People with celiac disease are accustomed to being on the lookout for gluten in their food, but they should also be aware of the gluten lurking in their cosmetics and toiletries, researchers warned Monday at a national meeting of gastroenterologists in Washington, D.C.
Food labels almost always say whether a product contains gluten, a type of protein found in wheat, barley, and other grains.
But the packaging of body lotions and other beauty products rarely provides that information, even though many such products contain substances derived from grain, says Pia Prakash, M.D., a resident in internal medicine at George Washington University.
"Lipsticks and powders and foundations are probably the ones we worry about most, and you really never see ingredient lists on those products," says Prakash, who helped conduct the research.
She and her colleagues surveyed the websites of 10 leading makeup companies, Prakash says, and found that "none actually provided any information on products that contained gluten".
An estimated 2 million people in the United States have celiac disease. When these people consume gluten, their immune system attacks structures (known as villi) that line the small intestine and are crucial for absorbing nutrients from food.
Symptoms can include diarrhea, bloating, weight loss, fatigue, and joint pain. The only way to treat celiac disease is to avoid eating gluten.
At the annual meeting of the American College of Gastroenterology, Prakash and her colleagues presented a case report on a 28-year-old woman with celiac disease who had successfully controlled her symptoms for several years by restricting the amount of gluten in her diet.
After starting to use a new body lotion, however, the woman developed an itchy, blistering rash on her arms, as well as abdominal bloating and diarrhea - all of which disappeared once she stopped using the lotion.
Pretty much anyone who's sensitive to gluten could experience a similar reaction, says Marie Borum, M.D., the lead author of the study and a professor of medicine at George Washington University.
Gluten can't be absorbed through the skin, but people may accidentally ingest small quantities of lotion, lipstick, or other products if they have the product on their hands or use it around their mouth.
Health care providers and consumers alike need to be aware of the potential for this type of inadvertent gluten exposure, Borum says. "If you're just focusing on food intake, you may be missing something that's very important and could make a difference in someone's life".
So how can celiac patients avoid hidden gluten in toiletries and cosmetics? A handful of companies do make gluten-free cosmetics, and consumers can also contact manufacturers directly to find out which of their products contain gluten.
(An informal survey of online forums for celiac patients shows that many companies are forthcoming with this information.)
When products do list their ingredients, careful label reading is a must, but simply looking for the word "gluten" isn't sufficient, the researchers say. For instance, the vitamin E found in beauty products may be derived from wheat and contain gluten, even though the label just lists "vitamin E," Borum says.
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