The cosmetic and beauty products industry is a $63 billion (and growing) business. Unfortunately, it is not well regulated and most products that we use every single day are full of chemicals that can be harmful to our health. When it comes to eye make up, this is especially important because, unknowingly, you might be causing an allergic reaction, inflammation and exacerbating your dry eye symptoms.

As a general rule, the following is recommended to maintain healthy ocular surface:

  • Avoid waterproof makeup.
  • Avoid applying eyeliner on the waterline.
  • Avoid using retinol and anti-aging products such as cis-retinoic acid/ tretinoin (Retina-A) around eyes.
  • Avoid products containing benzalkonium chloride.
  • Avoid use of Botox Cosmetic (onabotulinumtoxinA; Allergan) for crow’s feet. This application weakens the orbicularis muscle, leading to incomplete blink.
  • Avoid the so-called Botox-in-a-jar ingredients found in OTC cosmetics: acetyl hexapeptide-8 or acetyl hexapeptide-8 (Argireline; Lipotec).
  • Avoid neurotoxic ingredients such as phenoxyethanol and acrylamides.
  • Avoid periocular use of Preparation H (Pfizer Consumer Healthcare) near the eyes.

Things Patients Must Never Do:

  • Do not share cosmetics. Ever.
  • Do not buy OTC lash enhancers or growth serums. One ingredient in these products, isopropyl cloprostenate, is a synthetic prostaglandin analogue that can induce changes in eye color, changes in eyelid skin (loss of periorbital fat and darkening of the skin, also known as prostaglandin-associated periorbitopathy), stinging, blurred vision, eye redness, itching, and burning.
  • Do not use eyelash extensions. Eyelash glues contain volatile organic compounds and ocular surface-irritating formaldehyde. (Claims that glues are “formaldehyde free” are inaccurate). In addition, the abnormal eyelash:eyelid length ratio negatively alters the wind-and-debris–deflecting properties of the physiologic eyelash.
  • Do not opt for permanent makeup with eyeliner tattooing. Eyeliner tattooing is associated with meibomian gland disease. Do not use eyelash tint.

Things Patients Should Do:

  • Insert contact lenses prior to makeup application or 10 minutes after with clean hands and remove before makeup removal. This avoids the collection under your lens of debris that can irritate the ocular surface and contribute to discomfort. Remove contact lenses before makeup removal to avoid damaging the lenses with harsh chemicals.
  • If you are not a contact lens wearer, apply a drop of a preservative-free lipid-based artificial tear before applying eye shadow. You would be surprised at how much debris accumulates at the caruncle (inner corner of eye).
  • Shop for paraben-free powder eye shadow that has a high cling and is not easily tapped off the applicator or brush (known as fallout). Alternatively, use a paraben-free and retinol-free shadow base (primer) or use a paraben-free cream-based eye shadow to prevent fallout into the tear film.
  • Never apply makeup on the so-called waterline or tightline (the lower and upper lid margins). The waxes and resins in these products can block the meibomian gland terminal ductule orifices. Additionally, the alcohols that dry the liner in place also dry the delicate tear film.
  • Use paraben-free and formaldehyde-free eyeliner pencils, but avoid the eyelash roots and lid margins. This is too close to the meibomian gland orifices, and application here may cause superficial obstruction of the glands.
  • Stick with eyeliner pencils, and sharpen them before every application.
  • Replace moist cosmetics (eg, mascara) monthly. Clean eye makeup brushes regularly. Dr. Bronner’s unscented is a great brush cleaner.
  • Remove makeup daily. Coconut, argan or jojoba oil are recommended for removing eye cosmetics as long as there is no allergy to these oils. Never use facial cleansers or hand soap to remove eye makeup.

Some of our favorite products can be found at:

HekaClean
BeautyCounter
PetitVour
Credo Beauty
The Detox Market
LilyLolo (mascara)

Other clean cosmetics resources:

ThinkDirty® App

Healthy Living App by Environmental Working Group

EWG’s Skin Deep Cosmetics Database www.ewg.org/skindeep

TOP 10 OCULAR SURFACE–OFFENDING INGREDIENTS

  1. BENZALKONIUM CHLORIDE (BAK)
  2. ALCOHOL
  3. RETINOL
  4. PARABENS
  5. ISOPROPYL CLOPROSTENATE
  6. FORMALDEHYDE & FORMALDEHYDE DONORS
  7. PHENOXYETHANOL
  8. BUTYLENE GLYCOL
  9. ETHYLENEDIAMINETETRAACETIC ACID (EDTA)
  10. ARGIRELINE (ACETYL HEXAPEPTIDE-3, LIPOTEC)

INGREDIENTS TO AVOID AND WHY

Benzalkonium chloride: a disinfectant used as a preservative and surfactant associated with severe skin, eye, and respiratory irritation and allergies. Found in: sunscreens, moisturizers.

BHA and BHT: synthetic antioxidants used to extend shelf life. They are likely carcinogens and hormone disruptors and may cause liver damage. Found in: lipsticks, moisturizers, diaper creams, and other cosmetics.

Coal tar hair dyes and other coal tar ingredients: a byproduct of coal processing that is a known carcinogen. It is used as a colorant and an anti-dandruff agent. Found in: hair dye, shampoo.

Ethylenediaminetetraacetic acid (EDTA): a chelating (binding) agent added to cosmetics to improve stability. May be toxic to organs. Found in: hair color, moisturizers.

Ethanolamines (MEA/DEA/TEA): surfactants and pH adjuster linked to allergies, skin toxicity, hormone disruption, and inhibited fetal brain development. Found in: hair dyes, mascara, foundation, fragrances, sunscreens, dry cleaning solvents, paint, pharmaceuticals.

Formaldehyde: used as a preservative in cosmetics. A known carcinogen that is also linked to asthma, neurotoxicity, and developmental toxicity. Present where quaternium-15, DMDM hydantoin, imidazolidinyl urea, diazolidinyl urea, sodium hydroxymethylglycinate, 2-bromo-2-nitropropane-1,3 diol (Bronopol), and several other preservatives are listed. Found in: shampoo, body wash, bubble bath.

Hydroquinone: a skin-lightening chemical that inhibits the production of melanin and is linked to cancer, organ toxicity, and skin irritation. Found in: skin-lightening creams.

Methylisothiazolinone and methylchloroisothiazolinone: chemical preservatives that are among the most common irritants, sensitizers, and causes of contact skin allergies. Found in: shampoo, conditioner, body wash.

Oxybenzone: sunscreen agent and ultraviolet light absorber linked to irritation, sensitization and allergies, and possible hormone disruption. Found in: sunscreen, moisturizer.

Parabens  (methyl-, isobutyl-, propyl- and others): a class of preservatives commonly used to prevent the growth of bacteria and mold. Parabens are endocrine (or hormone) disruptors, which may alter important hormone mechanisms in our bodies. Found in: shampoo, face cleanser, body wash, body lotion, foundation.

Phthalates  (DBP, DEHP, DEP and others): a class of plasticizing chemicals used to make products more pliable or to make fragrances stick to skin. Phthalates disrupt the endocrine system and may cause birth defects. Found in: synthetic fragrance, nail polish, hairspray, and plastic materials.

Polyethylene glycol (PEG compounds): PEGs are widely used in cosmetics as thickeners, solvents, softeners, and moisture-carriers. Depending on manufacturing processes, PEGs may be contaminated with measurable amounts of ethylene oxide and 1,4-dioxane, which are both carcinogens. Found in: creams, sunscreen, shampoo.

Retinyl palmitate and Retinol (Vitamin A): a nutrient that may damage DNA and speed the growth of skin tumors when used topically. Found in: moisturizer, anti-aging skincare.

Sodium Lauryl Sulfate and Sodium Laureth Sulfate (SLS and SLES): SLS and SLES are surfactants that can cause skin irritation or trigger allergies. SLES is often contaminated with 1,4-dioxane, a byproduct of a petrochemical process called ethoxylation, which is used to process other chemicals in order to make them less harsh. Found in: shampoo, body wash, bubble bath.

Synthetic flavor or fragrance: an engineered scent or flavoring agent that may contain any combination of 3,000-plus stock chemical ingredients, including hormone disruptors and allergens. Fragrance formulas are protected under federal law’s classification of trade secrets and therefore can remain undisclosed. Found in: all types of cosmetics.

Toluene: a volatile petrochemical solvent that is toxic to the immune system and can cause birth defects. Found in: nail polish.

Triclosan and Triclocarban: antimicrobial pesticides toxic to the aquatic environment; may also impact human reproductive systems. Found in: liquid soap, soap bars, toothpaste.