I have never been comfortable telling patients to use Baby Shampoo for lid scrubs. I know it says, “No Tears” on the bottle, but that does not mean it was supposed to go into the eye. Now that there are alternatives, why recommend it? While I don’t, I am frequently told by new patients they were told to use baby shampoo on their lids. There are several reasons why I do not recommend this practice.
Problematic ingredients in baby shampoo
For starters, I do not recommend cosmetics that contain hazardous materials to be used around the eye. In conjunction, if you look at the ingredients of baby shampoo, you will see several problematic ingredients. Johnson and Johnson removed formaldehyde and 1,4-dioxane from its baby shampoo in 2013 but it contains other harmful ingredients. The first is fragrance, which does not need to be defined according to the FDA so you can’t be sure what that means.
Baby shampoo can also contain phenoxyethanol, which irritates mucus membranes in skin, eyes, and/or lungs. It has also been associated with allergies and immunotoxicity.
Another problematic ingredient is cocamidopropyl betaine. Dermatitis (a condition of the skin in which it becomes red, swollen, and sore, sometimes with small blisters, resulting from direct irritation of the skin by an external agent or an allergic reaction to it) has been reported with its use.[i] This is also associated with allergies, immunotoxicity, and ecotoxicology.
If the environment is at risk, why put it near your eyes?
Finally, by definition, the “shampoo” is a detergent. Detergents in the eye disrupt the tear film, which will exacerbate ocular inflammation. Murphy, et al, reported a significant increase in inter-eye variability in subjects using baby shampoo, and suggested this may indicate an increase in ocular surface inflammation.[ii]
Another reason I do not recommend its use is that most of my patients do not have only blepharitis. They typically have meibomianitis (inflammation of the meibomian glands), gland loss, chronic inflammation, or dermatitis – where other preparations are better suited.
With alternatives on the market that do NOT contain harmful ingredients, why suggest baby shampoo?
Alternatives include: Hot compresses for 10 minutes with no solution.
[i] Welling JD, Mauger TF, Schoenfield LR, Hendershot AJ. Chronic eyelid dermatitis secondary to cocamidopropyl betaine allergy in a patient using baby shampoo eyelid scrubs. JAMA Ophthalmol. 2014 Mar;132(3):357-9. DOI: 10.1001/jamaophthalmol.2013.6254.
[ii] Murphy O, O’ Dwyer V, Lloyd-McKernan A. Cont Lens Anterior Eye. 2019 Sep 20. pii: S1367-0484(19)30111-0. DOI: 10.1016/j.clae.2019.09.003.