For those who have written to me wondering how we doctors can possibly
absorb and retain all that medical lingo, let me tell you a secret: I advise
my students not merely to memorize but to understand the origins of the
terms. This leads to a fascinating image of medical problems, the way the
ancients saw them. The images are surprisingly accurate and indelible enough
even to get this large doctor through med school. A prime example is a word
we hear every day, cosmetics, which comes from the Greek kozmeticos meaning
to "arrange in order." If you are one of many female (and increasingly
male) consumers you are exposed to the plethora of some 4,000 make-up ingredients.
We pay a dear price for cosmetics, and not only monetarily. Many of us react
with anything from a mild skin irritation to life threatening allergies.
Hair dyes, preservatives, and fragrances are the worst culprits. The problem
is that for all the token research, the authorities do not follow cosmetic
safety as closely as drug safety. If people have a reaction to a prescription
drug they are likely to report it. If make-up irritates, it is usually thrown
away and the offending product proliferates.
The words "dermatology tested" on a product do not necessarily
mean it has been approved by a skin specialist. For that matter, animal
testing does not always parallel human conditions and is often considered
There are some specific conditions that you should be aware of. Make-up
foundation creams and/or blush can cause Cosmetic Acne in which pimples
crop up on the face. These pimples start as tiny glands that are normally
meant to secrete a fatty oil that protects your skin from drying out. Some
cosmetics not only block the pores but stimulate greater production of oil
which gets trapped. Before long acne prone individuals have a bunch of angry
volcanoes ready to burst. Treatment includes the use of make-up that specifies
it is "antiacne". You might also use benzoyl peroxide or medicines
that will help open up plugged pores, on the advise of a physician.
Another problem is Cosmetic Seborrhea. The term originates from the Latin
sebo which means suet or greasy fat, and rhea meaning "flowing."
As the term might indicate, irritation by cleansing creams and moisturizers
causes the oil glands to ooze too much yellow greasy stuff. The oil mixes
with dead skin causing itchy crusty flakes which, when scratched off. leave
raw red skin. Rose water and glycerin is a better moisturizer if you are
allergic to others.
What about the true allergies? Almost all make-ups and hair dyes can cause
reactions in certain individuals, especially those with fair hair and skin.
Allergies occur when the soldier cells in our blood stream sense that a
foreign substance is trying to invade. On first exposure, there is often
a mild redness and irritation; the body trying to get you to scratch the
substance off or at least pay attention to the problem. But the soldier
cells get prepared for the next battle by producing vast numbers of specialists
that recognize and specifically attack the offending substance. They lie
dormant until you eat peanuts (if that is your specific allergen) or use
perfume and then explode into battle. Their little chemical bombs can cause
itchy hives, or more seriously, swelling of the airways and tongue compromising
Hypoallergenic (hypo means "less than") products don't contain
the most common irritants, but some of you may still be susceptible to irritation
as individuals react differently. How often have you seen the claim "all
natural ingredients" and felt you were safe? Don't be swayed, these
products can be just as allergenic as pollen and poison ivy, which are after
all, produced by natural plants.
Some substances cause pigmentation problems. These are more common in dark
skinned people. Interestingly, perfumes are the worst culprits. In some
people they cause the tiny dark pigmented spots, like bunches of freckles
on faces and arms. Some fragrances actually combine with skin proteins,
which, when exposed to the sun form these dark pigmented areas that are
so clearly demarcated they look as if they were applied with a paintbrush.
This is called photosensitivity (photo means "light").
Bleaches or chemicals applied in strong concentrations can cause not only
red, burning skin but patchy hair loss, brittle hair etc. So called permanent
waves or straighteners can do this also. The good news is that the hair
usually comes back with cessation of use.
Years of nail polish use may cause a yellowish discoloration. After several
applications and removals, the polish absorbs right into the nail. If you
avoid polish, the nail will eventually replace itself with a normal texture.
You can prevent the process from recurring by applying an acrylic base coat
I'm sure this column will prompt many questions. Feel free to write, or
approach your doctor. The best advice for dealing with cosmetic reactions
is to simply discontinue using the offending product. ß