Should You Use Preparation H On Your Face?

Should You Use Preparation H under your eyes?

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!

Should You Use Preparation H under your eyes

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.

hemorrhoid cream under eyes

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.

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11 Comments

  1. March 5, 2014 / 5:52 pm

    Thanks for the info! I have it, but rarely use it & when I did, I never noticed an improvement. And seeing that I don't have what it's intended for, guess I will trash it because why take that risk!

  2. March 5, 2014 / 7:58 pm

    I didn't know this. Thanks for sharing, my best friend does this at night before bed.

  3. August 11, 2017 / 8:29 am

    Good info! i will keep it for me and my friends.

  4. Karen
    January 3, 2018 / 1:09 pm

    Thank you for your information, it came in handy.

  5. KA
    January 14, 2018 / 12:07 am

    The confusion lies in the fact that CANADIAN Prep H has bio-dyne in it. It used to have it in the US version but it was removed and replaced with Phenylephrine. Bio-dyne versions ARE recommended by the company for wrinkles. The US version is not. Your article dealt only with the phenelephydrine version. See the Canadian Prep H site here https://www.prep-h.com

    • 15mins
      January 15, 2018 / 11:06 am

      As I live in the US and about 95% of my readers are in the US, and that is the version that most “beauty secrets” articles recommend, that is what I’m discussing here. Note that phenylephrine does work quickly and with 1 application. However in the long term that isn’t a good idea due to the receptor effects I mention in the article.
      While you linked a site that discusses the yeast extract, you should know that in actual medical studies there is NO evidence that yeast extracts will reverse wrinkles or reduce swelling. It has been found to be no better than placebo. I can not find many of the studies mentioned on that site in searching on PubMed.

      • SLee
        February 6, 2018 / 2:12 pm

        I am wondering about all of this too. It’s interesting the conflicting information out there. Do you have the study you were looking at? I was trying to find something myself and only found this random study which seems to indicate there is some benefit (albeit this was specifically for menopausal women or something, still it is interesting…) — http://www.anti-aging.gr.jp/english/pdf/2010/v7-4_0224.pdf

        They say at the end, “In conclusion, 8-week treatment of premenopausal women with
        dried brewer’s yeast at 7,125mg/day produced a significant improvement
        in the subjective symptoms “cold skin,” “menstruation-related
        troubles,” “make-up runs easily” and “desiccated and gritty skin.”
        Further, skin analysis demonstrated a significantly increased
        moisture content (about 15%), improved elasticity, and an improved
        hemoglobin index. These effects in improving moisture content and
        skin elasticity were dose-dependent. Findings suggestive of
        unfavorable effects were increased scores for the subjective
        symptoms of “blurred vision,” “inability to solve problems,” and
        “glossless and easily broken nails,” and an increased volume of
        melanin, as determined by skin analysis, although no serious
        adverse events were noted.”

        Thoughts?

        • 15mins
          February 6, 2018 / 2:21 pm

          The study you linked is the only one I’ve ever found that yeast has helpful benefits for aging skin. Note that it was a very small study with only 32 people, and other than the moisture content being measured, the other findings were all based on questioning of the subjects (people tend to answer as they feel the questioners want them to answer, they are based on recall, etc, lots of potential flaws so I take those results with a grain of salt). Only topical retinoids have been found to consistently have benefits in terms of reversal of lines and wrinkles.

          Note, this is an ingredient that is NOT found in the US version of Preparation H.

          • S Lee
            April 12, 2018 / 7:42 pm

            Good point that memory is often flawed!

  6. Thom
    April 14, 2018 / 9:26 am

    So what is the main ingredient in the eye forming creams?

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