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The Gluten-Free Truth about Lotions, Cosmetics and Medications: A Conversation with Dr. Dominica Gidrewicz

Curious to hear what Dr. Dominica Gidrewicz has to say about gluten in lotions and cosmetics?  Listen here as she chats with Sue Jennett on her “A Canadian Celiac Podcast.” Sue is the president of the CCA Kingston Chapter and offers a regular podcast that often features CCA thought leaders and updates.

Click here to listen: https://bit.ly/33xeJcF

Gluten in Lotions/Cosmetics

Gluten in personal care products and cosmetics, is a common concern among patients with celiac disease and other gluten-related disorders. As these products are applied around or inside the mouth there is a concern for gluten ingestion. Small amounts of these products may be accidentally swallowed, especially lipsticks, lip balms and toothpastes. Gluten absorption through the skin has not been proven to be toxic for patients with celiac disease as it cannot cross from the skin blood vessels into the intestines. It is possible that some gluten may be ingested if the person does not wash their hands after touching products prior to eating. In order for gluten to cause damage in people with celiac disease, sufficient amounts of gluten must be swallowed and pass into the small intestine where the damage occurs. The question is, can enough gluten be absorbed from any of these products to cause the intestinal damage?

There have been a limited number of studies that have looked at the gluten content in these personal care products. One recent study (2019) from Italy tested 66 oral hygiene products and cosmetics, even though none of the ingredients in these products came from wheat, barley or rye (1). The researchers studied 36 toothpastes, 2 dental tablets, 5 mouth washes, 10 lip balms, 13 lip sticks. These products were selected as they are from popular Italian stores and pharmacies. Though many of these exact products are not available in Canada, some were from large companies that also supply products in Canada. In dental tablets, mouthwashes and lip-balms the gluten level was within limits not expected to cause problems in celiac disease (ranging from undetectable to 12.2 ppm). Thus 94% of the products tested were considered gluten-free and safe to use by a celiac patient. There were 4 products (3 toothpastes and 1 lipstick) that showed a gluten level > 20 ppm (maximum 35 ppm in one toothpaste brand). However, the maximum amount of gluten that could be ingested in the toothpaste (average of 0.25 grams of toothpaste per cleaning x 4/day) would be approximately 0.037 mg gluten. This level would be based on the assumption that a person consumed the entire 1 gram of toothpaste over the day, which is a very unlikely scenario.

A second, smaller US study from 2012 tested 4 lip products and 2 body/face lotions (2). In this study, the products were specifically chosen for testing as they contained at least one ingredient derived from gluten or oats (as they are contaminated with gluten). There was no quantifiable gluten in any of these 6 products.

Overall, the evidence suggests that it would be rare for enough gluten to be absorbed into the intestine following exposure from cosmetics, shampoo, other toiletries and skin care products. The vast majority of products have a negligible amount of gluten and given the small amounts (if any) normally ingested, gluten contamination in oral hygiene and cosmetic products is unlikely an issue for patients with celiac disease. A further advance has been the decision by many manufacturers to indicate that their products, such as toothpaste and mouth rinses, are gluten free, providing additional reassurance for patients with celiac disease.

References:
1. Verma AK, Lionetti E et al. Contribution of oral hygiene and cosmetics on contamination of gluten-free diet – Do celiac customers need to worry about? JPGN 2019; 68: 26-29.
2. Thompson T, Grace T. Gluten in cosmetics: is there a reason for concern? J Acad Nutr Diet 2012; 112: 1316-23.

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