Burt's Bees--is it really hypoallergenic?

I've had several moms bring their babies in who have very bad eczema since they were little babies--1-3 months old.  Everyone thinks there is probably a food allergy to blame, and usually there are one or two allergies.  However contact allergies are also a big deal.  But when I try to get the moms to change their baby products, they all say one thing, "Oh no, I use Burt's Bees products only."   Are Burt's Bees products really hypoallergenic as they claim?

Take the Burt's Bees Baby Bee Shampoo and Wash.

Here is the description in the advertising: 

"When it is time for your baby's bath, Burt's Bees Baby Bee Shampoo & Wash offers a tear-free, nonirritating formula to gently clean delicate skin and hair. Tested by pediatricans, the hypoallergenic Shampoo & Wash features moisturizing, plant-based ingredients such as aloe, oat flour, and soy proteins. It contains no phthalates, petrochemical, parabens, or synthetic fragrances, and it is safe and effective for everyday use."

Look closely and you'll see that although they claim the soap is hypoallergenic, they promise just that those certain ingredients listed which are widely known to be unpopular will not be found. For instance:

No synthetic fragrances:  people who are sensitive to fragrances aren't only sensitive to synthetic fragrances.  Many people are sensitive to citrus oils, lavender, rose and other natural fragrances.  To truly be hypoallergenic, a product should at least be fragrance free.  I've had many parents swear they are using fragrance free skin care products, only to go home and read their Burt's Bees label and discover that it contains fragrances. The Baby Wash contains rosewood, coriander and cedar oils.  I have found some people to be allergic to cedar wood (and thus the oils).  The Burts Bees Baby Bee Tear Free Shampoo contains fragrance, Orange Oil, Anise Oil, Lemon (Citrus Medica Limonium) Oil, Vanilla (Vanilla Planifolia) Extract, Clove Oil.  I have found many people to be sensitive to citrus oils.

No phthalates, petrochemical, parabens:  Ok, yes, we want to avoid these, but not because of allergen problems.  The distaste for these are due to their cancer causing and hormone disrupting potentials, not to mention how we don't usually like the term 'petrochemical' and it's possible detrimental environmental connotations.  Leaving these out of a product does not make it hypoallergenic.

So what is in Burts Bees Baby Bee Shampoo and Wash?

Glycerin:  although glycerin allergy is thought to be rare, I've seen about one case a year, so it does happen.  It is seen in kids with the worst types of eczema.  That's because parents have tried putting everything on the skin from different types of soaps to creams--all containing glycerin. It's ubiquitous in skin formulations.  It was written up in the Journal Contact Dermatitis as causing allergic dermatitis (Preston PW, Finch TM, Allergic contact dermatitis from glycerin in a moisturizing cream. Contact Dermatitis. 2003 Oct;49(4):221-2

Coco betaine: it's short for cocamidopropyl betaine (similar to cocoamide DEA): this is an ingredient that contains a derivitive of coconut oil that is when it is change by a reaction with dimethylamine.  Amines are proteins which are responsbile for the allergic reactions.  Cocamidopropyl betaine has been shown in some studies to be an allergen, causing contact dermatitis:

Mowad, C. (2001). "Cocamidopropyl betaine allergy".American Journal of Contact Dermatitis 12 (4): 223–224.
De Groot, A. C.; Van Der Walle, H. B.; Weyland, J. W. (1995). "Contact allergy to cocamidopropyl betaine".Contact dermatitis 33 (6): 419–422.
Brand, R.; Delaney, T. A. (1998). "Allergic contact dermatitis to cocamidopropylbetaine in hair shampoo".The Australasian journal of dermatology 39 (2): 121–122
My question is, if coconut oil is so great and the advertising says there is coconut oil in it, why not just put coconut oil in it?

Decyl and lauryl glucosides:  these are surfactants, much like the natural surfactants made to degrease your kitchen stove.  Although they are made from dervitives of natural things such as coconut and sugar, these are mentioned in the list of hidden allergens in sunscreen and skin products in the scientific article 

Contact-Allergic Reactions to Cosmetics, by An Goossens at the Department of Dermatology, Leuven, Belgium (Received 30 November 2010; Accepted 11 January 2011).

Now I understand it's frustrating to find a natural product because anyone can be sensitive to anything.  That's why I want parents to understand what is in Burt's Bees products and not just assume that because the advertising says 'natural and hypoallergenic' that it will be safe for everyone's skin.  The rule of thumb is if what you're doing isn't working, change it.

So what should you use?  

If your baby has very bad eczema, try using just water for the bath for a week at least to see if things improve.  As a lotion, I use Devita Natural Skin Care Shea Butter Hand and Body Brulee.  You can get it at our office.  An adult male patient with very bad eczema on his hands used it recently and said it took away the itch immediately and felt soothing and healing with long lasting effects.