Chapter 12
COSMETICS TODAY ARE A far cry from those used in ancient times. Application of today’s powders and potions will no longer poison you, let alone kill you, as they once could. The simplest cosmetics are powders, dusted on to the skin. Many others are pastes or creams. Clays, ochre and charcoal, together with various oils, waxes and greases, have all been common ingredients of face and body paints for centuries. Any substance applied to the skin to improve the appearance, beautify or make a person more attractive, can be called a cosmetic.
Henna and tadpole hair dye
Egypt has given us the earliest evidence of the use of cosmetics. Tombs contained not only mummies, but also many burial gifts – comforts and luxuries, including cosmetics, provided to accompany the person buried into the next world.
These gifts included kohl, made from stibnite, a poisonous black mineral containing antimony, used to decorate the eyes and paint the eyebrows. Various eyeshadows of mineral origin were found, and the plant dye henna, still used today, was used not only as hair dye, but also for colouring the palms of the hands and soles of the feet and decorating the finger and toenails. Ancient Egyptian ladies even used mud from the River Nile as a facemask.
Today’s perfumes are alcohol-based, but in Ancient Egypt the art of distillation had yet to be discovered, so perfumes were always oil based. One sacred perfume used in the embalming process was made from myrrh, cinnamon, cyprinum, juniper, honey and raisins steeped in wine. Many fragrant oils were used as body rubs and skin softeners,and to add to bathwater. The Ancient Egyptians even used crushed, dried tadpoles in oil as a hair dye.
Walnut hair restorer and powdered pumice tooth cleaner
By comparison, the women of Ancient Greece tended to use few cosmetics, and then only to colour the lips and cheeks. But we also know that they used hair dyes of both mineral or plant origin to change their hair colour.
The Romans were also very keen on hair dyes, as well as on bleaches, using recipes culled from far-flung outposts of their empire, such as Gaul and Germany. The green outer covering of walnuts, for example, was used to restore colour to greying hair. Another recipe included black wine, raw crow’s egg and putrefied leeches.
As a result of all this dyeing and bleaching, the Romans found that their hair became very coarse and brassy, and so, to improve its lustre and texture, they also used conditioning creams. Many of these preparations contained strange ingredients; for example, one contained pepper and hellebore together with rats’ heads and droppings. If all else failed, the Romans resorted to wearing wigs.
The removal of unwanted body hair was also very important in the Roman society. This was done by covering the area with a paste made from a mixture of lime and orpiment, that poisonous arsenic sulphide mentioned in Chapter 7. Or more safely – but more painfully – by rubbing the skin with powdered pumice. The pumice stone in your bathroom is a piece of volcanic lava that has cooled and solidified. The Romans would have had a plentiful supply of pumice from various volcanoes such as Mount Vesuvius, south of Rome, and Mount Etna, on the island of Sicily.
The Romans, like the Egyptians, also used facemasks, only theirs contained not Nile mud but powdered plants mixed with honey or lanolin, and were applied at night and then washed off the next morning using scented water. They also used powdered pumice in vinegar to clean their teeth – rather rough on the enamel though.
Kohl, carmine and woad
On their faces, Arabic women used white batikha, a powder made from ground shells mixed with borax, rice, lemon and eggs, and kohl eye make-up made of soot, lead ore, burnt copper, rosewater and sandalwood.
Indian women also used kohl – made from the poisonous stibnite, or the somewhat safer lampblack – mixed with oil for their eye make-up. They also used the poisonous vermilion to stain their lips, and the safer henna, not only to stain the soles of their feet like the Egyptians, but also to paint intricate designs on their hands and arms.
The Chinese and Japanese have used a lot of cosmetics in the past. To produce the traditional white face and bright red lips of the geisha they used a heavy layer of rice powder to dust the face and carmine to paint the lips, cheeks and nostrils.
In Britain, the ancient tribes used woad, a blue plant dye, both as a body paint and for tattooing. The Romans brought their own cosmetics with them when they invaded Britain and some of their cosmetics were duly adopted by the Celts. After the Romans left Britain in the fourth century, the idea of personal adornment came to be frowned upon, mainly due to the spread of Christianity.
And so, for several centuries, the Anglo-Saxons and later the Normans used very few cosmetics, although they did use a wide range of herbal lotions and mixtures for medicinal purposes. Then, during the Middle Ages, knights returning from the Crusades brought with them the knowledge of many new things, including cosmetics and perfumes, that they had seen both on their travels and while living in the Middle East.
Slowly, over the centuries, the fear of the Church and its teachings that vanity was evil began to give way to an increased use of cosmetics. The herbal preparations which had until then been used only medicinally now began to be used cosmetically as face creams and body lotions.
Elizabeth I – The Virgin Queen
Elizabeth Tudor used many cosmetics. A white face was considered to be very fashionable in her time and continued to be so for several centuries, and so lemon juice and rosewater were both used to bleach the skin. A pale complexion and white face demonstrated that you did not need to work; exposure to the sun while working in the fields produced the ruddy complexion of the farm labourer.
A variety of ingredients were used as face powders to produce the required fashionable whiteness. Ceruse (their name for white lead), a mixture of sulphur and borax powdered with finely ground alabaster or even perfumed starch set with a film of egg white were all used as face powders. Unfortunately once the egg white dried, it tended to crack. And the ceruse also turned grey as the day progressed.
Thick white face paint was much needed at that time to hide the ravages of smallpox, which in those days most people caught at some time in their lives.
The cheeks were rouged using the same white lead, but this substance was now coloured with red ochre or red mercuric sulphide. The lips were coloured by a salve made from cochineal mixed with gum arabic, fig milk and egg white.
Needless to say, some people died of lead poisoning just from their use of face powder or rouge.
Belladonna drops were put in the eyes to dilate the pupils and so gave ladies that wide-eyed and innocent look. Ladies in search of a husband may well have appeared more alluring as a result, but in fact using these eye drops meant that they could not focus properly and so had only a hazy view of their suitors, who may well have been pockmarked, old or just plain ugly. The eyes were lined with kohl, probably made yet again from the poisonous stibnite.
The Queen had naturally red hair, which in the past had been regarded as associated with witches and the devil. But now red or even golden hair became the absolute height of fashion. Red hair was achieved with a henna dye, while for golden hair turmeric, rhubarb steeped in wine or a rinse of saffron water was recommended. Today, people worry about a receding hairline, but not in Tudor times. It was the fashion then, as in medieval times, to pluck the eyebrows completely away and to pluck along the hairline to give greater length to the face.
One of the Queen’s beauty lotions contained eggs, including the shells, with burnt alum, sugar, borax and poppy seeds, all mixed together with water. Queen Elizabeth never married and never had any children, but those ladies of the court who became pregnant while using these lead and mercury cosmetics were prone to miscarriage or their children to birth defects as a consequence.
In 1724, an Act of Parliament was passed regarding the ingredients used in cosmetics. As a result many cosmetics became less harmful and safer to use. However, many people still preferred to use the old lead-based cosmetics as they gave much better coverage of pockmarks and other blemishes.
Even two centuries later in the 1920s, cases of lead poisoning due to the use of face enamel with a very high lead content were still being reported. In 1936, a serious case of lead poisoning was reported in the British Medical Journal concerning an actor whose theatrical grease paint was found to contain nearly 40 per cent lead, present as lead oxide.
Pink disease and calomel cream
Acrodynia, commonly called ‘pink disease’, was not just a problem for babies and small children, as mentioned earlier. It also resulted from adults taking calomel powders (calomel is mercury chloride) as a purgative. It was called ‘pink disease’ because of the unnaturally bright pink colour of the cheeks, nose, buttocks, hands and feet from the mercury poisoning.
In South America, adults regarded the bright pink colouration in a positive light, and so calomel powders and creams, marketed as beauty aids, were still on sale until quite recently. They were used by many people in Mexico as well as in some of the southern states of the USA. One such product called Crema de Belleza Manning, which contained up to ten per cent calomel, caused mercury poisoning to such an extent in some people that they required clinical treatment. This cream was widely advertised by its manufacturers for ‘skin cleansing and prevention of acne’!
Walnut juice and other wonderful hair dyes
Henna has been used for thousands of years as a hair dye. About a hundred years ago, it was also used in conjunction with indigo. A paste of one part henna and two parts indigo was left on the hair for varying lengths of time, according to the shade required: one hour for light brown, one and a half hours for darker brown, etc. It was a safe and effective natural hair dye, but some people are never satisfied and always want something better.
Potassium permanganate is an oxidising agent that occurs as tiny blackish-green crystals. A single crystal dropped into a glass of water dissolves to produce a beautiful purple-coloured fluid. But if you get it on your skin or on your clothes it will stain them brown. Potassium permanganate has been used in the past to dye white hair a chestnut brown colour and to produce an artificial tan. But, even 80 years ago, these uses were considered dangerous and inadvisable. Potassium permanganate is still used today, but for its antiseptic and astringent rather than cosmetic effects. It is used in a very dilute aqueous solution of one part in 10,000 for bathing areas of weeping eczema, to prevent infection of the weeping areas and also to help it dry up.
Silver nitrate is another chemical that stains the skin. This was the main problem with its use as a hair dye. In the late 19th and early 20th centuries, silver nitrate lotions of up to four per cent strength were used to dye eyebrows and eyelashes, and when combined with potassium sulphate could achieve different shades of brown or black. Combined with pyrogallic acid and ammonia these lotions could dye grey hair to jet black in a single application. But another problem with silver nitrate was the expense, so hairdressers looked for a cheaper alternative. They found it in a chemical called paraphenylenediamine.
Mrs Potter’s Walnut Juice Hair Dye was one of a number of these cheaper products that contained this substance as the active ingredient. There was not a drop of walnut juice in the product – the brand name was chosen simply as it alluded to the traditional use of walnut bark, which had been used since ancient times to dye wool a dark brown colour.
Paraphenylenediamine was present as an ingredient in hair dyes for at least a century. It was well known to doctors for causing dermatological and other problems even a hundred years ago. The use of soap, in an attempt to wash out the dye, aggravated the dermatitis that this type of hair dye caused. Many people were allergic to it.
Some ladies were so badly affected by the poisoning from the use of this type of dye that the only sensible course of treatment, although somewhat drastic, was to shave the head. The symptoms they experienced following use of these hair dyes included, initially, swelling of the head, neck, tongue, eyelids and face, followed by skin eruptions, eczema, nausea, nervous symptoms, sleeplessness, dizziness, weakness and even impairment of vision, sometimes leading to permanent blindness.
In 1922, Inecto Ltd issued a warning on the use of one of its products, which contained paraphenylenediamine and resorcin. However, this warning was insufficient to protect the company in a legal action brought forward following severe adverse reactions. Damages of £200 were awarded, a large sum of money in those days. It was claimed at that time that many hairdressers were using these hair dyes containing the problem ingredient paraphenylenediamine because they were so much cheaper than those containing silver nitrate.
Many hair dyes were very smelly to use, but in the 1920s a new odourless type, the copper pyro hair dyes, were introduced. With these, copper chloride and pyrogallol gave light brown, and the addition of ferric chloride gave dark brown. Or, by varying the quantities of the different ingredients used, even a natural looking black was possible.
Amidol hair dye, which contained different chemicals, was considered to be the best black hair dye available at the time and did not stain the skin, as silver nitrate did. Shorter application times with this dye gave various shades of brown, and several applications would be required to achieve a true black.
Lead acetate and sodium thiosulphate were also used as hair dyes and were included in products marketed as hair colour restorers, such as Grecian 2000 and Restoria, which are still on sale to this day. Apart from the henna mentioned at the beginning of this section, all these hair dyes are poisonous to a greater or lesser extent.
The importance of a patch test
The poisonous nature of hair dyes was well known even in the early decades of the 20th century, and deaths were reported from their use. In The Lancet in 1934, there was a report about a case of fatal systemic poisoning of a young hairdressers’ assistant. The young lady was only 21 years old and death was found to be due to liver damage caused by contact during her work with the chemicals in hair dyes and permanent wave solutions.
In spite of the known risks, paraphenylenediamine continued to be used as a hair dye because it was so easily applied, the colour was very permanent and it was capable of producing a range of natural looking shades. The hair dyed with it could also be permanently waved without difficulty, whereas this was not the case with those products containing metallic dyes, such as the silver nitrate and copper pyro dyes.
In 1937, the Medical Officer for the Ministry of Health issued a report in which it was stated that these substances should never be used without a previous patch test being done to determine any abnormal susceptibility to the ingredients. It is now recognised that about four per cent of apparently normal, healthy subjects are sensitive to paraphenylenediamine and that one per cent are acutely sensitive.
There have been a number of studies that have linked certain cancers to the use of hair dyes. Such findings have always been vigorously refuted by the manufacturers. Another risk was accidental ingestion, which caused vomiting, massive swelling, gastritis, increase in blood pressure, dizziness, tremor, convulsions, coma, cardiac and respiratory difficulties, sometimes needing treatment with an emergency tracheotomy. When used as hair dyes, the concentrations of the chemical phenylenediamine and its derivatives are now restricted by the Cosmetic Products Regulations, 1978.
Many hair dyes still contain phenylenediamine even today, but in much lower concentrations than used in the past, together with the addition of many other ingredients.
Hair dyes can now be safely used, providing that a patch test has been successfully completed before use.
Women still suffer adverse reactions to hair dyes, usually because they could not be bothered to take the time to perform the patch test before dyeing their hair.
Deathly depilatories
Depilatories, or hair removers, have been used for many thousands of years for purification, cleansing or cosmetic reasons. A variety of substances, mainly poisonous, have been used for this purpose. As already mentioned, the Romans were very keen on the removal of body hair, and they favoured the use of orpiment – that is, arsenic sulphide.
In more modern times, other less toxic sulphides have been used as hair removers, including the smelly sulphides of barium, sodium and calcium. Barium sulphide was used as a fine powder, which was first mixed with wheat starch, then made into a cream with water, and spread on the part to be treated. It had to be left for five to ten minutes before being removed with a blunt knife or spatula. This cream could not be used too frequently, because it caused dermatitis.
A patented German preparation available in the 1930s contained strontium sulphide mixed with corn starch, talc, dextrin, nerolin and essential oil. The dextrin in this preparation was claimed to protect the skin and hair follicles and prevent the bad odour associated with sulphides during use.
In the 1950s, it was suggested that the X-ray method of depilation, in use for the 40 previous years, was the method of choice. In the 1950s, X-rays were very popular and were used in a number of imaginative ways, until the dangers of excessive exposure were recognised, and precautions regarding their use were introduced. There were even special machines in most shoe shops at that time, so that children’s feet could be X-rayed and viewed through an eyepiece to see if the shoes allowed sufficient ‘growing room’.
Thallium acetate used to be recommended as a hair remover. Various hair removal creams containing thallium were once on sale as cosmetics, but the hair loss was really a symptom of thallium poisoning, caused by absorption of thallium through the skin. Thallium acetate is thankfully no longer used for such purposes.
Instead of thallium, thioglycollates are now the favoured ingredient for depilatory creams, and they are also used in the active lotion of home permanent wave and hair straightening kits. When used in hair straightening, the thioglycollate is subsequently neutralised by potassium bromate, or a similar but less toxic substance.
Contact dermatitis caused by thioglycollates can occur, with symptoms of swelling, redness, itching, and papular rash, which will all magically disappear when use of the offending substance is discontinued. As with hair dyes:
When permanent waving, patch testing before use is advised.
Rubber gloves should always be worn when using these lotions.
This is because barrier creams do not provide acceptable protection. Anyone who finds that they are sensitive to thioglycollates should take great care never to come into contact with them again.
Lipstick and eyeliner
Ladies are frequently surprised to learn that most lipstick is inadvertently swallowed and the more frequently it is applied, the more is swallowed. Lipstick is essentially a stick composed of waxes and oils blended together with dyes and perfumes, all of which must, of course, be perfectly safe when ingested. However, years ago some lipstick imported from Asia was found to contain the poisonous lead carbonate.
Kohl is the traditional eyeliner used in the Middle East, India and Asia. This black substance is traditionally made from a poisonous mineral called stibnite – antimony sulphide. There have been many, many cases throughout the twentieth century of lead poisoning that have been ultimately traced to various cosmetics.
Even today, there have been reports of lead sulphide in eye make-up, which has caused poisoning. Manufactured in India, this eye make-up was imported into Britain. Although such products containing lead are banned in the United Kingdom, eye make-up, such as kohls and surmas, may be imported privately, and some of these contain up to 83 per cent lead.
Today kohl tends to be mainly used for ornamental cosmetic purposes, but traditionally it was used as both a means of spiritual protection and a protection against conjunctivitis. This traditional protective use is unfortunately still continued, even today in the UK, by some misguided Asian parents on their children. They persist in using poisonous kohl and surma products, which they have imported privately from their homeland, when they could use Kajal, which is virtually lead free, and so much safer.
The scourge of skin colour
In addition to changing hair colour, cosmetics can also be used to change skin colour. The desire to lighten or darken skin colour has led to the production of a wide range of cosmetic products. Such changes are not without problems though, and these should be considered carefully before embarking on what may be irreversible and life changing.
A photographic developer called hydroquinone, which is still in use today, was first used in the early years of the 20th century. Those using it soon noticed that, after a period of time, it removed the pigment from skin. Entrepreneurs were quick to spot a new market and soon many preparations of creams, ointments and lotions containing hydroquinone were marketed for the treatment of pigmentation disorders. Many are still available today, particularly in Africa and South America. The use of hydroquinone in cosmetics and toiletries in the UK is now carefully controlled by the Cosmetic Product Regulations.
Hydroquinone reduces skin pigmentation in all races by interfering with the enzyme system involved within the skin. A radiographer who was exposed to a great deal of hydroquinone developed ‘darkroom hepatitis’ as a result of continuously using the film developer in the darkroom to develop X-rays. And he wasn’t even trying to improve his own looks!
Coloured people who use skin lightening products probably initially purchased them for cosmetic reasons. Unfortunately, after about six months’ use, those who use them regularly start to develop a blue-black hyperpigmentation called ochronosis. This effect occurs even when products containing a sunscreen are used. These people then fall into the ‘skin lightener trap’ as they then use other hydroquinone preparations to try to remove the disfigurement that has resulted. But the damage has already been done and they are now caught in a vicious circle. Most of them will only experience a partial improvement of their condition, even with the most careful management.
Ammoniated mercury was also included as the active ingredient in some skin lightening creams used in various parts of Africa. This resulted not only in mercury poisoning, but also damage to the kidneys.
Depigmentation can occur naturally in some medical conditions, such as vitiligo, an autoimmune disease most noticeable in dark-skinned races. The late pop star Michael Jackson suffered from vitiligo, although many thought he was a victim of skin-lightening products. He was diagnosed with the condition in 1986 and admitted to it during an interview with Oprah Winfrey in February 1993. Special cosmetic applications can be used to camouflage the affected area, even on the darkest skinned patient. The British Red Cross has a specialist service to teach patients how to use camouflage make-up successfully.
Faking a tan
For the lighter skinned who wish to appear suntanned, products containing colourants are available. The orange food colourant canthaxanthin is widely used today in fish farming. It is given to salmon and trout in their food to colour their flesh, as this improves the price that the fish can be sold for at the fish market. In the past this food colourant was sold for humans as Orobronze capsules, which were taken by mouth as a means of producing an artificial suntan.
The main problem with the use of this ‘cosmetic’ product was that it stained not just the skin, but the underlying flesh as well. This led to problems for doctors – and surgeons in particular – because if they needed to operate on a patient who was taking these capsules, the flesh appeared to be an abnormal colour and masked the normal colouration that would guide the surgeon as to the state of the patient while on the operating table.
Canthaxanthin was also used medicinally for a short time in the management of the medical condition erythropoietic protoporphyria, a metabolic disorder where the skin needs special protection from sunburn. Unfortunately, this use led to problems with the vision of such patients. There was even a report about someone who took canthaxanthin to produce an artificial tan and who subsequently died of aplastic anaemia as a consequence.
Recently a new tanning product, Melanotan, has been introduced. This is injected daily for the first seven to ten days until the desired level of colour is obtained, and then this colour is maintained by weekly top-up injections. The product stimulates the melanocytes, the cells that produce melanin, to produce even more melanin than normal, thus affecting a tanned appearance. But no long-term studies have yet been done to determine the product’s long-term side effects, or if it will increase the risk of malignant melanomas, so it has not officially been licensed for use.
A different approach to achieving an impressive suntan was to use 5-methoxypsoralen, an ingredient of bergamot oil that was included in a number of highly popular suntan preparations. This same substance was used medicinally, taken by mouth by sufferers of psoriasis and vitiligo in a treatment introduced about 30 years ago.
This treatment involved exposure of sufferers’ skin to ultraviolet A light. Concerns about the possible risk of phototoxicity were expressed, particularly about a type of photosensitivity resulting from this use of 5-methoxypsoralen, which became known as Berloque dermatitis. Apart from the short-term risks of sunburn, this treatment fell from use some years ago because of the long-term risks of skin cancer and accelerated skin ageing.
Para-aminobenzoic acid (PABA) was used as a sunscreen for many years, usually as a five per cent solution. It effectively absorbs ultraviolet light throughout the harmful UVB range while absorbing little or no UVA light. The UVB rays are harmful as they can cause mutations leading to skin cancer. However, photosensitivity reactions to PABA have occurred, as have hypersensitivity reactions to other chemically related drugs. Adverse skin reactions, such as vitiligo, have also been reported following its use. PABA can also stain clothing rather badly, which is a less than helpful problem with its use.
Safer sunscreen products have been developed in recent years, such as zinc oxide and titanium dioxide. Zinc oxide reflects ultraviolet radiation and so is included in many sunscreens, including the sticks used by sportsmen to apply to their cheeks and nose. Titanium dioxide also reflects ultraviolet light and so is used in sunscreen preparations to prevent sunburn. It is also contained in some face powders and other cosmetics. Having a similar action to zinc oxide, it is also used in creams to relieve itching and in the treatment of certain skin problems, such as nappy rash.
Poisonous perfume and a noxious necklace
Nitrobenzene was known a century ago as Oil of Mirbane or Artificial Oil of Almonds. It was widely used in cheap perfume and soaps. This pale yellow liquid, which smells somewhat like almonds and has a sweet taste, could cause poisoning by absorption through the skin or by inhalation. It is very toxic, and the ingestion of as little as 1g can be fatal. But, unfortunately, the symptoms of poisoning are usually delayed for up to 12 hours, by which time treatment may be too late. Starting with nausea, a burning headache, prostration and intense cyanosis, with vomiting and gasping for breath, the symptoms lead on to convulsions, coma and death in a few hours after they appear. It is interesting to note that strychnine, another deadly poison, was the recommended antidote, together with the use of stimulants, in the treatment of nitrobenzene poisoning in the 1920s.
In the 1960s, several medical journals carried reports about a woman who wore a necklace that included some ‘beads’ that were actually the seeds of the castor plant. She experienced a severe allergic response when one of the seeds was broken, exposing the neurotoxin ricin within. She had suffered two earlier mild attacks of itching on her neck, which were also later believed to be due to this poisonous necklace. Ricin is the poison that killed Georgi Markov, detailed in Chapter 3.
Creating the body beautiful
Cosmetic surgery has come a long way in recent decades, with botox and fillers to smooth out wrinkles, as well as more serious surgery to treat and repair disfigurements, both accidental like burns, and congenital like cleft lip and palate. Silicone implants are the modern way of increasing bust size. But even back in the 1920s and earlier in the twentieth century, some women were persuading doctors to help them improve their looks.
Before the silicones were invented, doctors used a special paraffin wax for similar purposes. It had a melting point about ten degrees above body temperature, so the operating theatre had to be kept very warm to prevent the molten paraffin wax from setting in the syringe before it was injected. Thus were deformities of the nose, ears and face improved a century ago. Liquid paraffin was also used for this purpose, but because it was liquid, various lumps and bumps could result in the wrong places.
In the 1970s, a case of liquid paraffin being inserted in the wrong place happened to the face of a 49-year-old Asian woman. She developed painful swelling and redness of the skin some seven months after she received injections of liquid paraffin around the eyes and in both cheeks for cosmetic purposes. Although her condition did improve after some surgery and steroid medication, it was felt that complete surgical removal of all the affected tissue was the only effective treatment. A few years later another patient, who had received injections of liquid paraffin into her breasts some 60 years previously, developed florid chronic inflammatory local reactions with hard cysts forming.
Since the introduction of silicone breast implants in the 1960s, there have been a number of reports of problems. Women undergo breast augmentation or reconstructive surgery following mastectomy or for cosmetic purpose, but there is always some risk of migration of the silicone, with cyst formation and other complications. In the past, there were many anecdotal reports of connective tissue disorders concerning silicone implants. And, in the 1990s, litigation by patients affected by autoimmune disease and cancer, which they claimed resulted from leakage from silicone implants, led the manufacturer Dow-Corning to file for bankruptcy.
Even today there are problems, particularly in the USA where there are many so-called cosmetic surgeons who are simply back-room quacks offering cut-price cosmetic surgery, sometimes even from make-shift clinics set up in hotels rooms. They tend to use industrial-grade liquid silicone, which is an inexpensive material often used in adhesives and paint.
The toxic effects of liquid silicone have been known since 1979, when the FDA published an article warning of the ‘serious and sometimes fatal complications’ of silicone injections, including ‘swelling, discolouration, cyst formation and migration of the silicone particles to the brain, lungs or heart’. The silicone migrates, creating granulomas, which are benign, inflammatory tumours. These can wreak havoc by appearing anywhere, on the face or wherever else the silicone was injected.
Even the breast implants comprised of silicone encased in plastic have caused problems as some of these have also leaked, allowing the liquid silicone to escape into the surrounding tissues. In 1992, the FDA called for a moratorium in the US on the use of breast implants. However, despite all the problems and attendant publicity, large epidemiological studies and a review by the British Medical Devices Agency have failed to show any association between silicone breast implants and connective tissue disorders.
Anti-wrinkle creams
Some cosmetics containing oestrogens, the female sex hormones, have been marketed in the last century. In 1938, an American medical journal carried a report about a face cream that contained oestradiol, sold commercially as an anti-wrinkle cream. The use of this type of product led to claims of a number of adverse effects, such as precocious puberty in children who used them, and gynaecomastia (development of breasts) in men, while elderly ladies became very distressed when they developed post-menopausal bleeding. The report included details of how the anti-wrinkle cream was tested by being applied daily to the skin of some experimental animals. Testers found that it was absorbed through the skin into the bloodstream of the animals, which resulted in definite internal effects. Needless to say, the use of such hormonal creams is very carefully regulated today.
Poisonous preservation
Whether packaged in pots, jars or tubes, as soon as the lid is first removed any cosmetic may become contaminated, from the air we breathe, or more likely from contact with our fingertips. Microbial contamination can readily spoil cosmetic preparations, particularly creams and lotions. All cosmetics need preservatives to prevent deterioration due to chemical changes such as oxidation. If they are prepared without a preservative such contamination could cause some very nasty infections.
Today in the UK, we have legislation that regulates cosmetic products and the ingredients used to make them. The use of colouring agents in cosmetics is also controlled. Any cosmetics containing lanolin must be labelled ‘contains lanolin’ because so many people were allergic to it in the past. Many of these hypersensitivity reactions were in fact due to impurities, such as detergent, used in processing, and naturally occurring fatty alcohols. When lanolin is suitably treated to remove these impurities the incidence of hypersensitivity is reduced to almost zero. It is reassuring to know that, today, lanolin causes far fewer problems – it is now far more highly purified than it was in the past.
A final sobering thought
In November 2008, researchers at Imperial College in London suggested that women exposed to hairspray during the early stages of pregnancy are more than twice as likely to give birth to a son with a serious genital defect, known as hypospadias. This unfortunate condition results in the urinary opening being on the underside of the baby boy’s penis. Certain chemicals in the hairspray aerosol, known as phthalates, may be the cause. The first three months of pregnancy are always the most crucial for the baby’s development.