In the sixth episode of Dry Eye Fireside Chat, Damon Dierker, OD, FAAO, and Laura M. Periman, MD, sit around the fire to discuss misinformation surrounding cosmetics and ocular health as well as steps that can be taken to debunk these myths.
Harmful cosmetic ingredients to the ocular surface
Due to the widespread use of cosmetics around the eyes, some common ocular health-related practices have become relatively well-known. Dr. Dierker says that it is best to avoid the waterline, remove makeup before sleeping, and be careful with eyelash extensions and serums.
However, there exists a significant amount of misinformation regarding cosmetics and ocular health. Although it can sometimes be tricky to provide guidance on proper cosmetic use while avoiding misinformation, the inaccuracies surrounding cosmetics can be combated by independently looking at unbiased scientific research and evidence.
Recognizing research-backed harmful ingredients
According to Dr. Periman, identifying a few key ingredients that have been demonstrated as detrimental by extensive research is a good place to start.
Prostaglandin analogs (PGAs) are commonly used for eyelash growth, but are associated with the following side effects:1
- Dermatitis
- Blepharitis
- Meibomian gland dysfunction
- Dry eye disease
- Permanent discoloration to the eyelid and/or iris
- Orbital fat atrophy
These negative side effects may inadvertently cause users to develop a more aged appearance in the pursuit of appearing more youthful, especially when using unregulated products.
Being leary of over-the-counter eyelash serums
Even ingredient labels may contain misleading information for consumers. Roughly ⅓ of over-the-counter (OTC) eyelash serums contain adulterated PGAs, and some have even been caught omitting PGAs from their ingredient lists.2,3
Unlike FDA-approved products, such as Latisse, which is an approved eyelash growth serum that has been studied with known effects, OTC serums are not required to undergo safety testing and may fail to disclose their potential risks to the public.
If she suspects a patient is using products with PGAs, usually by their abnormally long lashes and/or common side effects, Dr. Periman finds it best to approach the matter from an angle of ocular health with gentle concern.
Preservatives in cosmetics
Preservatives are always a topic of concern when it comes to ocular health, whether it be in eye drops or cosmetics. However, not all preservatives are the same. For instance, the use of formaldehyde-donating preservatives around the eyes has been shown to be harmful, as they can cause damage to the cornea even at very low concentrations.4
One of the most common preservatives found in cosmetics is hydroxymethylglycinate, which becomes a formaldehyde once it interacts with water.5 This can make avoiding these preservatives more of a challenge as a product can truthfully state that it is free of formaldehyde, but the presence of formaldehyde-donating preservatives can release formaldehyde once the product is applied.
The value of knowing safe preservatives according to scientific research
Additionally, the use of other chemicals, such as DMDM hydantoin, urea, and quaternium-15, should also be avoided around the eyes.6 However, not all preservatives are as inherently harmful.
Parabens are widely maligned preservatives in the cosmetics industry, with many products marketing their “paraben-free” formulas to appear safer for the skin. However, extensive research demonstrates that parabens at low concentrations are effective and safe preservatives.7
In fact, parabens are even found to occur at low levels in nature.8 Therefore, with the right balance of parabens with other molecules, they can be used safely and effectively.
Ethylhexylglycerin and phenoxyethanol are other preservatives that are often inappropriately maligned. Phenoxyethanol, which can be recognized at high concentrations by its rose-like scent, when used at low enough concentrations, especially when it is synergistically combined with ethylhexylglycerin, can effectively protect against ocular pathogens.9
Understanding the complexities of cosmetics chemistry
It is also crucial to remember that preservatives serve a protective purpose. Without preservatives in cosmetics, users would be at risk of using products that could be contaminated with bacteria or other harmful microbes that put the eyes at risk. Therefore, the key is to find the right preservatives in the proper formulations to minimize any negative impact on ocular health.
The manner in which cosmetics are applied and their formulations also play a significant role in their impact on ocular health. For example, products that are applied closer to the eye have a greater chance of causing harm due to their proximity to the ocular surface, while wash-off formulations of cosmetics may be less of a concern.
Additionally, it is important to remember cosmetic chemistry is its own complex science. While we as eyecare practitioners (ECPs) are the experts when it comes to maintaining ocular health, the field of cosmetics research has its own experts whose knowledge of cosmetics chemistry vastly surpasses our own.
Therefore, given this complexity, Dr. Periman suggests that rather than singling out a particular ingredient, it is important to take the entire formula and composition of the product into consideration.
Reliable educational resources on toxic cosmetic ingredients
Many organizations can be found online that list the toxicity of ingredients and claim to have the most accurate information regarding cosmetic safety. However, a large number of these organizations are paid to display certain information and much of the cosmetic research thus far has been done for marketing purposes and contains bias without thorough analysis.
Some of Dr. Periman’s favorite resources include independent cosmetic chemists who present scientific information on popular social media platforms. The Eco Well, for example, seeks to uncover the truth surrounding cosmetic ingredients and formulas from a research-based perspective.
Moving forward, Dr. Periman emphasizes that true transparency should be pushed for as a community. Widespread ocular research does not yet exist in the cosmetics industry, and it is therefore important for doctors and consumers to advocate for a more science-based approach to cosmetics development.
Conclusion
Although the impact of cosmetics, especially in regard to specific ingredients, on ocular health is a controversial topic that is often fraught with misinformation, it remains an important area of eyecare.
It can be misleading to focus on individual ingredients that are perceived as being harmful, as oftentimes, the overall formulation of a product and the application method of these ingredients can influence their impact on ocular health.
The pervasive misinformation surrounding cosmetic safety can be reduced through independent scientific research and an understanding of the fact that cosmetic science is a complex subject that requires expert knowledge to grasp its intricacies fully.
Therefore, ECPs and affected communities should advocate for thorough, evidence-based research rather than market-driven messaging to improve both transparency and safety in the cosmetics industry.
