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Original Investigation
November 2017

Consumer Preferences, Product Characteristics, and Potentially Allergenic Ingredients in Best-selling Moisturizers

Author Affiliations
  • 1Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
  • 2medical student at Feinberg School of Medicine, Northwestern University, Chicago, Illinois
  • 3School of Medicine, Tulane University, New Orleans, Louisiana
  • 4School of Public Health and Tropical Medicine, Tulane University, New Orleans, Louisiana
  • 5Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
  • 6Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
  • 7Northwestern Medicine Multidisciplinary Eczema Center, Northwestern University, Chicago, Illinois
JAMA Dermatol. 2017;153(11):1099-1105. doi:10.1001/jamadermatol.2017.3046
Key Points

Question  What are the consumer preferences, characteristics, and ingredient profiles of popular moisturizers?

Findings  In this cohort study, 174 best-selling moisturizer products available from 3 major online retailers varied widely by price and marketing claims, with lotions being the most popular vehicle. Few best-selling moisturizers were free of potential skin allergens.

Meaning  When making recommendations to patients with skin conditions that benefit from over-the-counter moisturizer use, dermatologists should consider recommending widely available and affordable products with a low risk of potential allergenicity.

Abstract

Importance  Because moisturizer use is critical for the prevention and treatment of numerous dermatological conditions, patients frequently request product recommendations from dermatologists.

Objective  To determine the product performance characteristics and ingredients of best-selling moisturizers.

Design and Setting  This 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). Products marketed for use on a specific body part (eg, face, hands, eyelids) were excluded.

Main Outcomes and Measures  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.

Results  A total of 174 unique best-selling moisturizer products were identified, constituting 109 713 reviews as of August 2016. The median price per ounce was $0.59 (range, $0.10-$9.51 per ounce) with a wide range (9400%). 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; interquartile range [IQR], $0.56-$1.27) than products without the claim ($0.59; IQR, $0.34-$0.92). Products with the claim “phthalate free” had higher median price per ounce ($1.38; IQR, $0.86-$1.63) than products without the claim ($0.59; IQR, $0.35-$0.91). Lotions (median, $0.49; IQR, $0.31-0.68) were statistically less expensive per ounce than butters (median, $1.20; IQR, $0.76-$1.63), creams (median, $0.80; IQR, $0.69-$1.25) and oils (median, $1.30; IQR, $0.64-$2.43). 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; IQR, $0.47-$1.69) were not statistically more expensive per ounce than products with 1 or more allergens (median, $0.60; IQR, $0.35-$1.06).

Conclusions and Relevance  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.

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