Should You Use Preparation H On Your Face?

Nothing to Disclose



I think this may have been the first "big" beauty secret to be revealed by makeup artists. Preparation H on your puffy eyes to shrink the bags. It was used in pagents, on the red carpet and of course on the runways. And soon it was being used by pretty much everyone at the local mall and grocery store as well, despite warnings from skin care experts!



Directly from the Preparation H website, you can see that they don't recommend use for anything other than what is on the label (they actually aren't allowed to recommend or promote any off label use per the FDA). And Preparation H is only labelled for use as a hemorrhoid cream.



The main issue with using Preparation H on your face is that main ingredient, Phenylephrine. You might recognize the name because it is also found in common over the counter medications like decongestants, and decongestant nasal sprays.

Physicians use it because it is an alpha agonist, meaning it works through a receptor on a blood vessel to make the blood vessel constrict. So, we use it when blood vessels are too dilated to shrink them. Ophthalmologists use it for glaucoma, I use it in my ICU for low blood pressure (it is typically a 3rd or 4th line agent) and it is the medication that is used for that 4 hour situation you may have heard about in ads for a little blue pill.

While applying Phenylephrine will constrict the blood vessels in the bags under your eyes, it isn't the only issue causing those bags. Usually there's quite a bit of extra fluid (aka-swelling) in the small fat pad there. So, it's only a partial solution. Long term use of the Phenylephrine can up-regulate the opposing beta receptors, making the Phenylephrine less effective. As well, if you suddenly stop using it you can actually see a rebound swelling. This is often seen when people overuse nasal decongestants for longer than is recommended.

I haven't even gotten into the side effects of the 1% Hydrocortisone that is in most of the Preparation H formulations (skin thinning, steroid acne, absorption into your body messing with your body's cortisol responses) or the moisturizing ingredients that aren't formulated for use in the delicate undereye area. While Preparation H is great for its intended use, as a hemorrhoid cream, it isn't good for the undereye area!


I asked a few of my favorite skin care experts for their take on Preparation H, here's what they had to say:

Ellen Lange is an esthetician and founder of Ellen Lange Skin Science
Preparation H is made with phenylephrine, which is a vasoconstrictor and only temporarily tightens skin. This can be irritating and will not provide the long tern results you are probably looking for.


Debra Jaliman, MD is a board certified dermatologist with a private practice in New York City.
Some use to reduce swelling. As an alternative you can use an eye cream with caffeine, gel packs or an anti-histamine.

Avery Kuflik, MD is a board certified dermatologist with a private practice in New Jersey.
Repeated use of Preparation H can possibly lead to an allergy, eczema, and thinning of the skin around the eye area. There are many clinically tested products on the market to help rejuvenate the eye area.

James C. Marotta, MD is a double board certified ENT and Plastic Surgeon who practices in Long Island.
In theory, Preparation H may seem to work, temporarily. It restricts the blood vessels, which could get rid of the redness for awhile, and contains 1% hydrocortisone, an anti-inflammatory that might temporarily reduce puffiness in theory.

However, it's very risky to apply Preparation H on your eye area because if you accidentally get some in your eye, the other ingredients can cause serious damage, and puffiness will be the least of your concerns. Also, prolonged use of topical steroids like this has been shown to cause skin thinning, increased skin fragility, enlarged blood vessels, and can even result in problems with your adrenal gland, causing your eyes to look worse over time.

The best way to deal with puffy eyes is to treat the root of the cause – by getting enough sleep and staying hydrated. Additionally, look for under eye creams that have “firming” or “lifting” properties that can tighten skin.