From the shoes you wear to the makeup you use, beauty has its risks. How can you protect yourself from bacterial infections and allergic reactions?

Two screenwriters were walking down Hollywood Boulevard when one of them exclaimed: "Oh my God! She must be beautiful!" Looking ahead, the other scribe saw only two other young men walking toward them. "Who must be beautiful?" he asked. "The woman walking behind us! Can't you see the looks on the faces of the guys up ahead?"

Not all women are concerned with turning every possible male head. Nonetheless, women have always spent considerable time, money and effort to look as attractive as possible. But, sometimes, the pursuit of beauty can actually be dangerous to your health.

 

"With artificial nails, it's a matter of when, not if, you come down with some sort of infection."
Karyn Grossman, M.D., dermatologist

Makeup maladies

The cosmetics you use everyday can cause serious infections and allergic reactions.

Infections

"Eyelashes naturally contain bacteria," says Alice Matoba, M.D., associate professor of ophthalmology at Baylor College of Medicine in Houston, Texas. "As soon as you use a makeup brush on the eyelash or eyelid, the brush becomes contaminated." Over time, bacteria grow in the cosmetic container, increasing the chance of an eye infection or allergic reaction. Liquid products—foundation, mascaras or moisturizers—are the most likely to harbor bacteria because water is their main ingredient. And bacteria thrive in water.

If you poke yourself in the eye while applying mascara, get thee to an eye doctor. It's more serious than you think, because many city water supplies carry a microbe that, left untreated, can lead to blindness. "Your eyes and lips are openings to your mucous membranes," says Karyn Grossman, M.D., a dermatologist based in Los Angeles, "so never share your lipstick or eyeliner. You could put yourself at risk of a staph infection or viruses like hepatitis, herpes, mononucleosis, or even warts."

To be safe, Dr. Matoba suggests keeping makeup for no longer than three to four months. It's probably safest to use inexpensive sponge tip applicators designed for eye makeup and just toss them away after each use.

Footwear fashions

Watch out, ladies. Those pretty shoes can cause leg problems. As a professor of orthopedics at the University of Southern California, Carol Fry, M.D., measured the feet and shoes of 350 women. She found that 88% wore shoes too small for their feet, which can lead to its own set of foot health woes. (For more on foot health, see "Buying Shoes to Save Your Soles.")

Footwear problems can also move up the leg. Scientists at Spaulding Rehabilitation Hospital in Boston have proven what millions of women have known for decades—that wearing high-heeled shoes can hurt. But your knees may pay the price, as well.

Casey Kerrigan, M.D., and colleagues at Spaulding and Harvard Medical school asked twenty fit women (average age 36) to walk in bare feet and then in high heels. Special sensors recorded the movement of the women's ankle and knees, and measured strains on the various joints. Results— In heels, 23% more strain was found between the kneecap and thighbone and on the inner side of the knee joint.

"I believe enough evidence has been gathered that women should switch to wearing flat-heeled shoes," says Dr. Kerrigan. More women might already be heeding that advice. Dr. Cherise Dyal, M.D., studied 531 working women in New York City and found 44% wore flats to work. Thirty percent had ditched fashion concerns altogether and wore running shoes.

Beware the salon

Doctors writing in Modern Medicine have reported a phenomenon in some older women called "beauty shop stroke." That happens when a woman who has atherosclerosis—hardening and clogging of the arteries—gets her hair washed and leans backwards into the sink or rinsing bowl. If her neck is also turned to one side, pieces of plaque can break away and become lodged in blood vessels of the brain. Avoiding this danger is simple—just sit facing the sink and bend forward.

And let's not forget your nails. "With artificial nails, it's a matter of when, not if, you come down with some sort of infection," says Dr. Grossman. "Yeast and fungal growth are the most common, but those type nails can turn red, black and then green before rotting off. If you are lucky enough to regrow your own nails, they may come in deformed." The artificial nail process is dangerous because the nail's top layer is usually ground away by an electric sander, which can damage the nail bed permanently.

And while you're in the beauty shop, says dermatologist Dean Kane, M.D., co-director of the Cosmetic Surgery Specialists at Mercy Medical Center in Baltimore, Maryland, you should also steer clear of any face peels using alpha hydroxy acid (AHA) or salicylic acid. "In the search for younger-looking skin, we see some women in our office who have had their faces burned, blistered and bleeding," says Dr. Kane. "Many beauty shop operators don't know your medical history and are not skilled enough to use those acids."

The FDA on alpha hydroxy acid

Since 1989, the Food and Drug Administration (FDA) has received more than 100 reports of adverse reactions in people using AHA products. Their complaints included severe redness, swelling (especially in the area of the eyes), burning, blistering, bleeding, rash, itching, and skin discoloration.

FDA believes reactions from AHAs are probably even more widespread. Past experience suggests that for every adverse reaction report the agency receives, the manufacturer receives 50 to 100. "This would translate into approximately 10,000 adverse reactions being received for AHA-containing products," says John Bailey, Ph.D., acting director of FDA's Office of Cosmetics and Colors.

Also, their relative newness (they've been widely available only since about 1992) means that their long-term effects are unknown. An industry-sponsored study found that people who use AHA products have greater sensitivity to the sun, raising the specter of greater risk of photoaging and skin cancer.

"There are many unanswered questions in front of us," Bailey says. "AHAs are unlike anything else ever introduced onto the cosmetic market on such a wide scale. They are not your traditional cosmetics."

Looking your best

There's nothing wrong with looking good. Just don't put yourself at risk in your quest to look your best.

Resources

Lotus Light Publications, 1998.

"Clearing up Cosmetic Confusion" FDA Consumer, May-June, 1998
http://vm.cfsan.fda.gov/~dms/fdconfus.html A great article outlining the differences between cosmetics and drugs, chemicals to avoid, buyer beware tips, and cosmetic safety.

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