Eyes are the most important constituents of the face. Not
only do they define overall beauty and personality of the being but also
express emotions and moods. They enable us to see the world and everything
around us. Unfortunately they don’t come as spares in our tool kits.
Accentuating the eyes with mascara, eye shadow, Kajal or Kohl and
liner to make them look bigger is a trait every woman has. However not so many
are meticulous when it comes to wiping these accentuators off in the evening,
carefully following the instructions for removal and following them by the
book. This is essential because overnight applications of liners,kajal and
mascara can result into blocking the tear ducts causing dry eyes or in some
cases even damage the cornea by penetrating into the eyes from the corners. In
general longer applications of foreign material on delicate areas such as the
eyes can cause irritation, infection and allergies or cause blepharitis. In general various adverse
effects may occur in the form of acute toxicity, percutaneous absorption, skin
irritation, eye irritation, skin sensitization and photosensitization,
subchronic toxicity, mutagenicity/ genotoxicity, and
phototoxicity/photoirritation.
Generally eye cosmetics are friendly and safe to use. The
products list out the ingredients on the packaging and label although more
diligently in the US and developed countries and not so much in India due to
lax laws and implementations. Cosmetic products generally come in small packs
making reading even more difficult. Careful buying of cosmetics needs to be
done, avoiding products which have mercury, lead and parabens which are
extremely harmful and hazardous. Safe buying is to be adopted which includes branded
products and in case of any problems during application you need to discard the
product. Using products beyond their validity and keeping them for longer
durations since all are expensive products can result into serious eye
problems. In such cases bacteria and fungi grow within the gels and liquids
which when applied shift their home into our eyes causing havoc. Similarly
cosmetics application and removal methods are also as important, for example
application on the inner lining of the lid shall ensure inner seepage causing
damage to the eyes.
Another option to circumvent the problem of chemicals in eye
products is to try out natural herb based products which are authentic although
no product whether herbal or otherwise should be used beyond expiry.
Dr. Louise A.Sclafani, OD, FAAO has some candid observations
listed on www.healio.com. According to him, “As eye care professionals we
should not avoid the topic of cosmetics and lid hygiene because we are afraid
of insulting our patients because if we don’t comment on what we see when they
are being tested, they assume that all is well.” He further suggests
introducing eye make up one by one into routine so that effects and reactions
of each can be clearly noticed. He strongly suggests that eye cosmetic make up
should never be shared with anyone no matter how intimate as this results in
communication of eye infections. He further says,” do not top off mascara with
water or be too aggressive on eye lashes with curlers which can cause damage to
delicate follicles and respect the eye mucosal line as the meibomian gland can
get blocked, resulting in dry eyes.”
Dr. Louise A.Sclafani recommends removal of make up daily
before sleeping usually with soap and water, which she says may not be always
effective. She recommends using branded soft lid and eye scrubs for removal and
even baby oil which is an amazing application for the job in hand.
“For soft contact lens wearers,
patients should put on makeup after putting in their soft contact lenses. For
gas-permeable lens wears, the opposite is true,” Dr. Sclafani said.
Make up residue or particles tend to enter the eye and
disrupt the tear film, causing discomfort and irritation. This is since cosmetics
are applied very near to the ocular surface or on the lid margins, giving them
ample opportunity to enter the eyes due to rubbing or other reasons. These
residual foreign bodies tend to stick on the tear film or even on the surface
of contact lenses or cornea, disrupting the tear film stability and function.
Meibomian gland
ducts thicken and get keratinized due to prolonged exposure to retinoid which
is an ingredient of anti aging and acne products. It causes degeneration and
necrosis of meibomian gland acinar cells, peri-acinar fibrosis and decreased
lipid content of meibomian tissue.
Similarly US FDA approved Latisse (Allergan) applied on the eyelashes
for hypotrichosis a condition of abnormal hair
patterns - predominantly loss or reduction was found to be responsible
for increased frequency of conjunctival eyelid hyperaemia which is excessive supply of blood to the eye lids also called
engorgement.
The most feared adverse effect of mascaras is that of
infection, particularly Pseudomonas aeruginosa corneal infections, which can
permanently destroy visual acuity, due to multiple reuses of applicator and
reinsertions into the tube between uses.
Some south Asian, middle eastern countries and parts of
Africa are still using old and outdated formulations which include ingredients
in cosmetic products suchas lead-compounds and preservatives such as
benzalkonium chloride, thimerosol and chlorhexidine. All products containing
such heavy metal or compounds are extremely harmful and need to be avoided at
all costs.
Products linked
with cosmetics have been put to scrutiny and analysis for rate of formation of
bacteria and contamination causing organisms and a related study found 30%
products affected after 90 days. Once the product has been opened and if being
used by more than one user, it is a potential bacteria rearing place. Although
preservatives slow bacteria formation they are short spanned and their
effectivity diminishes over a period of time.
Contact lens users
need to take precautions of cosmetic application in such a way that the lens
surface remains free of residual accumulation which not only will bllurr vision
but also cause irritation and infection. For users wearing lens regularly, daily
disposable lens are recommended as they are more hygienic and do not have to
undergo daily cleaning with solutions which is not foolproof if not done
properly.
Therefore it is
important that knowhow on the use of cosmetics is spread by opticians, cosmetic
retailers and manufacturers on the product itself. Patients coming for medical
treatment need to be educated on the cause of their disease without any
prejudices.Users must be properly told as to where all cosmetics are not
to be applied in the eye areas.
The US government on it’s official FDA website warns users
of the dangers of using substandard or persistetnt use of Kohl or Kajal as it
may contain lead and cause lead poisoning. This is since kohl is made up of
lead ( lead sulphide) and some brands may contain excessive percentage of lead
apart from other ingredients used in it’s commercial manufacture such as aluminum, antimony, carbon, iron, and
zinc compounds, as well as camphor and menthol.
Lead poisoning or exposure to excessive amounts of lead in
the environment is particularly harmful for children as they can absorb lead
from their surroundings. It can cause a host of diseases such as anemia (iron
deficiency), kidney related diseases and neurological disorders. Prolonged
exposure to lead can impair learning capability and behavioural patterns.
India which is a major producer of kohl needs to be
particularly careful as culturally kohl is used to accentuate children’s eyes
and kohl is widely used by all communities both in rural and urban India. It
needs to be mentioned here that US FDA had banned kohl or it’s use as a
commercially available cosmetic or it’s manufacture.
From a dermatologist’s point of view, cosmetics may be
grouped as: (a) skin-care cosmetics (cleansing agents, moisturizing agents,
etc.), (b) hair-care cosmetics (shampoos, hair colorants, styling agents,
etc.), (c) face-care cosmetics (facial foundations, powders, eye shadows,
mascara, lipsticks, etc.), (d) nail-care cosmetics (nail varnishes, paint
removers, etc.), (e) fragrance products (deodorants, aftershaves, perfumes,
etc.), and (f) ultraviolet (UV) light screening preparations. Skin cleansing
agents remain on the body for a very short period of time and rarely cause
significant adverse reactions, however, perfume and others constituents may
cause skin irritation and allergic reactions. Moisturizers increase the
hygroscopic properties of the skin; however, high concentration of these
substances may cause irritation and exfoliation.
Dr. P. K. Nigam, Professor and Head, Department of
Dermatology and STD, Pt. J. N. M. Medical College, Raipur in a study on effects
of cosmetics on skin and body parts and organs states- Ochronosis is a common
adverse effect of HQ (skin lightening/depigmenting agents, hydroquinone) characterized
by progressive darkening of the area to which the cream containing high
concentrations of HQ is applied for many years. ëBlack hennaí tattoo is a
chemical stain due to p-phenylenediamine (PPD), in the form of commercial hair
dye mixed into the henna paste. Addition of this artificial dye stains the skin
in much shorter duration, an hour or less. Adverse reactions to PPD can include
stinging sensations, with an erythematous rash, swelling, blisters, and surface
oozing. There have been several reports in the literature of immediate allergic
(and also anaphylactic) reactions on using henna dyes. Most cases have
sneezing, runny nose, cough, and shortness of breath instead of skin reactions.
Adverse effects to sun-screening agents may result in irritant, allergic,
phototoxic, or photoallergic reactions, and caused not only by the active
constituents but also by the additives such as fragrances and stabilizers.
Benzophenones are probably the most common sensitizers, while
dibenzoylmethanes, para-aminobenzoic acid (PABA), and cinnamates may cause photoallergic
dermatitis.[8] The allergic reactions associated with
deodorants/antiperspirants and fragrances are usually caused by fragrance or
other ingredients. Fragrance can enter the body through lungs, airways, skin,
ingestion, and via pathways from the nose directly to the brain and can cause
headaches, irritation to eyes, nose, and throat, dizziness, fatigue,
forgetfulness, and other symptoms. Fragrance is the number one cause of skin allergic
reactions to cosmetics. As much as 15% of the general population may find
fragrance a lower airway irritant and as much as 10% of the general population
may have skin allergy to fragrance. Fragrance in the air can cause airborne
contact dermatitis. Coumarin, methyl eugenol, and others are suspected
carcinogens. Some phthalates are suspected hormone disrupters.
Shampoos and
conditioners have only a brief contact with the skin and are not a common cause
of cutaneous irritant or allergic contact dermatitis. However, eye irritation
can be a problem. Possible sensitizers in shampoos include formalin, parabens,
hexachlorophene, triclosan, and fragrances. Matting of scalp hair is most
commonly a sudden, usually irreversible, tangling of scalp hair resulting from
shampooing.
Hair straightening
(relaxing) with pressing oils and heated metal combs or round tongs may be
associated with hair-shaft breakage and scarring alopecia. Hair removal
techniques may partially account for allergic and photoallergic reactions. The
adverse effects of shaving include skin irritation, cuts in the skin, ingrown
hair (pseudofolliculitis), etc. The active ingredients in hair bleaches are
hydrogen peroxide solutions that oxidize melanin to a lighter colour.
The adverse reactions may occur to one of the primary
constituents of the cosmetic formulation or contamination or procedural
misconduct.
Cosmetics and personal-care products may contain ingredients
whose safety is unclear or which are known to pose health risks. Adequate
testing or research has not been done on chemical combinations which are being
used. Notwithstanding the commercial nature of issue, it is advisable to be
prudent in choice, application and duration of use of all such products.
Necessary precautions and routines need to be adhered to and most of all
awareness needs to be spread around amongst whatever community groups one has
access to. It is seldom that an occurance least expected happens despite all
non possibilities however we should never extend our luck too far!
