It could be useful to memorize a few cosmetic facts to get your patient’s attention on the subject.
Here are a few facts I suggest you know:
• Carbon black—also known as D & C black, black #2, acetylene/lamp/channel black, furnace black—is a powder often used in eyeliner, mascara, and eyelid and eyebrow shadows that may cause cancers and organ toxicity.2
• Benzalkonium chloride (BAK) is still being used in eyeliners, mascaras, and makeup remover.3
• Prime yellow carnauba wax, or any wax, clogs the meibomian glands. It is used in mascaras and eyeliners to stiffen them and make them waterproof.2
• Formaldehyde in products causes allergic reactions and cancer.4
Report cosmetic problems to the FDA
There have been multiple public health controversies surrounding cosmetics involving lip balms, lipsticks, and eyelash makeups adulterated with prostaglandins.5 Reports of nail polish with dibutyl phthalate were identified in California in 2012. Dibutyl phthalate has been linked to asthma, birth defects and other chronic health problems. Other recent problems include formaldehyde in Brazilian blowouts (a treatment which straightens hair and add shine), lead in lipstick, carcinogens in baby shampoo, and mercury in skin cremes.6
To encourage more reporting, the FDA recommends patients use the Center for Food Safety and Applied Nutrition (CFSAN) Adverse Event Reporting System (CAERS). This system is used to record adverse events related to foods, dietary supplements, and cosmetics. The objective of CAERS is to examine adverse events to inform future policymaking.7
If a consumer experiences an adverse reaction with a cosmetic product, the reaction should be reported by the consumer. Adverse reactions after using cosmetics is reportable even if medical treatment was not required. Reactions include rashes, redness, burning, hair loss, headache, infection, illness, or any other unexpected reaction after using a cosmetic product.
Problems with the quality of cosmetic products should also be reported. This includes a bad odor, color change, contamination, or foreign material found in the product.8
Cosmetic users can use one of these three ways to report problems with cosmetics to the FDA:
• Call an FDA Consumer Complaint Coordinator to speak directly to a person about the problem.
• Complete an electronic Voluntary MedWatch form online.
• Complete a paper Voluntary MedWatch form that can be mailed to FDA.
1. U.S. Food and Drug Administration. Cosmetics Safety Q&A: Eye Cosmetic Safety. Available at: https://www.fda.gov/Cosmetics/ResourcesForYou/Consumers/ucm167467.htm. Accessed 5/7/18.
2. U.S. Food and Drug Administration. Color Additive Status List. Available at: https://www.fda.gov/ForIndustry/ColorAdditives/ColorAdditiveInventories/.... Accessed 5/7/18.
3. U.S. Food and Drug Administration. Antiseptic FDA Letters. Available at: https://www.fda.gov/Drugs/DrugSafety/InformationbyDrugClass/ucm538131.htm. Accessed 5/7/18.
4. American Cancer Society. Formaldehyde. Available at: https://www.cancer.org/cancer/cancer-causes/formaldehyde.html. Accessed 5/7/18.
5. Kwa M, Welty LJ, Xu S. Adverse Events Reported to the US Food and Drug Administration for Cosmetics and Personal Care Products. JAMA Intern Med. 2017 Aug 1;177(8):1202-1204.
6. Spear S. The Latest Cosmetics Scandal: Toxic Nail Polish. Available at: https://www.ecowatch.com/the-latest-cosmetics-scandal-toxic-nail-polish-.... Accessed 5/7/18.
7. JAMA Network. Research Letter: Adverse Events Reported to the US Food and Drug Administration for Cosmetics and Personal Care Products. Available at: http://jamanetwork.com/journals/jamainternalmedicine/article-abstract/26.... Accessed 5/7/18.
8. U.S. Food and Drug Administration. How to Report a Cosmetic Related Complaint. Available at: https://www.fda.gov/cosmetics/complianceenforcement/adverseeventreportin.... Accessed 5/7/18.