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From the Townsend Letter
June 2019

The Skin as Exposome: An Underappreciated Route of Entry for Toxicants
by Anne Marie Fine, NMD
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Lead and aluminum are the primary neurotoxins found in personal care products. The FDA conducted a study that found lead in 100% of all the lipsticks, with tested levels up to 7.19 ppm.24 (See Table 2)

Table 2: FDA Analyses of Lead in Lipsticks – Expanded Survey .pdf
Lead from lipstick poses harm because exposure is due to ingestion; after all, lipstick commonly winds up on teeth or the food that the woman is eating, which is why lipstick is commonly applied several times per day. As no level of lead has been proven to be safe in children according to the CDC, pregnant and breastfeeding women are a particularly vulnerable population.25 The CDC reports that even low levels of lead in children's blood have been shown to affect IQ, attention span, and academic achievement.
Researched NutritionalsAluminum is widely found in anti-perspirants and is considered a neurotoxin and metalloestrogen.26 It has been found in breast tissue and fluids at higher levels than in blood. Over time, breast cancer incidence in the upper outer quadrant of the breast has increased, leading to questions of whether or not aluminum-containing underarm cosmetics may be contributing to this phenomenon.26 In one small study analyzing nipple aspirate from women with and without cancer, significantly increased aluminum and pro-inflammatory and chemoattractant cytokines were found in the women with cancer, suggesting that aluminum accumulation in the breast may be a possible risk factor for breast cancer.27 In a recent case control study, the use of underarm cosmetic products containing aluminum salts multiple times per day commencing prior to age 30 had a significant increase in breast cancer risk (OR of 3.88 (95% CI 1.03–14.66)).28

Several agents listed by the IARC as Group 1 carcinogens can be found in personal care products: formaldehyde, 1-4 dioxane, and ethylene oxide.29 For the most part, these are found as contaminants in formulations except for formaldehyde, which is either intentionally added to formulations such as certain hair-straightening products, or released slowly into a product from a formaldehyde-releasing preservative system. Because of this fact, they will not be explicitly listed on a label as "formaldehyde," making it important to know how to determine its presence.
In the case of formaldehyde-releasing preservative systems, the chemicals that are listed on the label slowly release formaldehyde over time, which preserves the product. The health concerns with formaldehyde releasers include direct toxic effects and contact dermatitis for many users. In fact, the American Contact Dermatitis Society awarded formaldehyde its dubious honor of being the 2015 contact allergen of the year. Twenty of all cosmetic products, including 17% of stay-on products and 27% of wash-off products contain formaldehyde releasers. These formaldehyde-releasing preservative system chemicals include the following:

  • Quaternium-15,
  • Dimethyl-dimethyl (DMDM),
  • Hydantoin,
  • Imidazolidinyl urea,
  • Diazolidinyl urea,
  • 2-bromo-2-nitropropane-1,3-diol (bronopol),
  • Sodium hydroxylmethylglycinate.30

IMMH 2019Both 1-4 dioxane and ethylene oxide are by-products of the ethoxylation process, which is a method used to make certain agents less harsh by reacting them with ethylene oxide. This process can result in small amounts of 1-4 dioxane and residual ethylene oxide in the product. You will not know if this appears in the product of question because these are an unintentional byproduct of the ethoxylation process and may or may not be present at all since some companies use vacuum stripping to remove them. However, if the label contains the following chemicals that have been subject to the ethoxylation process, then the contaminants might appear in the final product:

  • Sodium laureth sulfate,
  • Polyethylene,
  • Polyethylene glycol (PEG),
  • Polyoxyethylene,
  • Polysorbate,
  • Or any ingredient with "xynol," "ceteareth," or "oleth."30

When assessing the entirety of the exposome that affects human health, it is important to consider the invisible sea of synthetic chemicals being applied to our patients' bodies every day. Consumer awareness about human health concerns associated with various ingredients used in personal care products is increasing markedly. This has placed considerable demand on the companies that formulate these products to produce safer products even in the face of regulations that have simply not kept up with the science. Indeed, other countries are already adhering to the Precautionary Principle and formulating safer products for their people through the lens of stricter regulations. As we evaluate our patients' toxic body burden with appropriate attention paid to the daily use of myriad personal care products, we can identify problematic exposures and make well-informed suggestions for replacement products.

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References .pdf

Anne Marie Fine, NMD, is a practicing naturopathic doctor focused on environmental medicine who is based in Newport Beach, California. She currently serves as vice-president for the National Association of Environmental Medicine, teaching healthcare providers this emerging specialty. She is also a member of the American Academy of Environmental Medicine and a science advisor for the non-profit Dr. Fine speaks and consults globally within the personal care product industry and guides companies to formulate with cleaner ingredients.

Dr. Fine has been published in peer-reviewed medical journals, Thrive Global, and popular magazines alike. She is featured regularly on health podcasts, TV, and radio shows. Dr. Fine is also the international bestselling author of Cracking the Beauty Code: How to program your DNA for health, vitality, and younger-looking skin, a book that synthesizes her knowledge of skin aging, gene-environment interactions, and environmental medicine. She is also the founder and CEO of IAMFINE®, an integrative beauty and wellness brandthat empowers women to take control of their health and beauty.

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