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 cruel.

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 breathing.

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 first.

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

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Heretic Physician