Cuidado con lo que se lee y si es publicado no necesariamente es totalmente solido: Toxic Ingredients in Personal Care Products: A Dermatological Perspective

Lectura critica!

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• This review explores data regarding environmental pollutants, including bisphenols, phthalates, parabens, poly-fluoroalkyl substances, p-phenylenediamine, and formaldehyde, found in personal care products. The article delves into the toxicology and pathophysiologic mechanisms of these compounds as well as the potential dermatological manifestations.
• This review examines the various environmental pollutants in personal care products, offering medical professionals insight into their potential effects on dermatological health.

–  Lillian Sun, MD

Written by

 

 

JiaDe Yu MD, MS

Less is more

Personal care products constitute a multibillion-dollar industry that is expected to grow significantly in the ensuing years. Propagated by celebrities and social media influencers, trends in personal care products continue to evolve. One thing that has stayed constant is the dizzying array of unreadable and unpronounceable ingredients that constitute a product. Most ingredients are there for a reason — whether it is a preservative that prevents the harmful growth of bacteria or an emulsifier that prevents the separation of oils in the sunscreen sitting in your cabinet — some may cause more harm than good. Social media and environmental activist groups have promoted "clean" beauty to avoid these potentially harmful ingredients. However, is the evidence truly robust enough to discount these potentially dangerous ingredients?

Lin et al published a comprehensive review of potentially "problematic" ingredients in personal care products, including bisphenols, phthalates, parabens, per-fluoroalkyl and poly-fluoroalkyl substances, p-phenylenediamine, and formaldehyde, identified by the Environmental Working Group. Many of these ingredients, such as bisphenols and phthalates, are labeled as potential endocrine disruptors. Some ingredients, including bisphenols, parabens, and phthalates, have been linked to the development of cancers, while others are listed as potential contact allergens, such as parabens, formaldehyde, and p-phenylenediamine.

Although the article cites numerous sources for its claims (137 sources!), this is a perfect example of an instance where just because the article is published in a journal, does not mean it is clinically relevant. Most studies on endocrine disruption have been conducted in animal models or ex-vivo cells and not at physiologic doses of the chemical. Similar to the aluminum and breast cancer scare, there are no high-quality studies that support this relationship. While the jury is still out for these chemicals, I would suggest reading this review with a critical lens. The American Contact Dermatitis Society named parabens as the non-allergen of the year to dispel the myth that parabens are common causes of allergic contact dermatitis and to support its use in personal care products in lieu of potentially more sensitizing allergens such as methylisothiazolinone. The American Cancer Society states that there is no good evidence to suggest that aluminum or parabens increase the risk of breast cancer, citing poor-quality studies.

At the end of the day, less is probably more. Patients often ask me about my skin care routine, and I say "soap and water" because I don't need more than that. Is there evidence that an eight-step nighttime routine is better than my 8-second one? The jury is out for that.

Abstract

Environmental dermatology is the study of how environmental factors affect the integumentary system. The environment includes natural and built habitats, encompassing ambient exposure, occupational exposures, and lifestyle exposures secondary to dietary and personal care choices. This review explores common toxins found in personal care products and packaging, such as bisphenols, parabens, phthalates, per- and poly-fluoroalkyl substances, p-phenylenediamine, and formaldehyde. Exposure to these toxins has been associated with carcinogenic, obesogenic, or proinflammatory effects that can potentiate disease. In addition, these compounds have been implicated as endocrine-disrupting chemicals that can worsen dermatological conditions such as acne vulgaris, or dermatitis. Certain pollutants found in personal care products are not biodegradable and have the potential to bioaccumulate in humans. Therefore, even short-term exposure can cause long-lasting issues for communities. The skin is often the first point of contact for environmental exposures and serves as the conduit between environmental toxins and the human body. Therefore, it is important for dermatologists to understand common pollutants and their acute, subacute, and chronic impact on dermatological conditions to better diagnose and manage disease.

"Lin RR, Lin DA, Maderal AD. Toxic Ingredients in Personal Care Products: A Dermatological Perspective. Dermatitis. 2023 Dec 18. doi: 10.1089/derm.2023.0215. Epub ahead of print. PMID: 38109205."

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Benjamin Hidalgo-Matlock
Skin Care Physicians of Costa Rica

Clinica Victoria en San Pedro: 4000-1054
Momentum Escazu: 2101-9574

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