Natural Skin Care.

Natural skin care uses topical creams and lotions made of ingredients available in nature. Much of the recent literature reviews plant-derived ingredients, which may include herbs, roots, flowers and essential oils, but natural substances in skin care products include animal-derived products such as beeswax, and minerals. These substances may be combined with various carrier agents, preservatives, surfactants, humectants and emulsifiers.

There are no legal definitions in the U.S. for advertising terms "natural" or "organic" when applied to personal care products. Consumers often express a preference for skin products with organic and natural ingredients. The personal skin care market based on natural products has shown strong growth. Clinical and laboratory studies have identified activities in many natural ingredients that have potential beneficial activities for personal skin care,but there is a shortage of convincing evidence for natural product efficacy in medical problems.

Some natural products and therapies may be harmful, either to the skin or systemically. People prone to allergies should pay careful attention to what they use on their skin. Dermatologists may feel that there is enough scientific evidence to assist in the selection or avoidance of particular natural ingredients.

Many countries require that the ingredient composition of skin care products is listed on the product, using the International Nomenclature of Cosmetic Ingredients (INCI) conventions. Ingredients are listed in the order of their percentage within the product; natural ingredients are listed in Latin and synthetic ingredients are listed by technical name. "The U.S. government has documented more than 10,500 ingredients in cosmetic products, but only a small percentage of those chemicals have been tested for safety. Of those that have been tested, some have been identified as carcinogens (causes cancer), teratogens (causes birth defects), and reproductive toxicants (damages the ability to reproduce)."

The FDA surveyed 1,687 consumers ages 14 and older in 1994 about their use of cosmetics. Nearly half of these consumers felt that a product claiming to be "natural" should contain all natural ingredients. However, although the United States Department of Agriculture (USDA) has designated within its certain requirements within its specific area of regulation for organic products, the U.S. Food and Drug Administration (FDA) does not recognize a definition for natural products. Accordingly, there are no legal definitions in the U.S. for the advertising terms "natural" or "organic" in personal care products. The FDA prohibits certain ingredients in cosmetics.

Some organic products which are designated organic may be intensely modified, sometimes considerably more so than conventional products.

Plant extracts and herbs have been used by many cultures as cosmetics and perfumes since ancient times.

Research is scientifically assessing natural products, selected based on experience in the ancient era. Validated use of these materials and products awaits further assessment.

There are significant reservations about complementary and alternative medicine (CAM) including a "shortage of evidence supporting the efficacy and safety of CAM" for skin problems. However, patients express a desire to utilize natural ingredients as treatment. A literature search found a growing prevalence of CAM use for skin conditions. A number of textbooks address CAM perspectives of skin care. The purpose of this section is to review botanical compounds in skin care; a broader review the history and theory behind other CAM modalities such as psychocutaneous therapies, acupuncture and homeopathy can be found in recent reviews.

Ayurveda

Ayurvedic skin care is derived from medicinal practices that began over 5,000 years ago in India. Ayurvedic medicine and healing practices are based on Indian philosophical, psychological, conventional, and medicinal understandings. Most of the ayurvedic skin care products contain the following herbs—aloe vera, almond, avocado, carrot, castor, clay, cocoa, coconut oil, cornmeal, cucumber, cutch tree, emu oil, ginkgo biloba, ginseng, grape seed oil, ground almond and walnut shell, horse chestnut, witch hazel and honey.

Ayurvedic approaches have been used in molluscum contagiosum, lymphatic filariasis, vitiligo and lichen planus.

Phyllanthus emblica (amla, Indian gooseberry) has been used in ayurvedic medicine. Standardized extracts of Phyllanthus emblica have a long-lasting and broad-spectrum antioxidant activity. This may be suitable for use in anti-aging, sunscreen and general purpose skin care products.

Cosmeceuticals are topically-applied, combination products that bring together cosmetics and "biologically active ingredients". Products which are similar in perceived benefits but ingested orally are known as nutricosmetics. According to the United States Food and Drug Administration (FDA), the Food, Drug, and Cosmetic Act "does not recognize any such category as "cosmeceuticals". A product can be a drug, a cosmetic, or a combination of both, but the term "cosmeceutical" has no meaning under the law". Drugs are subject to an intensive review and approval process by FDA. Cosmetics, and these related products, although regulated, are not approved by FDA prior to sale.

Cautions

Some alternative and natural products and therapies may be harmful, either to the skin or systemically.

The FDA recommends understanding the ingredient label and says "There is no list of ingredients that can be guaranteed not to cause allergic reactions, so consumers who are prone to allergies should pay careful attention to what they use on their skin", further warning that "[t]here is no basis in fact or scientific legitimacy to the notion that products containing natural ingredients are good for the skin". Food preservatives are commonly used to preserve the safety and efficacy in these products. Alternative remedies may increase the prevalence of eczema. Bhuchar recommends that "ingestible substances including most homeopathic, Ayurvedic, and traditional Chinese medicine herbal formulations that are not US FDA regulated should be viewed with caution as they may cause severe adverse effects" such as arsenic poisoning and liver failure."

Given the shortage of evidence for natural skin care efficacy, if applied it may often need to be used in combination with conventional treatment, rather than independently.

According to Bhuchar, there is a consensus in the literature that dermatologists need more information about CAM. Wu advises that "dermatologists should be aware of what patients may be using and be able to advise them about the efficacy of these ingredients or the potential for adverse effects". Many patients fail to inform their physicians about their use of herbal ingredients. 

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