fabric like a magnet. This leaves the end of the particle that ‘likes’ water exposed. The exposed end of the surfactant that’s looking for water finds it readily in the washing machine and attaches like a magnet to the water. This pulls the soil off the fabric and keeps it suspended in the water to reduce the likelihood of it redepositing on the fabric until it rinses away with the water.


 


 


Chelating agents work like water softeners to reduce the impact of minerals in water from causing discoloration in fabrics and reducing the tendency toward soap scum. Soap scum can reduce the ability of a detergent to do its job. In this category, you may have heard of names such as sodium citrate, other sodium salts, and EDTA.



Enzymatic agents break down specific types of stains. Given the vast array of sources for stains in clothing, there will often be a cocktail of different enzymes in detergents, each one with a different target. For example, lipases are used to target greasy stains such as fatty materials, butter, and oil. Proteases are focused on breaking down protein-based stains. An example of a protease is Subtisilin. Proteases are focused on blood, sweat, and grass as these stains have a high affinity for textiles making them more challenging to remove. Amylases are focused on starch-based stains caused by foods such as spaghetti, chocolate, and potatoes. Mannanase is used to break down sugars.



Brightening agents are used in detergents to have whitening effects or brightening effects. These are designed to be left behind on the fabric. Once deposited in the textile, they convert UV light into blue light which gives a brighter look to most colors. These will often be listed as fluorescent brighteners on the label. Remember that this is fine for the average person, however, if military uniforms or gear is cleaned with detergents that contain these brighteners, it can place them at risk given the light emitted from the clothing that can be picked up by night vision goggles.



Fragrances are designed to be left behind in the textile to provide a clean fresh smell. Some of these scents are designed to linger for longer stretches of time which can benefit items that are not frequently washed. Lighter scents will be more obvious right after a wash.



Benzyl benzoate has been added to some laundry detergents to particularly target dust mites that have been demonstrated not completely to be removed by the laundry cycle. This ingredient has been associated with skin reactions.




Have surfactants been linked to skin rashes?



In shampoos, examples of surfactants are sulfates while in detergents you will see sulfonates among other products. These may have the potential to irritate the skin if retained in the textile and not completely rinsed out. Examples found in medical studies as linked to contact dermatitis include Decyl glucoside and Lauryl glucoside. In addition, propylene glycol has been used in detergents to avoid soil and dirt from redepositing on textiles during the wash and has also been linked to skin reactions.



Have chelating agents been linked to skin rashes?



Again, these are focused on the water and not the textile, and less likely to linger in clothing, and are less commonly associated with skin reactions.



Have enzymatic agents been linked to skin rashes?



Enzymatic agents have been studied and found to be less likely to cause skin reactions, likely because they also are not left on the textile routinely after the wash.



Have fragrances been linked to skin rashes?



Fragrances have been found to potentially be linked to contact dermatitis and found to be the most likely cause of allergic contact dermatitis from detergents in those that develop reactions from laundry detergent use.



Has Benzyl Benzoate been linked to skin rashes?



This ingredient has been associated with skin reactions.



What are the most common triggers for skin rashes with regard to laundry detergent?



When it comes to fabric care as skincare, the agents that appear to come up most frequently in allergy testing are fragrances and preservatives such as formaldehyde can often come up as triggers for allergic contact dermatitis. If the detergent is not completely rinsed out of the clothing- think college kids overloading the washing machine and thinking the detergent will actually move around when it has no space to do so- the actives in detergents such as the surfactants and enzymes can be left behind on the textiles. When sweating these can impact the skin directly and trigger irritant contact dermatitis. Preservatives in detergents may be left behind on textiles from incomplete rinse or they may even be meant to do so to help retain the fragrances in the product after the wash. The most common triggers from the preservative category are :

  • Benzisothiazolinone

  • Cocamidopropyl betaine

  • Methylisothiazolinone

  • Methylchloroisothiazolinone

  • Phenoxyethanol

Contact dermatitis to laundry detergents is rare and when it has occurred it has been thought to have a stronger correlation to preservatives such as methylisothiazoline. A study evaluating contact dermatitis to laundry detergents showed that not only was it rare, but the researchers also could not reproduce the results in most cases.



One of my favorite articles to quote is a letter from Dermatologist Dr. Rockoff from Boston to our main Dermatology journal the Journal of the American Academy of Dermatology entitled “Detergent Allergies: An urban legend”. Toward the end of his letter, he says:

“Several years ago I called the laundry departments of several teaching hospitals in Boston, Massachusetts, to ask about their procedures when wards send down sheets with the message that a patient is allergic to the detergent in their bedclothes. “Can I be frank?” asked one laundry director, in a conspiratorial tone. “We wash them again, pack them in a different-colored wrapper, and send them back up.” “Then what happens?” I asked. “Nothing,” he said.”

I couldn’t agree more.




Do you have any laundry product recommendations?


  • Tide Pods Free & Gentle Laundry detergent: this detergent is free of fragrances and does not have the above most commonly found allergens in terms of preservatives. (even All Free has these preservatives and All baby has both the preservatives of concern and the fragrances). The word “free” tends to only reference fragrances and not to preservatives.

  • Dreft Pure gentleness liquid detergent is fragrance-free and free of these preservatives.






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