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Tole­rable make-up options for Sali­cylate Sensi­ti­vity, AERD & MCAS

As an anal­gesic-asthma sufferer and sali­cylate into­le­rant woman who never used to leave the house without makeup, it was a shock to realize that all cosmetic products usually contained sali­cylates and could there­fore trigger symptoms. Not just once did I suffer from swel­ling of the eyelids and/or lips because I felt I had to test whether this or that makeup really caused me problems because it contained sali­cylates. So I think it’s important to share my expe­ri­ence and explain how I prepare my make up.

There are some makeup formu­la­tions that do not contain sali­cylates, espe­cially if they are mineral foun­da­tions. However, the latter some­times contain irri­t­ants that can cause allergic reac­tions, such as bismuth oxychlo­ride. Luckily, there are manu­fac­tu­rers like Lily Lolo that produce foun­da­tions that do not contain them.

I am spon­sored by * none * of the named cosmetic compa­nies, espe­cially Lily­Lolo, but just want to share my expe­ri­ences so that they might help someone. In the case of skin dise­ases, aller­gies and into­le­rances, I always ask you to do your own rese­arch and, if necessary, to consult medical staff if you are unsure. Thank you, your Lisa.

Subs­tances in makeup that are not tole­rated by people with sali­cylate intolerance

Sali­cylic acid is not only used in higher doses in creams against skin blemishes or for callus removal, but it is also contained as a preser­va­tive in many cosme­tics. Even so-called “organic cosme­tics”, which do not use indus­tri­ally produced preser­va­tives, are often not an alter­na­tive for people with sali­cylate into­le­rance, because they very often use sali­cylic acid as their main preser­va­tive, which is natu­rally contained in plant extracts.

Like­wise, in addi­tion to plant extracts, oils that are very high in sali­cylate, such as olive or coconut oil, are often included in organic products and can also trigger symptoms.

Often, sali­cylate into­le­rance, or NSAID into­le­rance, occurs in the context of Samter’s disease (AERD) with the main symptoms of the dise­ases being asthma and the forma­tion of nasal polyps. Not too infre­quently though, sali­cylate into­le­rance is seen in poeple with mast cell acti­va­tion syndrome (MCAS) or it is paired with other allergic symptoms as well as fragrance into­le­rance, so: the fewer and the less irri­ta­ting the ingre­dients, the better.

The Solu­tion? The Ingre­dients of Mineral Foun­da­tions in Detail

If you’re looking into irri­tant-free cosme­tics that are as unscented as possible, sooner or later you’ll come across mineral-based loose foun­da­tions, which are usually unscented and are made of mineral parti­cles that in most cases don’t trigger allergic reac­tions. However, the liquid mineral makeup formu­la­tions often contain oils and subs­tances that may cause problems.

But there is often a catch with mineral-based powders/cosmetics: They contain the subs­tance bismuth oxychlo­ride / CI 77163, which has a repu­ta­tion for being able to trigger allergic reac­tions due to its parti­cular crystal­line structure.

Although the FDA consi­ders the subs­tance unpro­ble­matic in small doses as an addi­tive in cosme­tics [1], if alter­na­tives are avail­able, these should usually be preferred. In an in vitro study, human kera­ti­no­cytes, horn forming cells of the upper skin layer, were exposed to bismuth oxychlo­ride in nano form and the rese­ar­chers were able to demons­trate cell toxic effects caused by this subs­tance. However, since makeup does not usually contain nano­par­ti­cles, this result should not be over­stated [2].

Expe­ri­ences with mineral-based foundations

Pros

Mineral foun­da­tions usually don’t have a scent and consist of only a few ingre­dients. Often, among other things, zinc oxide is included, which can have a bene­fi­cial effect on skin blemishes and is also a natural sun protec­tion factor (SPF). Various iron pigments are then used to color the powder, which are also usually tole­rated by sensi­tive people.

The company Lily Lolo does not use bismuth oxychlo­ride in its formu­la­tions and provides many beau­tiful nuances for diffe­rent skin tones. To find the optimal shade for one’s own skin tone, the loose powder foun­da­tions are very easy to mix, which I like to take advan­tage of: depen­ding on the season, I mix “Barely Buff” and “Popcorn” in the ratio that suits me. [I added the lette­ring on the powder cans so I don’t mix them up 😉 So normally the powder cans come without any scribbly handwriting…]

Cons

Using mineral-based foun­da­tions is a comple­tely diffe­rent expe­ri­ence than oil-based organic cosme­tics or sili­cone- and paraben-contai­ning normal cosmetic formu­la­tions. It is a loose powder that is best applied with a dense kabuki brush. (You really have to invest in some good brushes, other­wise you will make yourself unhappy.)

And yes, unfor­tu­n­a­tely the loose powder tends to settle into wrinkles — no need to sugar coat that either. Espe­cially when it comes to wrinkles around the eyes, mineral powder can tend to make them a bit more pronounced over the course of the day.

As a former wearer of 24h makeup (my “MCAS self” shakes her head), I just have to say that mineral foun­da­tions don’t come close to long-lasting 24H formu­la­tions, espe­cially when swea­ting, but I was still amazed at how well they held up.

The zinc oxide in these powders can help against shine and oily skin, but this can also turn into an disad­van­tage as they unfor­tu­n­a­tely can lead to skin dryness and the feeling of tigh­tened skin.

Pros of Mineral Foun­da­tions (powder)Cons of Mineral Foun­da­tions (powder)
Less ingre­dients + no scentGetting used to applying it correctly
Econo­mical in consumptionMore expen­sive to buy
Many diffe­rent nuances + easy to mixCan pronounce some wrinkles
Natural SPFNot long-lasting when sweating
Reduces shine and oilinessCan increase skin dryness
Can help with blemishes

Testing the tole­rance of mineral makeup in sali­cylate into­le­rance and MCAS.

Case 1: My personal experience

I was very happy that I found a makeup I could tole­rate — given my sali­cylate into­le­rance and MCAS. I had already gotten into the habit of being comple­tely without makeup, but the skin simply looks more even with makeup and you can conceal the dark circles or redness, so I missed wearing make-up to “soften” those little imper­fec­tions very much in that time.

I don’t have to deal with skin blemishes apart from medi­ca­tion-induced ones (steroid acne anyone?!). I also do not suffer from dry skin, although I have noticed that these powders can dry out the skin more easily.
Because I sweat rather quickly and shine, I addi­tio­nally apply a finis­hing powder (SPF 25 Mineral Veil powder — without bismuth oxchlo­ride) over my mineral foun­da­tion from Lily Lolo, espe­cially in summer.

The finis­hing powder has an even higher SPF than Lily Lolo’s Mineral Foun­da­tion (SPF 15), which is also great for me because of my photo­sen­si­ti­vity. However, without me applying suncream before using the mineral-based foun­da­tion, I would probably be struggling more with feelings of tight­ness or dryness.

Case 2: A good friend’s expe­ri­ence with sali­cylate into­le­rance and MCAS

One of my best friends also suffers from sali­cylate sensi­ti­vity and MCAS. She is in her early 20s and has signi­fi­cantly more problems with skin blemishes. Aside from allergic reac­tions, many cosme­tics worsen her skin condi­tion. In her case, the use of Lily Lolo powders has led to an impro­ve­ment in her skin’s appearance and she is very happy that she can cover the blemishes and redness.

Case 3: Expe­ri­ence of a patient with MCAS

One of my pati­ents who suffers from a pronounced form of MCAS has also tried the Lily Lolo Foun­da­tions. She is now in her mid-40s and comp­lained about the powder’s ability to settle into wrinkles under the eyes, naso­la­bial lines and other areas when applied (too) liber­ally. However, the tole­ra­bi­lity of the powder was also good in this case allergy-wise.

However, she tends to have very sensi­tive, dry skin and she found the makeup unplea­sant and rather irri­ta­ting to the skin when applied frequently. For ever­yday wear, the powder is there­fore not working in her case.

Conclu­sion

Despite the limi­ta­tions mentioned above, mineral foun­da­tions can be an alter­na­tive for people with sali­cylate into­le­rance, MCAS or fragrance into­le­rance. Lily Lolo’s products are often a bit cheaper compared to BareMinerals.

I use the following combi­na­tion with these ingre­dients (as of January 2021). In any case, please check if the compo­si­tion has changed and if so, feel free to let me know here in the comments. Thank you!

As makeup: Mineral Foun­da­tion by Lily Lolo — I use the colors “Popcorn” and “Barely Buff” for my fairer skin.
Ingre­dients: MICA, ZINC OXIDE [+/- CI 77891 (TITA­NIUM DIOXIDE), CI 77492 (IRON OXIDE), CI 77491 (IRON OXIDE), CI 77499 (IRON OXIDE)]

As a finis­hing powder (espe­cially in summer): SPF 25 Mineral Veil by BareMi­ne­rals
Ingre­dients: Zea Mays(Corn) Starch, Corn Starch Modi­fied, Tita­nium Dioxide (CI 77891), Zinc Stea­rate, Silica, Magne­sium Stea­rate. (+/-): Iron Oxides (CI 77491, CI 77492, CI 77499).

As concealer: Mineral Concealer by Lily Lolo — I use the color “Barely Beige” for my lighter skin.
Ingre­dients: KAOLIN, ZINC OXIDE [+/- CI 77891 (TITA­NIUM DIOXIDE), CI 77492 (IRON OXIDE), CI 77491 (IRON OXIDE), CI 77499 (IRON OXIDE)]

As blush: Mineral Blush by Lily Lolo — I use the color “Cherry Blossom”
Ingre­dients: MICA [+/- CI 77491 (IRON OXIDE), CI 77492 (IRON OXIDE), CI 77891 (TITA­NIUM DIOXIDE), CI 75470 (CARMINE)

Is there any suitable non-mineral makeup for sali­cylate intolerance?

I have not found any option so far: If the loose formu­la­tions are not tole­rated, perhaps the “creame” formu­la­tions of the mineral makeups might be some­thing. These tend to have less tendency to settle, keep the skin smoother, and can be applied like “normal” makeup. However, they usually contain a wide variety of sili­cones. Whether you want that is a matter of personal prefe­rence. Sili­cones also contain no sali­cylates and have long been used in the medical and cosme­tics industries.

Luckily mineral-based products from compa­nies like Lily Lolo or BareMi­ne­rals are due to incre­a­sing poplu­la­rity now avail­able in many diffe­rent coun­tries all over the world.

Refe­rences

[1] U.S. Food & Drug Admi­nis­tra­tion (Info April, 2020): https://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfcfr/CFRSearch.cfm?fr=73.2162&SearchTerm=bismuth%20oxychloride

[2] Gao X, Zhang X, Wang Y, Wang Y, Peng S, Fan C. An in vitro study on the cyto­to­xi­city of bismuth oxychlo­ride nano­s­heets in human HaCaT kera­ti­no­cytes. Food Chem Toxicol. 2015;80:52–61. doi:10.1016/j.fct.2015.02.018

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Natur­o­path, hypno­the­ra­pist, owner of an immune system gone crazy with various auto­im­mune special effects. She likes reading through medical papers and is an avid learner of all things regar­ding the human immune system. When her joints and body allow it: enthu­si­astic do-it-your­selfer around the house.

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