The potion in your beauty lotion may do more harm than good

SINGAPORE — They wanted to look better. But some people got more than they bargained for and ended up with disfiguring side effects after using products that were supposed to enhance their looks.

One of the more severe cases Dr Elias Tam, founder and medical director of EHA clinic, has seen was a male patient in his 50s who suffered inflammation and scarring on his scalp after trying various anti-hair loss products. He ended up with permanent scars and hair loss.

Another patient desired a fairer complexion but developed patchy skin after using a skin whitening product that she had bought from a multi-level marketing company overseas. Although the patient saw good results initially, she developed hypopigmentation (complete loss of skin colour) after two months, said Dr Tam.

“When she stopped using the product, other parts of her skin became hyperpigmented,” said Dr Tam, who suspects that the product contained heavy metals such as lead or mercury.

From lotions and shampoos to nail polish and makeup, the use of beauty and personal care products is growing. In Singapore, revenue of the cosmetics and personal care market is estimated to hit US$1.13 billion (S$1.55 billion) this year and is expected to grow 2.1 per cent annually in the next five years, according to market and consumer data provider Statista.

However, emerging research suggests that some chemicals commonly used in these products are hazardous and can potentially cause serious health problems, particularly though excessive or long-term exposure.

THE TOXIC TRIO: STILL SOME UNKNOWNS

Among the chemicals are the “toxic trio” of dibutyl phthalate (DBP), toluene and formaldehyde.

At high concentrations, DBP, a plasticiser that is added into nail polish products to reduce cracking of coating after application, can disrupt hormonal function and cause reproductive problems, said Associate Professor Ho Han Kiat from the department of pharmacy, faculty of science, at the National University of Singapore. It is also used in body lotions, perfumes and other personal care products.

Toluene is a solvent commonly found in nail polish, while formaldehyde is used as a preservative in cosmetic products such as hair straighteners and nail products.

“Both (substances) have been associated with allergies in some individuals. At higher concentrations, they may cause neurological and respiratory side effects,” said Assoc Prof Ho. Long-term exposure to formaldehyde has also been linked to increased cancer risk.

Studies have investigated the toxicity of each single ingredient, according to a recent report by insurer Allianz Global Corporate and Specialty, and science-based data analytics firm Praedicat.

But it is currently not known if co-exposure to two or more of the chemicals can increase health risks, beyond what is expected from any chemical alone, stated the report titled Emerging Liability Risks: The “Toxic Trio”.

In Singapore, regulatory controls are in place for the three chemicals.

The Health Sciences Authority (HSA) told TODAY that DBP is not permitted in cosmetic products here, while restrictions are in place for formaldehyde and toluene.

“Formaldehyde is restricted to a maximum concentration of 0.2 per cent when used as a preservative and a maximum concentration of 5 per cent in nail hardening products. Toluene is allowed for use in nail polish products up to 25 per cent and not allowed in other cosmetic products,” said HSA’s spokesperson.

Cosmetic products tested under HSA’s surveillance programme for DBP, formaldehyde and toluene were found to be compliant with its requirements, said HSA’s spokesperson.

It has not received cases of adverse reactions associated with these three ingredients in the last three years.

OTHER CHEMICALS CAN TRIGGER ALLERGIC REACTION, SKIN IRRITATION

The “toxic trio” are not the only substances found in beauty and personal care products that can cause health issues.

“The list of chemicals that may cause an allergic reaction or (skin) irritation is endless. Any chemical that has a potential beneficial action, such as lightening, anti-wrinkle effect, stimulate collagen, may also cause an unwanted reaction from the skin,” said Dr Tam.

Every week, Dr Tam treats at least one patient complaining of itchy skin and rash after trying a new beauty product or service. Occasionally, he might even see patients with swelling on the lips and eyes after colouring their hair.

“These patients usually come (to the clinic) with a whole bag of products that they have purchased from various places, and it’s hard to even know where to start checking,” said Dr Tam.

Skin irritation can occur due to use of inappropriate concentration (example, excessively high concentration) or when multiple products are inappropriately used on the skin at the same time, said Adjunct Associate Professor Leow Yung Hian, senior consultant at the National Skin Centre.

An allergic contact reaction to makeup or skin care products is less common and symptoms may spread to other parts of the body beyond the area of direct contact, he added.

Fragrances, such as cinnamaldehyde and sorbic acid, are one of the common chemicals known to cause allergic reaction in patients, say experts.

Besides formaldehyde or formaldehyde-releasing preservatives, other preservatives that can cause an allergic contact reaction include methylisothiazolinone (MI)/ methylchloroisothiazolinone (MCI), and parabens, said Adjunct Assoc Prof Leow.

Other substances that can cause health issues include colouring and para-phenylenediamine (PPD) found in hair dye including many commercial henna dyes, said Dr Tam.

However, the experts stressed that a chemical that causes allergies for some people does not mean it is dangerous.

“Allergies depend on the immune reaction of individuals and, therefore, we do not see the same effect on everybody. A chemical that causes allergies… may still be considered safe for the majority of the population,” said NUS’ Assoc Prof Ho.

Using nail polish and other products according to their intended indication is also unlikely to result in high-concentration exposure that leads to long-term health effects, added Assoc Prof Ho.

SIDE EFFECTS MAY NOT BE IMMEDIATE

Still, Dr Tam advised consumers to be cautious and monitor for any side effects.

“While we are more knowledgeable with each study done, there will always be more things that we have yet to discover,” he said.

In some cases, the side effects may not be immediate.

“This is especially for products that contain heavy metals. It’s a question of when they will accumulate enough to cause problems. Heavy metals are particularly dangerous as they accumulate in the body over time, causing poisoning,” said Dr Tam.

Heavy metals such as lead, mercury, nickel, manganese, chromium and copper may be found in face powder, lipsticks, lightening cream and hair dye, as well as some natural products, such as henna products, depending on the source and processing, said Dr Tam.

Cosmetic products in Singapore must comply with the requirements under the Health Products (Cosmetic Products — Asean Cosmetic Directive) regulations, which are in line with the Asean Cosmetic Directive that adopts similar regulatory principles and requirements as the European Union on cosmetic products.

Importers of cosmetic products are required to notify HSA before placing the products on the local market.

The product notification is to facilitate regulatory follow-up should safety concerns arise. “It is not a form of certification or approval of the product’s quality, safety and efficacy,” said HSA’s spokesperson.

HSA adopts a post-market surveillance programme to monitor the safety of cosmetic products sold here, including those on local websites and e-commerce platforms. Based on the programme, HSA has detected cosmetic products that were found to contain mercury as well as potent Western medicinal ingredients such as tretinoin.  

HOW CAN CONSUMERS PROTECT THEMSELVES?

Those who develop an allergic reaction to a product usually experience itchiness and redness within the first few applications, said Assoc Prof Ho.

Typical red flags include itchiness, redness, swelling, discoloration or scaling, said Dr Tam.

Stop using the product immediately and consult a doctor if you notice these signs.

Other long-term effects occur over a longer duration, and it will be difficult to pinpoint specific signs and to associate them to such exposure as the cause, said Assoc Prof Ho.

Patch testing may be helpful to those who have experienced allergies due to certain chemicals. The procedure is performed in some clinics to ascertain the cause of allergies, said Assoc Prof Ho.

Consumers should also read product labels and, when shopping online, check retail stores to verify the product.

“Buying online or from individuals not only exposes you to possibly poor-quality control but also leaves you with no recourse should there be an issue,” said Dr Tam.

If buying online, consider buying from websites with an established retail presence in Singapore, said HSA’s spokesperson.