Introducing the Seal of Acceptance Program

The National Rosacea Society's (NRS) groundbreaking Seal of Acceptance program is designed to aid individuals living with rosacea in selecting appropriate skin care and cosmetic products. Because sensitive and easily irritated skin poses a significant challenge for those with this chronic disorder, the NRS aims to provide guidance by identifying products unlikely to cause flare-ups. With an estimated 16 million Americans and 415 million people worldwide affected by rosacea, the demand for suitable products is high. The Seal of Acceptance, to be displayed on approved product packaging, signifies adherence to stringent criteria developed under the guidance of Dr Zoe Diana Draelos.¹

The Dermatologist: What is the purpose of the NRS’s Seal of Acceptance program?

Dr Draelos: The Seal of Acceptance program is designed to help people with rosacea identify products that are suitable for their skin. The NRS receives questions from consumers all over the United States, and the most common questions they get are: What cleanser should I use? What moisturizer should I use? What anti-aging products will not make my rosacea worse, but possibly might even make it better?

The NRS developed the program to help consumers understand which products have been tested and validated by the organization, and which products might be better for patients with rosacea to use to prevent disease progression and the undesirable symptom of facial redness.

The Dermatologist: What motivated the NRS to establish this program? Could you elaborate on the common requests and concerns voiced by patients with rosacea that led to the program's development?

Dr Draelos: The NRS has members from all over the United States and provides valuable information relevant to those members. The Seal of Acceptance program aims to efficiently communicate which products may be suitable for facial use in individuals with rosacea. Many consumers invest significant amounts of money in purchasing products that prove ineffective, causing frustration and uncertainty when trying new products that could potentially worsen their rosacea. As a nonprofit organization, the NRS offers this service to help consumers make informed choices, ensuring they spend their skin care budget wisely and instilling confidence that their purchased products will not flare their rosacea.

The Dermatologist: What are the criteria for skin care or cosmetic products to be considered for the Seal of Acceptance?

Dr Draelos: To qualify for the Seal of Acceptance, the first requirement is to conduct a study on patients with rosacea. Although many products undergo testing on individuals without skin conditions, certain tests like the repeat insult patch test, which is done to be sure that a given cosmetic product is not an irritant, are typically performed on the upper back of volunteers with normal skin. Many of these testing centers are located around college campuses. They enroll young college students and test the product on the back. It is important to note that the back of a young man is very different than the face of a mature woman. Therefore, a product that does not cause irritation on the back does not guarantee it will be effective for patients with rosacea.

To ensure product compatibility, the NRS developed a testing platform that involves evaluating the product on 30 patients with rosacea to identify and prevent any potential issues. The NRS accepts applications where these data have been collected. Manufacturers also need to disclose the ingredients that are in the product and their purpose. Then, a panel of experienced dermatologists reviews the comprehensive data to determine whether a product meets the criteria necessary to receive the Seal of Acceptance.

The Dermatologist: How does the Seal of Acceptance program help individuals with rosacea?

Dr Draelos: The Seal of Acceptance program helps patients with rosacea because there have been people with rosacea who have tested the product, and this testing methodology helps them better understand if this might be a product suitable for their face. Further, the ingredients are also evaluated to ensure that they do not cause allergic contact dermatitis or irritant contact dermatitis, and that no sensates such as menthol are present, which can flare rosacea in some people. It also ensures that there are no unnecessary ingredients, and the formulations are compatible with the sensitive skin of rosacea. The NRS is doing this prework for the consumer to give them confidence that this product is suitable for their sensitive skin.

The Dermatologist: What specific type of skin care and cosmetic products is the Seal of Acceptance program targeting? Are there any ingredients that
are considered harmful for individuals with rosacea?

Dr Draelos: The program is suitable for a wide array of facial products, including facial cleansers, makeup removers, nighttime moisturizers, daytime moisturizers, sunscreen-containing moisturizers, sunscreens, and colored cosmetics like facial foundations and powders, as well as lipsticks and eyeshadows. Essentially, any product that is topically applied to the face of individuals with rosacea is eligible for the Seal of Acceptance. This comprehensive program covers a broad range of products, encompassing over- the-counter drug products that are monographed, cosmetics used for facial color enhancement, anti-aging products, and skin brightening products, as well as moisturizers and cleansers. Anything touching the face that would be used by patients with rosacea can be put through the program.

A definitive list of beneficial and harmful ingredients is challenging to compile, which is why testing is so important. Testing holds greater importance than relying solely on a list of ingredients. But there should not be any ingredients in the formulation that destroy the skin barrier. Examples of such ingredients include isopropyl alcohol and propylene glycol, which are penetration enhancers that can tear apart the skin barrier. It is also very important that products do not contain sensates because they can flare rosacea. Sensates are anything you can put on the skin that produces a sensory response, either detrimental or beneficial depending on whether you have rosacea or not. Examples of sensates that should be avoided include menthol, known for its cooling sensation; capsaicin, a chili pepper extract that makes some people with rosacea turn red; peppermint, which is occasionally used as a preservative or fragrance in skin care products that can evoke a sensation; and wintergreen, a relative of peppermint. It is advisable to stay far away from any sensate that causes flushing or blushing in patients with rosacea. Moreover, the rapid evaporation of substances from the skin surface can also invoke rosacea-related problems. Examples of such substances include ethanol, sometimes used as a solvent in products, and isopropyl alcohol. Anything that heightens the neuro sensitivity of the skin—we call it heightened neurosensory awareness—should be eliminated.

The Dermatologist: How does the application process for the Seal of Acceptance program work?

Dr Draelos: The NRS has developed an online application. Andrew Huff, the director of the NRS, can be contacted for more specific information at andrewhuff@rosacea.org. The manufacturers are required to fill out an application for the products that they would like to receive the Seal of Acceptance. To be eligible, the products need to be free from ingredients that can cause damaged skin barrier function, flushing, and burning or itching. The company must provide the following information associated with their products:

• Ingredients, concentration, and unction
• Any animal or human repeat insult patch testing that has been done for product safety
• Any studies that have been completed
• Samples of each of the products for the dermatologist evaluators to examine 
• A processing fee

The Dermatologist: What are the benefits for companies whose products receive the Seal of Acceptance?

Dr Draelos: For companies, the benefit is that they can reach consumers with rosacea in an up close, intimate way and let them know their products are suitable for people with sensitive skin. It is a way for companies to quickly tell people about the testing behind their products. It also allows companies to reach a large market of patients with rosacea, gives them market distinction, and allows them to have a seal on their product that helps consumers separate out the myriad products on the shelf, which may be positively overwhelming. The seal helps the consumer pinpoint products suitable for their skin and helps companies attract an appropriate customer base for their product sales.

Companies interested in pursuing the NRS Seal of Acceptance can find more information and apply online by visiting https://www.rosacea.org/patients/seal-of-acceptance/information.

Reference

1. National Rosacea Society offers new seal of acceptance for skin care and cosmetic products. Press release. National Rosacea Society. June 21, 2003. https://www.rosacea.org/press/2023/june/national-rosacea-society-offers-new-seal-of-acceptance- for-skin-care-and-cosmetic-products