Day in, day out, most of our patients wear make up; these products often contain preservatives, chemical dyes, fillers and numerous fragrances – all potentially detrimental to the skin, particularly after aesthetic treatments. Following most treatments, skin can be left sensitive and penetrable. Because of this, make-up has the potential to be damaging to the skin, either by increasing the risk of further irritation, instigating an allergic reaction or causing acne. Advice on post-treatment make-up varies, depending on the product and treatment used. In the case of dermal fillers, it is advised that light make- up can be applied immediately to hide redness.1 Botulinum toxin requires a minimum of four hours2 before application. Other treatments may require a longer waiting period before products of this kind can • be applied. With chemical peels, it is advised that the patient should avoid make-up on the day of the peel,3 whilst patients who have undertaken derma-rolling treatments should avoid the use of cosmetic products for 12 hours post treatment. However, radio frequency treatments allow the patient to ‘put make up on as desired.’4 Abiding by these guidelines will enhance good results, and, as advised after a derma-rolling treatment, it may also be beneficial for the practitioner to supply the patient with specialist mineral make-up, in order to avoid potential irritation.5 As professionals in aesthetics, we should have an understanding of how patients’ lifestyles influence their health and wellbeing, and take every opportunity to promote health, prevent illness and support patients to make lifestyle changes where appropriate.6 Most of our female patients, and some male, wear make-up or use some form of cosmetics on a daily basis. To follow on from the care that they receive in-clinic, it follows good and thorough practice to find out what cosmetics and make-up your patients use. It is also imperative to look at the evidence supporting the ingredients contained in the make-up and cosmeceuticals that we advise patients to use, or that we sell to them.
Below is an overview of some ingredients found in make-up, which can cause skin issues, and, if possible, should be avoided by patients who have recently undertaken a procedure:
- Methyl, propyl, butyl and ethyl parabens are used as inhibitors of microbial growth, and to extend the shelf life of products. They are widely used, even though they are known to be toxic and can cause allergic reactions and skin rashes in individuals with paraben allergies,7 hence they should only be used in small quantities (less than 0.8%). With other paraben ingredients, such as isopropylparaben, isobutylparaben, phenylparaben, benzylparaben and pentylparaben, the human risk could not be evaluated because of a lack of data.8
- Petrolatum is found in most lip products, and is usually advertised as protecting the lips from sunburn, chapping and so forth. Petrolatum is mineral oil jelly, and mineral oil causes a lot of problems when used on the skin, such as photosensitivity (i.e. promotes sun damage). It tends to interfere with the body’s own natural moisturising mechanism, leading to dry skin and chapping – therefore, resulting in a product that creates the very conditions it claims to alleviate.9
- Imidazolidinyl urea and diazolidinyl urea are the most commonly used preservatives after parabens. They are found in many cosmetics, skin care products, shampoos and conditioners, as well as bubble baths, baby wipes and household detergents. Both preservatives are well established as a primary cause of contact dermatitis.10 Neither has a good shelf life and must be combined with other preservatives, with imidazolidinyl urea releasing formaldehyde, which can induce allergic reactions.11 These chemicals have been found to be toxic to the skin and body system.10
- Propylene glycol, which is recognised as safe for use in food as well as cosmetics,12 is a vegetable glycerin mixed with grain alcohol, both of which are natural (so consumers often assume this is safe), but both can cause skin sensitivity and eye irritation.13
- Sodium lauryl sulphate is a synthetic substance used in shampoos for its detergent and foam-building abilities. It can cause eye irritations, skin rashes, hair loss, scalp problems and allergic reactions.14
- Stearalkonium chloride is largely used in hair conditioners and creams. This can cause allergic reactions, eye irritation and even hair loss. Stearalkonium chloride was developed by the fabric industry as a fabric softener, and is a lot cheaper and easier to use in hair conditioning formulas than proteins or herbals.10
- Synthetic colours, which aim to make a cosmetic ‘pretty’, should also be used with caution due to skin irritation. Many artificial colours are now banned due to their carcinogenetic effects.15
- Synthetic fragrances used in cosmetics can have as many as 200 ingredients. There is no way to know what the chemicals are, since on the label it will simply say ‘fragrance’. Some of the problems caused by these chemicals are headaches, dizziness, rash, hyperpigmentation, violent coughing, vomiting and skin irritation.10
- Triethanolamine (TEA) is used to adjust pH, formulated with fatty acids to convert acid to salt (stearate), which then becomes the base for a cleanser. TEA causes allergic reactions including eye problems, dryness of hair and skin, and could be toxic if absorbed into the body over a long period of time.16 A natural mineral derived additive, bismuth oxychloride, has been used in make-up for centuries. It gives a pearly shimmer and is usually found in foundation. This can potentially cause irritation and, in many cases, cause or worsen cystic acne and rosacea.17
It is best to advise patients to look out for make-up that contains as few additives as possible, fragrance- free and made with natural ingredients. Patients prone to acne should also seek non-comedogenic products. Preservatives are in almost any product that contains water, and the most common preservatives have been linked to skin allergies. However, it is important to remember that this doesn’t mean they will cause allergic reactions in everyone.
Mineral makeup, because of its nature, cannot harbor bacteria and therefore does not need a preservative. Recommending this kind of product or approach to a patient following an aesthetic procedure, as is suggested after a derma rolling treatment, (where it is advised that a practitioner may provide a patient with mineral make up),5 is encouraged as a clinically sound, and realistic, approach to post-procedure cover up.