Personal-Care Cosmetic Practices in Pakistan: Current Perspectives and Management

Figures & data

Table 1 List of local skin-whitening creams containing high doses of mercury in Pakistan

Number	Cream name	Sample ID	Hg (ppm)	Hg more than standard (ppm)
1	Skin White milk and haldi cream	IC-35	0.8	˂ 20
2	Hemani Advance herbal whitening cream	C0017	2.59	159
3	Goree beauty cream	C0012	4.39	339
4	Fair & Lovely advanced multivitamin (Pakistani)	C001	5.02	402
5	Current Fairness cream	C0015	8.45	745
6	Hitone whitening cream	C0023	9.11	811
7	Skin White gold beauty cream	LC-21	13.49	1.249×10^3
8	Face Fresh cleanser cream	LC-28	19	1.8×10^3
9	Skin Clear whitening cream	C008	21	2× 10^4
10	Gipsy with jojoba oil	P-45	36.29	3.5×10^3
11	Blush On beauty cream	C002	65	6.4×10^3
12	Permanent whitening cream	X-46	128	1.2×10^4
13	Whiteface whitening cream	IC-34	324.7	3.2×10^4
14	White Touch whitening cream	C0013	1257	1.2×10^5
15	Face Tonic whitening formula	P-42	1,405	1.4×10^5
16	CinciBrido whitening cream	KC-37	1,479	1.479×10^5
17	Nine Herbs whitening cream	C006	2,420	2.41×10^5
18	Era beauty cream	C007	2,458	2.458×10^5
19	Alpha white beauty cream	C0016	3,923	3.922×10^5
20	Biocos emergency whitening cream	C0021	5,129	5.128×10^5
21	Dermolite whitening cream	C0019	6,035	6.03×10^5
22	Pure White beauty whitening cream	I.C-23	7,862	7.861×10^5
23	Look Fresh beauty cream	IC-41	7,912	7.911×10^5
24	Forever skin-whitening cream	C0014	8,181	8.18×10^5
25	Denso beauty cream	C009	9,681	9.68×10^5
26	White Secret beauty cream	C004	10,369	1.03×10^6
27	Sandal whitening Beauty Cream	LC-27	12,044	1.2043×10^6
28	Lead whitening cream	X-47	13,658	1.3657×10^6
29	Infocus pearl beauty cream	C0020	14,493	1.4492×10^6
30	White Face whitening cream	LC-29	14,895	1.4895×10^6
31	Sandal whitening beauty cream	C0018	15,566	1.55×10^6
32	Cherry skin-whitening cream	C005	15,710	1.579×10^6
33	White Gold whitening cream with blackberry extracts	LC-22	15,795	1.5794×10^6
34	Zuni beauty cream (female)	C0010	15,973	1.5972×10^6
35	Maxdif skin-brightening cream	C0022	16,004	1.6×10^6
36	Due whitening cream	KC-50	16,805	1.6804×10^6
37	Winsome whitening beauty cream	P-44	18,173	1.8172×10^6
38	Zuni beauty cream for men	C0011	18,177	1.8176×10^6
39	White Gold whitening cream	C003	19,069	1.9068×10^6
40	Delicate whitening beauty cream	IC-39	23,780	2.3779×10^6
41	Parley herbal whitening cream	LC-29	40,131	4.013×10^6

Notes: From a joint project of the Ministry of Climate Change and Sustainable Development Policy Institute, Islamabad, Pakistan. Results showed that most SWC brands had the potential to cause mercury toxicity effecting the general public health. Techniques used for mercury analysis were HGASS and ICP.^19,25

Table 2 International skin-whitening creams in Pakistan with high volumes of mercury

Number	Name of cream	Sample ID	Hg (ppm)
1	Co Natural whitening cream	C0034	1.88
2	Palmer’s Skin Success	C0035	1.94
3	Garnier Skin Naturals Speed White	IC-38	1.98
4	Garnier Light Complete White Speed	C0033	2.11
5	Nivea Natural Fairness	C0030	4.2
6	Ponds white beauty cream	LC-25	5.01
7	Olay Natural White	C0029	5.41
8	Olive whitening cream	C0024	8.31
9	Garnier Skin Naturals White Complete	LC-24	15.52
10	Eveline Cosmetics White Extreme, 3D	C0032	9.27
11	Stillman’s skin bleach cream	IC-36	44,292
12	Fair and Lovely	P-43	40
13	Vince skin lightening night cream	C0028	21.35
14	Fair and Lovely Max Fairness Multi Expert face cream	IC-40	21
15	Ponds Flawless White	C0031	0.74
16	YC whitening pearl cream	C0025	0.93
17	Fair & Lovely advanced multivitamin	C0026	1.43
19	Janssen Cosmetics brightening night restore	C0027	1.82

Notes: From a joint project of the Ministry of Climate Change and Sustainable Development Policy Institute, Islamabad, Pakistan. The results showed that most SWC brands had the potential to cause mercury toxicity, affecting both the skin and general public health. Techniques used for mercury analysis were HGASS and ICP.OES.^19,25

Figure 1 Mutagenic effects of the henna plant and PPD action on skin. Leaves of the henna plant contain a red-orange dye (lawsone, also known as hennotannic acid) and PDD, which causes allergic and inflammatory reactions that develop carcinogenic effects.^92,93.

Table 3 Commonly used cosmetic items and their adverse consequences on consumer health

Number	Cosmetics	Ingredients	Use	Side effects
1	Lipsticks	Manganese, lead, cadmium, titanium dioxide, aluminum, formaldehyde, and parabens	Volatile white and yellow colors	Carcinogenic, renal failure, coughing, and hazards in pregnancy^Citation40,Citation41,Citation43^–^Citation45
2	Kohl (surma)	Lead sulfide	Darkening of eyelids	Increased lead levels in blood and damage to the liver^Citation30^–^Citation34,Citation46
3	Nail polish	Formaldehyde, nitrocellulose, plasticizers, iron oxides, manganese, benzophenone 1	Ticking agent, coloring agent, and nonbrittle film to stop bacterial or fungal infections in cosmetics	Nausea, respiratory problems, cognitive and neurological symptoms, uncontrollable muscle contraction.^Citation35^–^Citation37,Citation47,Citation48
4	Eye and facial makeup, baby wipes, and household detergents	Diazolidinyl urea, DMDM, methylisothiazolinone, phenoxyethanol, mercury, copper, titanium, tretinoin	Cleanser, killing bacteria, slowing and preventing spoilage, facial expression	Headaches, allergic reactions, burning of skin, carcinogenic^Citation49^–^Citation51
5	Hair care, moisturizers, shaving products	Parabens, salicylate, coloring agents	Preventing bacterial growth, ultraviolet-light absorbance	Skin irritation, blotches, blemishes^Citation39,Citation52
8	Shampoo, body soap, toothpaste	Sodium sulfate and laureth sulfate, fluoride, triclosan, diethanolamine, triethanolamine	Cleansing and emulsifying agent	Hair loss, breast cancer, skin irritation, possible impurity contamination^Citation53
9	Aging and skin-care products	Beta-hydroxy-acids, dihydroxyacetone, phthalates, salicylic acid	Improving skin texture, reducing signs of aging, stopping harmful ultraviolet radiation	Effects in pregnancy, skin burning, allergic reactions^Citation54
10	Face makeup, hair products	Diethanolamine, polyethylene glycol	pH adjuster, foaming agent	Skin irritation, contamination concerns^Citation52

Figure 2 Associations between hair-coloring products and cancer risks. The Hair-dye ingredients increase the risks of different cancer types, such as leukemia, lung, breast, and skin.

Figure 3 Directions to save cosmetic consumers from the effects of hazardous, unauthorized personal-care cosmetic products.

Bushra Afzal SR, Waqar Ali S, Abbas Z, Mahmood A, K. Mercury poisoning associated with international and local skin whitening creams in Pakistan. Ministry of Climate Change (MOCC), Sustainable Development Policy Institute (SDPI) Islamabad, Pakistan. Available from: https://www.think-asia.org/bitstream/handle/11540/9423/MercuryPoisoningAssociatedwithInernationalandLocalSkinWhiteningreamsinPakistan.pdf?sequence=1. 2018.

 Google Scholar

SWA MAK. Assessment of prevalence of health complications and skin diseases due to mercury containing Skin Whitening Creams (SWCs) use among the population at selected cities of pakistan. sustainable development policy institute (SDPI) Islamabad Pakistan. Available from: https://think-asia.org/bitstream/handle/11540/9423/MercuryPoisoningAssociatedwithInernationalandLocalSkinWhiteningreamsinPakistan.pdf?sequence=1. 2016.

 Google Scholar

Mukkanna KS, Stone NM, Ingram JR. Para-phenylenediamine allergy: current perspectives on diagnosis and management. J Asthma Allergy. 2017;10.

 Web of Science ®Google Scholar

Interest C. The chemistry of henna; 2019. Available from https://www.compoundchem.com/2019/08/12/henna/.August.

 Google Scholar

Martinez PA Is wearing lipstick bad for your pregnancy? August 20, 2013. Available from: https://www.parents.com/pregnancy/everything-pregnancy/is-wearing-lipstick-bad-for-your-pregnancy/. Accessed November 16, 2020. Parents.

 Google Scholar

Brown VJ. Metals in lip products-a cause for concern? National Institute Environmental Health Sci. 2013.

 Google Scholar

Ziarati P, Moghimi S, Arbabi-Bidgoli S, Qomi M. Risk assessment of heavy metal contents (lead and cadmium) in lipsticks in Iran. Int J Chem Eng Appl. 2012;3(6):450. doi:10.7763/IJCEA.2012.V3.241

 Google Scholar

Zakaria A, Ho YB. Heavy metals contamination in lipsticks and their associated health risks to lipstick consumers. Regulatory Toxicol Pharmacol. 2015;73(1):191–195. doi:10.1016/j.yrtph.2015.07.005

 PubMed Web of Science ®Google Scholar

Tiffany-Castiglioni E, Barhoumi R, Mouneimne Y. Kohl and surma eye cosmetics as significant sources of lead (Pb) exposure. J Local Global Health Science. 2012;2012(1):1. doi:10.5339/jlghs.2012.1

 Google Scholar

Coroneo MT, Rosenberg ML, Cheung LM. Ocular effects of cosmetic products and procedures. Ocul Surf. 2006;4(2):94–102. doi:10.1016/S1542-0124(12)70031-9

 PubMed Web of Science ®Google Scholar

Al-Hazzaa SA, Krahn PM. Kohl: a hazardous eyeliner. Int Ophthalmol. 1995;19(2):83–88. doi:10.1007/BF00133177

 Web of Science ®Google Scholar

Doheny K. Is your nail polish toxic? reseacher find toxic in nail polish labeled ttoxin- free; industry says report lacks perspective. Radiance by WebMD; 2012. A vailable from: https://www.webmd.com/beauty/news/20120411/is-your-nail-polish-toxic#1. Accessed November 16, 2020.

 Google Scholar

Qazi MA. Is nail polish bad for your nails? FHM Pakistan; 2019. Available from: https://www.fhmpakistan.com/fhm-breeze/is-nail-polish-bad-for-your-nails/. Accessed November 16, 2020.

 Google Scholar

Ouremi OI, Ayodele OE. Lipsticks and nail polishes: potential sources of heavy metal in human body. Int J Pharm Res Allied Sci. 2014;3(4):45.

 Google Scholar

Felzenszwalb I, da Silva Fernandes A, Brito LB, et al. Toxicological evaluation of nail polish waste discarded in the environment. Environ Sci Pollution Res. 2019;26(27):27590–27603.

 Web of Science ®Google Scholar

Nnorom I, Igwe J, Oji-Nnorom C. Trace metal contents of facial (make-up) cosmetics commonly used in Nigeria. African J Biotechnol. 2005;4(10).

 Google Scholar

Odio M, Streicher-Scott J, Hansen RC. Disposable baby wipes: efficacy and skin mildness. Dermatology Nursing. 2001;13(2):107.

 Google Scholar

Bukhari IH. Determination and toxicological effects of metals on human skin by using hair removing creams and lotions by spectroscopic techniques. Int Res J Pharm Appl Sci. 2013;3(4):9–11.

 Google Scholar

Toosi P, Sadighha A, Sharifian A, Razavi GM. A comparison study of the efficacy and side effects of different light sources in hair removal. Lasers Med Sci. 2006;21(1):1–4. doi:10.1007/s10103-006-0373-2

 PubMed Web of Science ®Google Scholar

Bondi CA, Marks JL, Wroblewski LB, Raatikainen HS, Lenox SR, Gebhardt KE. Human and environmental toxicity of sodium lauryl sulfate (sls): evidence for safe use in household cleaning products. Environ Health Insights. 2020;9(1).

 Google Scholar

Allemann IB, Baumann L. Antioxidants used in skin care formulations. Skin Therapy Lett. 2008;13(7):5–9.

 Google Scholar