How do cosmetics affect my skin health?
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Follow Power and Politics wherever you get your podcasts, including YouTube. This is a CBC Podcast. I'm Dr. Brian Goldman. Welcome to The Dose. I don't wear cosmetics, but I do know they're big business. Hayley Road Bieber recently sold her brand of cosmetics for an estimated $1 billion.

Hi, Renee. Welcome back to The Dose. Hello. Thank you for having me, Brian. So, Renee, how much time do you spend each day taking care of your skin? A lot.

On a good day, I'd probably say 10 minutes in the morning and maybe 10 to 15 at night. Well, then that means you put some effort into it. So is the morning routine more important or the night routine? The night routine, because that's when we're settling our skin down. Okay. So that's why we came to you for the answers. And we know that you've got them. But before we begin our conversation, please give us a hi, my name is. Tell us what you do and where you do it.

Hello, my name is Dr. Renee A. Beach. I'm a dermatologist and I practice both medical and cosmetic dermatology in Toronto at Derm Atelier on Avenue, as well as being an assistant professor at the University of Toronto Faculty of Medicine. Let's start with makeup. How can it affect the health of our skin? Well, I think in the best case scenario, makeup can affect skin health depending on the actives that are included in it.

So when you have a makeup, for example, that says it's oil control or it says it's acne fighting, what we'd want to see in that list of ingredients is something like salicylic acid because that's going to act as a mattifier of the skin and it's going to help to treat oil which can produce acne. I think in the worst case scenario, when one is wearing too much makeup or perhaps they're using something that's significantly containing oils or perhaps they're putting makeup on skin that's uncleansed or acne prone,

that would negatively impact skin health, leading to more acne, which leads to discoloration, or in the worst case scenario, having a change in the face that is really the exact opposite of what they want, which is enhancement. Instead, it's detracting from their appearance.

Is it the additives that give the health-giving properties of makeup, the medical additives, or is it other things? I mean, it's actives, and it's also things like minerals. So take, for example, tinted sunscreen or even foundation or concealer. When those come out of their bottles, they're colored. And that, we now know in the last five years, is actually helpful in preventing things that discolor the face, things like melasma, or it's protective for patients who might have vitiligo.

So it depends on the formulation, of course, but also the consistency with which one applies said product. It can be the best product in the world, but if one isn't using it consistently, it's not going to perform. Those are two separate areas. Let's take them one at a time. Makeup can actually be a good thing, but what are the conditions where makeup can actually harm our skin? Well,

Well, for one, using expired makeup. Expired makeup then has the chance to basically form bacteria. So when you turn your bottle around and you see that it has that little open jar icon or cartoon and then a number, that's to signify the amount of months that it's good for before it starts to form bacteria. So if you put on expired product, that's going to have bacteria, that's going to lead to more bacteria. So somebody may get something like acne or they may actually get a type of a rash or reaction to the makeup.

That would be the negative side of it. You also mentioned that it's possible that applying makeup can increase the risk of acne. Yeah, I probably see that the most often in my practice. So people are using makeup to cover up acne. And in fact, they're actually inducing more acne or pimples. And I think it's possibly due to the formulation. For example, if it's not light or water-based, it's going to lead to

lean more towards that acne genic or acne trending type. And also, I wonder whether patients or people who come to see me are giving their skin enough chance to get improved. So for example, it's like trying to get two

two cars into one lane on the highway. You've got your acne medication and you've got your makeup. Well, guess what? You need to get that acne medication through the lane in order to get to the destination, which is clear skin, before we start trying to add on something else, another car like makeup. So it's taking the sacrifice, if you will, and saying, well, I'm going to commit to acne medication, whether that's in the daytime or in the nighttime or whatever the particular schedule that's been prescribed to that person is.

What are some of the ingredients that people should look for when buying makeup? That's really broad. And to be fair, it really depends on the category that they're using on their face. So, for example, if they're using a concealer or tinted sunscreen, they would want to have something that contains iron oxide. Iron oxide is the pigmentation ingredient in various different concentrations and formulations to make the color, to make the tint.

Now, if they're looking, for example, for something like a lipstick, they may look for the same pigmentations, but perhaps they're looking for something that has more staying power, like a waxy substance that's literally called, you know, a wax or Cerra Alba is one of the ingredients. But

You know, in contrast, if they're looking for something like an eye makeup, they're not necessarily going to want to have that waxy texture because they want something that's going to be relatively easy to remove from the eyelids. Are there general principles regarding ingredients, for instance, that people should avoid?

I think so, and I'm probably going to be called out as harsh on this, but I think if you talk to most dermatologists, we're going to agree that an ingredient to be avoided in leave-on products like makeup would really be fragrance. I know it's part of the sensorial experience, and it's very culturally tied to one's cosmetic choices, but really, fragrance is...

in most circumstances, while fun, isn't necessarily fun for the skin. So it's probably the number one reason people get a reaction or irritation or even allergic to a leave-on product.

And I think another one that I'd add high up there is some of the plant derivatives. So, you know, some of the plant oils, extracts that are used, those can really cause issues with people with irritancy as well. So if I had a magic wand, I'd probably remove the fragrance and some of the plant derivatives out of various cosmetics.

And people aren't going to know if they're allergic until they start applying it. Yeah, that's a good point. And it can be really vexing and frustrating for patients. So most of the people who come to see a physician or a dermatologist with a skin issue, they really have irritancy. So that's about 80% of people who come in, they apply a product and within minutes, they're

They're feeling burning, itching, maybe warmth, tingling. That's irritancy. And most of the time, you know, they wash off the product, they avoid it, and they feel better. Now, there's a minority of people for whom that irritancy isn't the main problem, and instead it's allergy. And that's where we really have to put our detective hats on because patients will say, oh, yeah, I've

I've been getting this rash behind my ears and it's really annoying and it happens, you know, every eight weeks or so. And so then we're saying, well, what's going behind the ears? And, you know, it takes some digging to find out, oh, well, that corresponds to when they dye their hair.

And so some of the hair dye is leaching onto the skin and when they go on their Saturday morning hair appointment, they get their rash on Monday or Tuesday. So two to three days later. And that's the minority of people, but for that minority, it can be quite debilitating and in some cases even affects their occupational choices. For example, if they're a manicurist or a hairdresser or maybe even a massage therapist using various carrier oils.

Those are the two scenarios in which people would come to see a dermatologist and the allergen group, that minority group, they really need to straight out, flat out avoid anything, whether it's a commercial product or an occupational exposure that

contains that specific allergen, that specific ingredient. The sense I'm getting is that makeup, well, obviously it covers blemishes, moisturizes the skin, and it has SPF factor. Are those the major things that cosmetics do? Well, I think in the case of face makeup, so foundation and concealer, really what it's meant to do is create the appearance of clear skin. So skin that's blemish-free, uniform color,

and even texture. - How do those kinds of products contribute to health? - Well, I think they contribute to the appearance of health. So when you think about, you know, what do people think as healthy and attractive?

Well, they think of skin that looks soft and supple and smooth and uniform. And that's the appearance, the attraction that one has when you apply makeup, you know, in 30 seconds, one can achieve that look, even if they don't naturally have that. That to me is the health. And one could argue that in addition to the appearance of physical health, it gives oneself emotional or mental health and boost the confidence when they've applied it.

Yes, there are some ingredients in makeup that, you know, can hydrate the skin. But I would be stretching if I said, oh, yes, you know, it's healthy every single day to cover oneself in a sheet of makeup. That's not why we do it. Wrong frequency, wrong amount. Can you say more about that? Yeah. So, for example, it makes no sense to apply makeup to skin that's not already clean.

So skin needs to be clean when the makeup goes on and that means clean face and clean hands that are applying the makeup. If it's not, well then you're applying, you know, something that as soon as we open it has some bit of bacteria in it as makeup would. And so then you're applying that and combining it with the bacteria that's on your hands and on your face. It's all going to be a breeding ground for pimples. Now the other point that's important is when it's removed. So this is where else people get into trouble.

If you remove your makeup and you're still seeing color streaks on your towel or on your hands or whenever you move to the next step in your night routine, well, guess what? It's not really off and you need to go and rewash it. Having residues of makeup on the face is one step away from basically sleeping with your makeup on. And we know that that contributes to people getting acne breakouts or it contributes to them having more fine lines. And instead of a refreshed look, just having the skin have that

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I want to talk about some specific types of products. Let's talk about anti-aging and anti-wrinkle creams. How do they work? Well, when used correctly and consistently, they really are beneficial at decreasing some of the fine lines that we get, whether it's from sun exposure or repetitive aging of the skin, generally contain one of three things. They generally contain a vitamin A derivative,

which is the OG or the early 80s discovery where a vitamin A derivative known as retinol or retinol AL or retinyl YL or prescription retinoid OID, any of those derivatives when used consistently helps to decrease fine lines by stimulating collagen formation.

And then there's some of the newer ingredients. So you might hear things like, oh, peptides are really sexy and these peptides are boosting things like collagen in that way, helping to decrease wrinkles. And these can be, you know, lab formulated. They may have plant derivative in them somewhere in the formulation, but they're usually lab formulated.

And then the third group is what I refer to as preservers. So these in and of themselves may not boost collagen or boost elastin, but what they're doing instead is they're not allowing us to degrade or break down or decay those enzymes and ingredients that do preserve our collagen and elastin. So yeah, the creams do work. Now, are they a supplement to...

Things like procedures and surgery, sure, they're a supplement, but they're not a solution to them. They don't supplant or replace a surgical endeavor, a surgical procedure. I'm guessing that if they're going to work, you have to use them consistently. For sure. I mean...

Anything that tells you, oh, it's done in a week or it results in days, that may sound attractive. And sure, you put it on, you may immediately look a little bit more hydrated or glowy. But the reality is the skin cell cycles are not a week. You know, these things take time. And typically, I ask patients to give something three months before they decide whether they think it's been beneficial. Three months on the face and neck.

That's pretty standard. And any other product that's touting substantial results within one month, I'd say is probably stretching. Sure, you can get preliminary results, but substantial end results in a month, I think that's a stretch. Let's talk about price. Obviously, it's a major point here. Some brands are affordable and some are very, very expensive. So what's the difference between a $20 cream and a cream that costs $200?

Yeah, I think there could be a couple of differences. I think sometimes the products are cheaper when they're just coming onto the market because they're trying to, you know, obtain some loyalty and some market share with the intent of increasing the price later. I think that sometimes the brand formulators will claim that the raw materials that they source to make the product are of a specific quality and of a specific caliber that warrants them needing to have a price tag.

commensurate with that. And I really think that sometimes they're selling an image and the exclusivity that they have attributed to or attached to a particular price tag. And the idea of that, oh, yes, demand will be higher if it's seen as this unattainable or aspirational price

product, then that's going to attract a certain type of clientele, a certain type of consumer. Let's turn to chemical peels, which claim to remove layers of our skin and target imperfections. Which ones do they target? How do they work? That depends on the ingredient that's in the peel. So classically, they use things like alpha hydroxy acids and beta hydroxy acids. So, you know, it may be glycolic acid or lactic acid, malic acid, mandelic acid.

TCA, which is a deeper acid, a deeper peel. And the ingredients in the peel, so the concentration as well as the duration, which it's left on the face, are going to help formulate and dictate the results. Now, a peel is usually done for one of two reasons. It's done because it's a complement to another regimen, whether that's a prescription cream or an oral pill or

Or it's done because people really want to avoid traditional medications. So in the case where they're using medications at home that are prescribed, the peel is a great complement. It does help to boost and show results faster. In a scenario where the patients are using only the peel for results, I tend to caution them. You'll get results, but, you know, they will be slower and you have to be more patient than the person who's doing different modes of therapy.

I think in the worst case scenario, a peel that's inappropriately applied or used in too high of a concentration, it's going to lead to a skin burn. And that's when it gets pretty tragic. And that's when one is seeking medical attention for a cosmetic procedure.

Is that the major risk that it can burn the skin? I assume you can also be allergic to it as well. Yeah, one could have an irritation to it. That's for sure. There is going to be a little bit of irritation when it's applied. But when I think of the people who've come to see me and they've had the biggest amount of trouble, it's been second degree burns from having had a peel applied. And again, sometimes it's the contents of the peel that was inappropriate for their skin. Sometimes it's the duration in which it was left on. And

Sometimes it's a lack of communication. A patient had been using, for example, a vitamin A product to help smooth the skin and what really helps to exfoliate the skin. And then when you add a chemical peel onto that, well, it's just too much. And so the skin reacts by basically trying to blister itself to deal with the inflammation. So it brings me to a point. What do people actually need?

in terms of products to have healthy skin? Yeah, I think it's pretty simple. I think that in terms of products, it's cleanse in the morning and then wear a sunscreen in the daytime. And particularly for somebody who has concerns with discoloration, they would want to wear a sunscreen that's tinted. So that means they have iron oxide in it and that's dictated on the label on the back of the product or the side of the product. And then at nighttime, it's cleanse again.

and hydrate the skin with a moisturizer, ideally something water-based. And then there's the option to use a corrective product. So corrective product may be one to decrease fine lines or wrinkles. It may be one to provide some extra hydration to the skin, hyaluronic acid-based products.

serum, or it could be something that's going to treat acne or improve discoloration. That's the basics. Now, there's more to it, of course. There's the fact that people tend not to be consistent. You know, there's seven nights in a week and maybe they do the routine two or three. Well, you're not going to get 100% of the results.

Or that people are impatient and inconsistent, which is a bad combination. Because if they're impatient, in addition to being inconsistent, they're really not going to give something the requisite amount of time to know whether it's had the chance to be sufficiently effective for their skin. How much of healthy skin is influenced by genetics and how much is influenced by the routine? I do think there is the genetic heroes category.

And there's, you know, the genetic zeros. And I say this because there are people who will never need to see a dermatologist for any reason. There are people for whom they can pick up a bar of soap, basically, that was on the ground, wash their face, and they're going to be fine.

And there may be people who don't get a lot of sleep and their skin doesn't show any changes or detracting features. But I can tell you there's also the people who it's very clear that genetics are huge. You know, I walk into a room and there's a 16 or 17 year old sitting there with pimples. And I look at mom or dad and I say, oh, yes, I can see. Because in addition to them, you know, resembling their offspring, I can see their acne scars.

from, you know, a couple decades before that I'm now seeing, okay, yes, there's that genetic link. So I think it is real. And, you know, you just kind of hope that you're on the right side of the genetic lottery there. Is there anything that can actually reverse the effects of aging skin? Yeah, there is. There are quite a few things. And I think it depends on, you know, how far one's willing to go, whether it's with time, budget,

healing from a particular procedure. I think probably the best known example in our, you know, 21st century lifestyle is the use of things like Botox and Dysport and Xeomin and Nuceva. Now, those all belong to a category known as neuromodulators. Those neuromodulators literally

use a mechanism to remove wrinkles. So it's injected into particular muscles in a particular pattern. And two weeks later, patients notice that, geez, those lines I had between my eyebrows are

are no longer there. Or those lines I had making up little newspaper lines across my forehead have been softened or smoothened away. Or the little crinkles I had by my eyes are no longer present. And of course that's associated, reducing wrinkles, that's associated with looking younger. And I think that's probably the best example.

Another example is people who look like they're starting to look gaunt in the face. They have that tired look. Maybe they look like they're starting to get bags under their eyes. What's happened there is they've lost volume. So we lose cheek volume. Our cheeks deflate and our cheeks descend. And we now have products and indications for said products that will provide more of that volume, more of that hydration. And that's in the form of hyaluronic acid filler, which is injected underneath the skin.

And it provides a hydrating, volumizing, restoring effect. And it lasts, depending on the individual and the product, you know, it's a year, year plus. So I think those are the two most popular examples in at least the dermatology world where patients can walk in on a, you know, Monday and then a couple weeks later on that same Monday between the wrinkle reducer, neuromodulators and the fillers,

look quite restored, refreshed, and rejuvenated. At a cost, obviously. Yes, at a cost. Not on the public purse. It doesn't go through OHIP. Yes, it's at a personal cost. What's the kind of price range that we're talking about? It depends on who's holding the syringe to some extent. I'd say if somebody wants to erase the lines between their eyes, eyebrows, I'd probably think you're looking somewhere between...

$200 to $500, depending on whom you're going to, their level of experience and expertise and follow-up.

And for some people, that price tag three, four times a year is something that they really cherish dearly and they save up for. And for some people, of course, it's, you know, pocket change. Last question I want to ask you, what's your warning for people buying over-the-counter cosmetics in the hopes of improving their skin health? Think about your why. And if your why is, boy, I'm really looking to treat these pimples or I'm really looking to decrease these fine lines.

How long are you willing to wait to see the results? And because the answer really, to be honest with yourself, needs to be about three months in either scenario. And then the other thing is, you know, buyer be savvy, not buyer beware, because I think that's a little bit

But buyer be savvy. You know, if it sounds too good to be true, it probably is. You know, there's a reason why people choose to get surgery for things or undergo procedures in the office with devices and lasers and microneedling and everything.

all those things. And it's because they achieve better results faster. So there's nothing wrong with being consistent with a jar of cream or a pump bottle, but you have to also be realistic in terms of to what lengths that's able to attain a result. Dr. Renee Beach, thank you so much for explaining the ins and outs of good skincare and applying cosmetics and helping us, those of us who want it, to turn back the clock.

Well, thank you for having me, Dr. Brian Goldman. I hope that we demystified a few things and encouraged people to use their cosmetics with care. Dr. Renee Beach is a dermatologist and owner of Dermatelier on Avenue.

She's also an assistant professor with the University of Toronto's Faculty of Medicine at Women's College Hospital. Here's your dose of smart advice. Your skin plays an important role in your overall health by acting as a barrier protecting your body from germs, dehydration, ultraviolet sun rays and injury.

Cosmetics improve psychological well-being by covering skin blemishes. They can also benefit your skin's health. For instance, makeup products with an SPF of 45 or higher, including some foundations, have been shown to reduce signs of aging and the risk of skin cancers. Other helpful ingredients include moisturizers, acne-fighting chemicals like salicylic acid, and anti-aging compounds like retinol.

Cosmetic products contain different ingredients, including water, preservatives, dyes, fragrances, chemical compounds, natural rubber, and metals. Some of these ingredients can irritate the skin, and some can cause allergies. As well, some of these ingredients act as endocrine disruptors, which can affect your body's own production of hormones.

Anti-aging creams help maintain your skin, but they do not reverse the effects of aging. Any meaningful results require consistent application. To reverse the effects of aging requires special procedures like Botox and fillers that are typically done under the supervision of a physician.

For best results, take the time to read about how your product should be used. This is especially important if you're combining makeup or skincare products. Some ingredients interact, increasing the risk of irritation or making it hard for a product to work as intended. In general, clean your skin first before applying makeup containing sunblock. At the end of the day, remove makeup thoroughly before applying moisturizer.

Leaving makeup on your skin overnight can weaken the skin barrier, causing clogged pores, breakouts, and even eye infections. Choose makeup that is free of ingredients that could be endocrine disruptors like phthalates. Avoid potential allergens like metals, fragrances, and dyes. Avoid any product that causes skin irritation.

Because makeup can clog pores and cause irritation, try using it every other day to give your skin time to recover. Finally, throw out expired makeup that might cause skin infections and especially dispose of makeup that becomes discolored or has an obvious change in texture or consistency.

If you have topics you'd like discussed or questions answered, our email address is thedoseatcbc.ca. If you liked this episode, please give us a rating and review wherever you get your podcasts. This edition of The Dose was produced by Samir Chhabra, our senior producer is Colleen Ross. The Dose wants you to be better informed about your health. If you're looking for medical advice, see your health care provider. I'm Dr. Brian Goldman. Until your next dose. For more CBC podcasts, go to cbc.ca slash podcasts.