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Cosmetics and cosmetic procedures
A cosmetic is any substance applied to the body for cleansing, beautifying, promoting attractiveness or altering the appearance. The fields of cosmetology and dermatology have now converged so that patients often present having had a reaction to a cosmetic or asking for advice about cosmetic usage. Cosmetic procedures, i.e. minor surgical techniques designed to enhance the physical appearance of the skin, are now part of a dermatologist’s role in many countries (though not in the UK) and are outlined here.
The range of cosmetics and their usage
Cosmetics in some form are used by almost everyone ( Table 65.1 ). The market for cosmetic sales is vast and far exceeds that of dermatological products. Cosmetics are normally used to augment the body’s appearance, to clean it, to impart a pleasing smell, to mask an unpleasant one or as a fashion accessory. Some cosmetics are marketed as ‘cosmeceuticals’ with the claim that they have an ‘active’ ingredient, e.g. one that can ‘reverse ageing’.
Table 65.1
The range of cosmetics
| Site | Product |
|---|---|
| Skin | Moisturizer, cleanser, soap, make-up remover, powder, rouge, foundation, toner, perfume, aftershave, bath additive, sunscreen |
| Hair | Shampoo, conditioner, bleach, colourant, permanent waving, straightening, lacquer, gel, hair-removing agents |
| Eyelids | Mascara, eyeshadow, eyeliner, pencil |
| Nails | Nail varnish, false nails, acrylate glue |
| Lips | Lipstick, lipgloss, sunscreen |
Constituents of cosmetics
The exact contents of a cosmetic depend on its proposed function. Many cosmetics contain perfumes, preservatives and, quite often, a sunblock agent ( Table 65.2 ). Cosmetics are often emulsions (e.g. oil-in-water or water-in-oil). Full content labelling is required in the European Union (EU). This allows patients who are allergic to cosmetic ingredients to avoid products that would be problematic. Certain preparations deserve special mention, as follows.
Table 65.2
Some ingredients of topical cosmetics
| Ingredient | Action | Examples |
|---|---|---|
| Antioxidant | Prevent degradation | Butylhydroxyanisole, gallates, tocopherol |
| Colourant, dye | Colour | Cochineal, azo compounds, iron dioxides, paraphenylenediamine, titanium dioxide, metal salts, dihydroxyacetone in fake tan |
| Perfume | Smell or for masking smell | Myroxylon pereirae , limonene, geraniol, linalool |
| Preservative | Antimicrobial | Parabens, formaldehyde, iodopropynyl butyl carbamate, methylisothiazolinone/chloro-methyl isothiazolinone, quaternium 15, bromo-nitropropane-diol, imidazolidinyl urea |
| Polyol | Humectant (retains water), emollient | Glycerol, propylene glycol, sorbitol |
| Oil, fat, wax | Emollient, lustre | Vaseline, almond oil, lanolin |
| Sun filter | Absorb or reflect UV | Titanium dioxide, oxybenzone, avobenzone |
| Tensioactive agent | Emulsifier, surfactant, detergent | Soaps, stearic and oleic acids |
| Water | Hydration | Purified water |
Paraphenylenediamine hair dye
Hair dyes, principally paraphenylenediamine (PPD), are widely used. Adverse reactions occur in 5%, usually as a scalp or facial eczema. ‘Henna’ tattoos often contain 15%–30% PPD and can induce allergy to PPD.
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