Whilst makeup can transform a woman’s face and boost her confidence patients must be made aware of the dangers of possible eye infection and injury caused by makeup. mivision spoke to optometrists to find out more.
It’s a well known fact that much of what we put on our skin is absorbed by the body. For the more sensitive among us, this can be problematic. A friend’s young daughter for instance, has to avoid certain sun creams and moisturisers as they’ll have her scratching the welts that rise up for days on end. Expired products or products that have been unwittingly contaminated cause her even greater upset.
It stands to reason then that should she put anything near her body’s most delicate organ – the eye – she needs to be even more careful.
It’s not just the sensitive that need to be wary of the risks, because the occasional itch or red eye caused by makeup can develop into permanent vision damage or on rare occasions, even blindness. According to medical research, that’s because over time bacteria sitting in makeup multiplies rapidly, increasing the chances of infection or an allergic reaction with ongoing use of the product.
Optometrists need to take a sterner approach when examining and questioning patients about their eye care habits
Not that many people seem to take heed of this fact. In the United Kingdom, 49 per cent of women do not look at expiration dates and 66 per cent admit to using expired products because they’re not worried about health concerns.1
In Australia, cosmetic products are regulated by the Therapeutic Goods Administration (TGA) and the Department of Health and Aging’s National Industrial Chemicals Notification and Assessment Scheme (NICNAS), however, once the products are on the shelf at home, the controls go out the window.
Catching the Culprit
Eye infections can affect people in any age group and, like most other diseases, can only be effectively treated if they are accurately diagnosed. That’s essential because, according to research, even the smallest amount of scar tissue resulting from an infection, can cause irreversible visual impairment.
Narelle Hine, an optometrist at Hinesight Sydney, believes optometrists need to take a sterner approach when examining and questioning patients about their eye care habits.
“Most people have some degree of the staphylococcus bacteria that constantly live around the eye lid and that’s considered normal. However, I’m really concerned about the rate of eye infections and injuries in patients that are caused simply by a lack of knowledge or understanding of the basics of eye care hygiene,” says Ms. Hine.
“There is a classic story of a woman who used to apply her eyeliner while eating breakfast every morning. She would eat a spoonful of yoghurt, lick the makeup brush, and then dip it into the pot of eyeliner before applying it to her eye.
“Human saliva is rife with bacteria, so naturally, her constant eye irritations and infections were the result of the build up of bacteria from the yoghurt and saliva as well as re-infection from the eyeliner! What a melting pot of bacteria – literally!”
While infections due to contact with contaminants is one area for concern, another is the diseases that result from expired products.
Dr. Patrick Bowler, a leading dermatologist and the founder of The British Association of Cosmetic Doctors said: “All products have a length of time during which they are most effective. If you keep cosmetics longer than that, they no longer work well and you increase the risk of contamination.”
All cosmetics contain preservatives of one type or another to slow the rate of growth of bacteria during storage. However, bacteria will continue to multiply the longer it is in the product, exposed to air and being used. According to experts, once opened, liquid eyeliners and mascaras have a shelf life that’s as short as three to six months, even less for contact lens wearers.
Taming the Tools
One of the most serious eye related complication stemming from the use of makeup is injury to the cornea. An accidental scratch by a mascara or eyeliner wand or fingernail can cause a corneal abrasion that can become infected leading to a potentially blinding corneal ulcer.
Optometrist and Director of Specsavers Randwick, Helen Brown recommends female patients sharpen their eyeliner pencils regularly before use to ensure the rough wood casing doesn’t scratch the eye or lid.
“Kohn pencils can be particularly worrying as they can not only harbour bacteria, but are sharp objects used directly around the eye. Its important patients sharpen kohl pencils every few days. Swirl a tissue around the tip of the pencil to wipe off surface bugs and bacteria and always replace it into its end cover,” advised Ms. Brown.
“The wax from kohl pencils is particularly troublesome as it can easily become inserted into the tears when it’s used too closely to the inner rim of the eye. This clogs the meibomian glands with a waxy substance that’s trapped in the tears and is unable to be released from the eye until it’s appropriately cleaned.”
All women who wear eye makeup will at some stage go to sleep without carefully cleansing their eyes. According to the optometrists we spoke to, this can exponentially increase the chances of infection as most people inadvertently rub their eyes with their fingers or against the pillow while asleep. Bacterial accumulation and makeup flakes seeping into the eye can result in red, itching, bloodshot, weeping and even scratched corneas.
Both Ms. Hine and Ms. Brown recommend using specially formulated cleaning products daily to remove cosmetics, accumulated oils and crusted matter while cleansing the eyelids and lashes, without leaving an oily residue.
“I recommend patients apply a hot compress to the eyes and use cotton buds soaked in a gentle ophthalmic cleanser in an outward to inward sweeping motion, to ensure all makeup residue is adequately removed at the end of the day,” said Ms. Brown.
Extreme Eye Measures
It’s not just cosmetics that contribute to the number of eye infections presented to practitioners. Increasingly popular beauty and skin care services such as the application of eyelash extensions, eyelash tinting, and permanent eye makeup tattooing is raising concerns. Reportedly, many service providers fail to provide after care packages and advise, or follow up consultations.
Christina Reed has synthetic eyelash extensions professionally applied to her natural lashes every fortnight at a Sydney nail and beauty salon. It is a simple walk in, walk out process. However, she too has never been offered after care advice or a care pack upon leaving the salon.
While Ms. Reed says she is fortunate to not have had any allergic reactions to the adhesive glue used to bind the lashes, she admits her at home eye care routine now leaves a little to be desired.
“Besides using soap and water to wash my face, I don’t use any separate eye makeup remover on my lashes. As it is, you need to be extremely careful when touching or rubbing the eye area as the lashes can fall out quite easily, so I tend to avoid really rubbing or cleaning the eye area too much.
“I haven’t had any serious eye infections, however, I frequently wake up with itchy and sometimes red or watery eyes and they often become irritated during the day. I’ve learnt to just deal with it.”
Contrary to Ms. Reed’s belief that she has not suffered from eye infections, her symptoms suggest otherwise.
Optometrist Narelle Hine stresses it’s imperative for eye practitioners to correctly identify and differentiate between eye infections or injuries that are caused from improper eye care or cosmetic practices as opposed to those resulting from other means and to advise accordingly.
“Relatively minor infections can quickly develop into serious disorders, so it’s wise to treat any initial infections quickly and aggressively. It’s worth noting they’re also highly contagious so those who come into contact with someone who has the infection are at a higher risk of contracting something.”
One of these infections is bacterial conjunctivitis (commonly referred to as pink eye infection) which results in redness, burning, itchiness and discharge. Patients often mistake these symptoms for tired or irritated eyes and leave it undiagnosed.
Blepharitis, a chronic inflammation of the eyelid caused by the staphylococcal bacteria is a major cause of eye discomfort. The symptoms include burning, redness, tearing, light sensitivity, and a sandy or gritty sensation that’s usually worse upon waking.
Sty infections, another common disorder, often manifest as tender, red bumps in the oil glands of the eyelid, and they are also frequently makeup induced.
Where Are the Watchdogs?
According to The Trade Practices Act 1974, ‘A consumer product information standard exists for cosmetics. It requires products to be labelled with a list of ingredients so consumers may:
- Identify ingredients to which they may be allergic or which may cause an adverse reaction; and
- Compare various cosmetic products.’
Interestingly, the National Industrial Chemicals Notification and Assessment Scheme (NICNAS) classes ingredients in cosmetic products as industrial chemicals, even those described as naturally occurring; a slightly disturbing revelation considering many of us apply generous lashings of these products to our faces and around our eyes on a daily basis.
Eye irritation testing is done by a wide variety of industries from cosmetics to pharmaceuticals to industrial chemicals. The type of information required by each varies but is generally designed to assess five parameters – cytotoxicity, changes in tissue physiology and biochemistry, quantitative structure-activity relationships, inflammation mediators, and recovery and repair. Many of the endpoints measured in these whole organ cultures are the same as those measured in vivo, such as corneal capacity and corneal swelling. 2
While cosmetics giant Shiseido defines their products labelled ‘dermatologist and ophthalmologist tested’ as ‘formulated to minimise the risk of allergy and eye irritation’, the majority of cosmetic brands who claim their products are also dermatologist and ophthalmologist tested, do not actually provide an explanation on their products or websites, substantiating this. These claims are not standardised by any regulatory body, nor are they verified, but are made on the part of the manufacturer, to reassure customers that their products are safe to use on skin.
“Ella Bache’s eye care products undergo specific testing to guarantee that they are safe to be used around the eye area,” said Amber Scott, National Field Training Manager at Ella Bache. “The products highlight this by having a claim that the product is ophthalmologically and dermatologically tested,” she said.
According to Cranberry Lane Natural Beauty, “These terms usually mean that a test on the product was conducted to ensure that the product is not (or less) irritating to eyes or skin, and that this test involved a skin or eye doctor at some point during the study. They test to gauge the safety of the product, rather than to assess the quality or performance of the product. There are no regulations that standardise the type or number of tests needed to use this claim on labels.” 3
Cosmetics and Contact Lenses
Optometrists advise that contact lens patients need to be especially vigilant when selecting and using mascara, eye shadow and other eye makeup as they can run the risk of suffering corneal abrasions or ulcers if dust or makeup specs become trapped under the lens. Contamination of a lens is mainly due to oil, residues or bacteria found in cosmetics.
“Contact lens wearers should never use waterproof mascara as it’s impossible to remove if it gets onto the lens,” says Ms. Brown. “The iridescent particles in frosted eye shadows can also easily fall into the eye and stick to the lens, possibly scratching the cornea.”
While this may sound like trouble for contact lens wearers who love to wear makeup, it doesn’t need to be the case. However it is up to the eye care practitioner to remind patients of simple, common sense precautions that will minimise the chances of contracting eye infections or injuries through poor cosmetic hygiene rituals.
2. Encyclopaedia of Occupational Health and Safety, Volume 1; Volume 5, By Jeanne Mager Stellman, International Labour Office, 1998, p33.48
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