The emergence of “clean beauty” as a consumer label has become a notable marketing trend, developed in the absence of standardized regulatory definitions, and it has been associated with shifts in consumer behaviors on a global scale. Terms such as “natural,” “organic,” and “cruelty-free” are frequently used without clear definitions, complicating safety assessments and potentially misleading both consumers and clinicians. Although these products are marketed as safer alternatives, emerging evidence challenges this assumption. The exclusion of certain ingredients, such as parabens, has in some cases led to substitution with more allergenic compounds, including isothiazolinones, contributing to rising cases of allergic contact dermatitis.1 Analysis of pediatric-targeted “clean” products reveals the presence of potential allergens such as fragrances and cocamidopropyl betaine, which can exacerbate conditions such as atopic dermatitis in vulnerable populations.2 A critical gap exists between marketing claims and evidence-based dermatological guidance in the clean beauty space, particularly with product labelling and its implications for inflammatory dermatoses. This review addresses the gap by evaluating the current literature to inform clinical decision-making and enhance patient education.
METHODS
This review was conducted using the PRISMA-ScR guidelines. A comprehensive search strategy was developed to identify literature intersecting clean beauty marketing, dermatological relevance, marketing and consumer perceptions, and inflammatory skin conditions. A search was conducted across MEDLINE, Embase, Scopus, and Web of Science in January 2025, including all studies from 2015 to 2024. A total of 72 articles were identified. Full text review was conducted independently by the authors, which included seven studies. Standardized data were collected, and findings were synthesized narratively.
Eligibility Criteria
Eligibility criteria included studies on all populations, especially those with inflammatory dermatological concerns, including but not limited to acne, eczema, contact dermatitis, psoriasis, rosacea. The intervention included skincare or cosmetic products marketed, labeled, or described using terms associated with “clean beauty,” such as “clean,” “green,” “natural,” “organic,” “non-toxic,” or “chemical-free.” Outcomes studied included adverse reactions, such as irritation, allergy, or contact dermatitis; clinical efficacy such as anti-inflammatory or antimicrobial effects; safety profiles; and allergenic potential of the products. All designs were eligible, including observational studies, experimental studies, in vitro or laboratory-based studies, and individual case reports or case series published in English within the past 10 years, as consumer trends reflect marketing cultural contexts and evolve rapidly.
RESULTS
This scoping review identified seven studies published between 2015 and 2024. Studies showed considerable heterogeneity in design, including observational studies (n = 1), case studies with literature review (n = 1), experimental lab testing (n = 3), in vitro studies (n = 1), and cohort analysis of product data (n = 1), but the predominant methodological approach involved laboratory evaluation of natural ingredients, with limited clinical testing on human subjects. Various skin conditions were also reviewed. Among the studies included, acne vulgaris was the most frequently addressed condition (3 studies, 42.9%). Contact dermatitis and atopic dermatitis/eczema were each examined in a smaller but still notable proportion (2 studies each, 28.6%). Less commonly studied conditions included urticaria (1 study, 14.3%), wounds and inflammation (1 study, 14.3%), UV-induced skin damage (1 study, 14.3%), hyperpigmentation (1 study, 14.3%), and xerosis (1 study, 14.3%).
Antimicrobial and Anti-inflammatory Properties
Natural extracts demonstrated variable antimicrobial activity against dermatologically relevant pathogens, primarily tested through in vitro methodologies (Table 1).
A descriptive-experimental study combining laboratory testing with consumer sensory evaluation reported 100% reduction in acne by Day 12 using 8% Tamarind leaves soap in limited experimental studies.3 Similarly, a case study and literature review documented rapid resolution of inflammatory dermatitis with unstandardized Manuka honey application.4
A notable inverse relationship was observed between antimicrobial efficacy and safety, with the most potent agents (essential oils) exhibiting higher cytotoxicity. Thymus citriodorus essential oil demonstrated strong activity against acne-associated bacteria but had an EC50 of 0.01%, indicating potential for irritation at therapeutically relevant concentrations.5
Product Labeling and Consumer Safety
A systematic analysis of product labeling revealed significant discrepancies between marketing claims and actual ingredient composition. A cohort study of publicly available product data on the top 100 body moisturizers across Amazon, Walmart, and Target found that only 12% were free of allergens identified by the North American Contact Dermatitis Group (NACDG), 45% of products labeled “fragrance-free” contained botanical fragrance ingredients with known allergenic potential, and 83% of those marketed as “hypoallergenic” included at least one NACDG allergen.6 One included study identified 121 cosmetic ingredients marked as “natural” associated with contact allergy.7 Claims such as “dermatologist recommended” and “noncomedogenic” were not associated with reduced allergen presence. These findings align with observation that products marketed as “natural” often contained allergens.2
Adverse Effects
Reported adverse effects varied by ingredient class and concentration (Table 2). Essential oils demonstrated the highest rate of adverse effects, with cytotoxicity observed in vitro for Thymus citriodorus essential oil and mild cytotoxicity for green tea extract.6,8
DISCUSSION
The terminology used in dermatology marketing has evolved rapidly, driven by consumer concerns about safety and health. Labels such as “clean,” “green,” “vegan,” “eco-conscious,” “microbiome-friendly,” “non-toxic,” “plant-based,” “cruelty-free,” and “biomimetic” have become widely advertised and accessible on the internet. Despite their popularity, these terms lack standardized definition or regulatory oversight.9 These terms are not defined or enforced by any governing body, yet consumer attitudes can be heavily influenced by these labels, leading to misleading assumptions on product gentleness or efficacy.10
Definitions and Dermatologic Relevance
of Common and Emerging Terms
“Clean Beauty” and “Natural Beauty”
The “clean beauty” nomenclature, adjacent to “natural skincare,” is proposed by each brand with internal definitions and policies on marketing.11 Consumer perceptions, especially those of young women driven by social media marketing, understand it as a lifestyle- and values-driven choice, creating strong preference and brand loyalty through an unclear association with skin safety, ethical practices, and sustainability.12 However, there is no universally accepted definition, and it serves as a branding tool promoting “safe” and “non-toxic” through exclusion of certain ingredients, rather than creating a clinically meaningful distinction. A marketing surveillance study with chemical analysis and exposure estimation notes that diethyl phthalate (DEP) was present in more than 40% of tested cosmetic products in Canada, including baby lotions and skin cleansers, with concentrations as high as 2.6% in some fragrances.13 While products marketed under the “clean” label often pledge to exclude phthalates, there is no formal standard or testing requirement to verify this, making the absence of such ingredients inconsistent across brands. Thus, although clean beauty may be less likely to contain phthalates—especially those explicitly declaring a lack of DEPs in their ingredients—the label itself offers no guarantee of ingredient safety. On the other hand, while parabens and stabilizers are often avoided by consumers, parabens are generally safe allergenic preservatives while alternatives can cause allergic reactions, and parabens are critical to prevent infections.14 The current responsibility of critically evaluating full ingredient disclosures when available falls on the consumers.
“Hypoallergenic”
“Hypoallergenic” implies that a product is less likely to cause allergic reactions. Yet, there are no standardized criteria or required tests to substantiate this claim. As noted in this review, 83% of top-selling products labeled “hypoallergenic” contained at least one known allergen from the NACDG standard allergen series.6 Brands may justify the use of “hypoallergenic” claims by testing only for irritancy rather than true allergenic potential, formulating below known sensitization thresholds, or excluding only a few common allergens such as fragrances while still including others, like essential oils and preservatives, despite the continued risk of allergic contact dermatitis.7,15 The EU cosmetics legislation requires skin sensitization assessment for all cosmetics ingredients, including the regulated ones (for which the full toxicological dossier needs to be analyzed by the Scientific Committee on Consumer Safety (SCCS). Dermatologists should advise patients with allergy-prone skin and inflammatory dermatoses to view “hypoallergenic” labels with caution, as the term could include sensitizers. Scrutinizing full ingredient lists and choosing products free from known personal allergens should be advised, to favor brands with robust safety and allergy testing beyond minimal industry standards.
“Fragrance-free”
The “fragrance-free” label is commonly interpreted to mean that a product is free of fragrance compounds that could trigger irritation or allergic reactions, but many of these products still include botanical extracts, essential oils, or masking agents that are aromatic compounds.16 Terms such as “fragrance-free” and “unscented” are often used interchangeably, despite differences in composition, with unscented products often containing fragrance-masking agents to neutralize fragrances even if not scented.10 Almost half (45%) of products labeled “fragrance-free” in the market analysis still contained fragrance-related allergens, often concealed as botanical ingredients.6 For patients with fragrance allergy, these hidden compounds pose significant risks.
“Non-comedogenic”
By definition, “non-comedogenic” suggests a product does not clog pores or cause acne. This term, however, is poorly standardized, with early and outdated definitions based on rabbit ear assays 4 decades prior.17 Although modified human comedogenic assays have been conducted since then, the concept holds significant interindividual variability. Many products include known comedogenic ingredients, such as coconut oil, isopropyl myristate, isopropyl palmitate, lanolin and derivatives, and sodium lauryl sulfate.10 Unstandardized formulations including tamarind leaf soap and Manuka honey showed positive outcomes in limited settings, but without full ingredient transparency or control for comedogenic excipients, the comedogenic risk remains uncertain.
“Paraben-free” and “Sulfate-free”
“Paraben-free” products are marketed to avoid potential endocrine-disrupting preservatives, although parabens are among the safest and most studied preservatives in cosmetics.14 “Sulfate-free” typically refers to the absence of sodium lauryl sulfate or similar detergents thought to be harsh or drying. However, alternatives contain chemically similar sulfate derivatives with the “sulfate-free” label, which can be drying and irritating while increasing the manufacturing costs, and often, higher concentrations of other surfactants would be needed to achieve similar efficacy profiles.10 These terms reflect consumer trends more than evidence-based dermatologic benefits.
“Green Beauty,” “Edible Beauty,” and “Vegan Beauty”
“Green Beauty” commonly claims plant-based and minimally processed natural ingredients providing the consumer perception of being eco-friendly,18 with “edible beauty” emerging as a concept of creating products safe enough to eat, with edible packaging, which would be recyclable and environmentally conscious.18 “Vegan” indicates that the product contains no animal-derived ingredients. While this could align with consumers’ ethical values, it has no specific dermatologic marketing goals. Edible cosmetics often utilize plant-derived polysaccharides, animal proteins, and natural antioxidants. Edible ingredients or packaging may not mean dermatologic safety because natural extracts with antimicrobial activities, such as Thymus citriodorus essential oils as discussed earlier, lead to cytotoxicity at higher concentrations. For patients with inflammatory dermatoses, occlusive edible films or balms can alter sebum flow or microbiome balance, leading to irritation and comedogenicity.18
LIMITATIONS
This scoping review is limited by significant methodological heterogeneity. The predominance of in vitro and observational studies (n=7), absence of RCTs, inconsistent operational definitions of “clean” and “natural” products, lack of a dose-response relationship evaluation, and variable outcome measures precluded meta-analysis. Selection bias toward certain conditions such as acne and atopic or contact dermatitis; inadequate reporting of formulation specifics; limited demographic data; and lack of longitudinal assessment further constrain generalizability and causal inference. These limitations highlight the need for standardized protocols and more rigorous study designs in natural cosmetic ingredient research.
CONCLUSION
Despite increasing popularity and widely perceived safety, products marketed as “clean beauty” frequently include allergenic ingredients, marketed using unregulated terms that mislead consumers. This scoping review reveals a consistent disconnect between branding language including “hypoallergenic,” “natural,” and “fragrance-free,” and actual product composition. Among the seven studies, natural skincare ingredients including protein-derived ones showed notable allergenic potential. While some plant extracts had antimicrobial effects, cytotoxicity and inconsistent formulations implicate those claims.
While select natural ingredients demonstrate promising antimicrobial and anti-inflammatory effects, these findings are largely confined to in vitro models, with a lack of robust clinical validation. Clinicians should be aware of marketing claims and advocate for transparent ingredient disclosure and standardized testing. Controlled trials and the development of regulatory frameworks are necessary define and test for dermatologic descriptions in products. n
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Collin Blattner, DO
