Are gluten-free skin and body products important for people with celiac disease?

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Melinda Dennis MS, RDN, LDN
I am unsure of the importance of using gluten free skin and body products for someone with Celiac Disease? For example, lotions, makeup, shampoo, conditioner, lip balm or lipstick, etc., things that do not pass through the GI tract necessarily. Even touching things like Play Doh... Is the skin contact dangerous for Celiacs? I have heard mixed information from several sources. And when the person has little to no outward symptoms when glutened, it's hard to know how to proceed with these choices!

Answer


Per celiac gastroenterologist, Dr. Alessio Fasano, “there is currently no scientific evidence that gluten used in cosmetics that are not ingested is harmful to individuals with celiac disease, including those with dermatitis herpetiformis (the skin form of celiac disease). If you have celiac disease, then the application of gluten-containing products to the skin should not be a problem, unless you have skin lesions that allow gluten to be absorbed systemically in great quantities. The reason why this should not be a problem is that, based on what we know right now, it is the oral ingestion of gluten that activates the immunological cascades leading to the autoimmune process typical of celiac disease.”¹

Dr. Fasano’s statement applies to products applied to the skin or hair, such as body lotion, shampoo, conditioner, sunscreen, shaving cream, deodorant, makeup, and perfume, especially if hands are washed after use.

A few details to consider:

  • Hand lotion –an “in-between” case. Some gluten exposure could occur if the individual uses a lot of lotion and does not wash his/her hands before eating.
  • Products used in and around the mouth, such as lipstick, are more suspect. Even if they do contain gluten derivatives, per dietitian Tricia Thompson’s calculation, it would likely only contribute very minimal gluten to the diet. There was no quantifiable gluten found in any of the four lip products and two lotions containing ingredients derived from wheat, barley, rye, and oats that were tested in her 2012 study.¹

That being said, it is my clinical experience that several patients with celiac disease and dermatitis herpetiformis have reported reactions to what appears to be topical exposure to gluten (or air-borne in the case of hair spray) in body care products and that this reaction resolved once they stopped using the gluten-containing product. We do not know for certain if it was a gluten-containing ingredient or some other ingredient that caused the reaction, or if the product was tested for gluten. However, each of us knows our own body best. I support my patients who follow a gluten-free diet in selecting cosmetics free of gluten, in particular lip products and hair and face lotion, should they choose to do so.

People with a wheat allergy are recommended to avoid skin or body products containing wheat.

Here are some tips on selecting gluten-free products for the concerned consumer:

  1. Read the ingredients listed on cosmetics looking for the words “wheat,” “barley,” “malt,” “rye,” “oat,” “triticum vulgare,” “hordeum vulgare,” “secale cereale,” and “avena sativa.”
  2. Look for off-packaging ingredient lists when the product packaging is too small to include this information on the label. This may be in the form of tear sheets located next to the product display case.
  3. Contact cosmetic companies when ordering products by mail order and ask whether their products contain any derivatives of wheat, barley, rye, or oats.
  4. Use cosmetics labeled gluten-free. An increasing number of manufacturers are labeling their products.”¹

The Food and Drug Administration (FDA) does not issue rules addressing the use of the term ‘gluten-free’ in labeling of cosmetics. Therefore, gluten does not have to be definitively declared on cosmetic labels. The FDA, however, does not prohibit cosmetic companies from labeling products gluten-free.

More studies are needed on the gluten content of cosmetics containing ingredients derived from wheat, barley, rye, and oats, particularly for the lips and hands.

Play Doh™ is made from wheat flour. As long as it is not eaten and hands are washed carefully after use, it is ok to use. However, since children often have their hands in their mouths, I prefer to recommend gluten-free Play-Doh™ whenever possible. There are gluten-free recipes online.

¹Reference: Thompson T, Grace T. Gluten in cosmetics: is there a reason for concern? J Acad Nutr Diet. 2012 Sep;112(9):1316-23.

Note: This information is provided by NCA and Melinda Dennis, NCA's Senior Consulting Dietitian. This information is meant for educational purposes and is not intended to substitute for personalized medical advice or replace any medical advice provided directly to you by your health care provider. This information can be printed and used in consultation with your physician or dietitian. No liability is assumed by NCA, Ms. Dennis or her nutrition consulting service Delete the Wheat, LLC. by providing this information..

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About Melinda Dennis MS, RDN, LDN

Melinda Dennis, Senior Nutrition Consultant for NCA, is an expert celiac dietitian and and Nutrition Coordinator for the Celiac Center at Beth Israel Deaconess Medical Center in Boston, MA. Diagnosed with celiac disease in 1990, she specializes in the nutritional treatment of patients with celiac disease and gluten-related disorders.

Melinda lectures internationally and has written extensively on the nutritional management of celiac disease including the award-winning book Real Life with Celiac Disease. Melinda was the original founder of NCA in 1993 and so it is only fitting that she comes back to us in this capacity. We are truly honored to have her on our team.