THE HEALTH HAZARDS OF BEAUTY TREATMENTS AND HOW BEST TO AVOID THEM

Research into cosmetic products and beauty salon practices suggests that beauty treatments are not as safe as previously believed. The following discussion looks at common health problems associated with frequenting the beauty salon, as well as concerns and pitfalls associated with various beauty treatments. Read on for suggestions on how to lower the risks and make the most out of cosmetic treatments.

The Impact of Beauty Treatments on Health

Although beauty and health are frequently equated, cosmetic treatments can pose adverse effects that eventually lead to health issues. Research in recent years has shown that even standard appointments with the hairdresser can pose health consequences if adequate precautions are not taken. Beauty salon health hazards include:

• Chemicals Found in Beauty Salons. Formaldehyde can be released from some cosmetic products in beauty salons. Without sufficient ventilation, levels of formaldehyde have been shown to exceed safety standards^[1] and may be carcinogenic. Other carcinogenic compounds found in cosmetic products and the air in beauty salons include benzene, acetaldehyde, acetone, butyl acetate, ethyl acetate, and ethyl methacrylate.
• Infections Passed Around in Salons. Beauty salons have been shown to be a vector for common infections. One study revealed that many skin-pathogenic bacteria, as well as bacteria that cause food poisoning, were found in beauty salons. These include staphylococcus aureus, P. aeruginosa, K. pneumoniae, E. Coli, Salmonella, Shigella, and Bacillus subspecies^[2]. Some of these microbes promote neutral infections that subtly compromise immune function, while others can cause major gastric illness, symptoms, and fever.

The Dangers Associated with Beauty Treatments were mostly revealed in studies that assessed the effects on beauty salon workers, who are more at risk than the general population. These studies hint at long-term health problems that susceptible individuals who frequent beauty salons may suffer. A few large-scale studies have additionally connected cosmetic chemical exposure to pressing health concerns in those who frequently opt for beauty treatments. The current evidence is summarised below:

• Allergenic Symptoms. Nail salon workers that were exposed to high amounts of acetone, methyl methacrylate, and toluene were shown to suffer from symptoms such as headaches, light-headedness, and nose, eyes, throat, or skin irritation. Additional symptoms of workers exposed to these chemicals include shortness of breath, nausea, and confusion.^[3] Respiratory conditions also appear to be common in nail and hair salon workers^[4].
• Endocrine Disruption. Many cosmetic products include endocrine-disrupting compounds, which may place handlers and users at risk for reproductive diseases and cancer. For instance, phthalate exposure amongst nail salon workers was shown to greatly exceed safe limits due to being present in multiple nail cosmetic products.^[5]
• May Promote Infertility. Beauty salon workers appear to be at an increased risk for reproductive disorders. According to one study, hairdressers and cosmetologists are at a higher risk of miscarriage, infertility, or premature birth compared to the general population.
• ^[6] Another study reported that 11.7% of pregnant women that worked in a nail salon had at least one miscarriage.^[7]
• Cancer Risk. There have been various investigations into the potential cancer risk of chemical exposure in beauty salons. In one long-term trial conducted from 1988 to 2005, the average occurrence of cancer was around 2.8% in more than 325 000 beauty salon workers in California^[8]. Thyroid and lung cancer appeared to be the most common types in this study. Elevated risks for breast cancer, bladder cancer, and Hodgkin’s lymphoma have been associated with the use of permanent hair dyes and related chemicals^[9]. While the risk is low, frequent beauty treatments can be detrimental to susceptible individuals. Further risks and recommendations pertaining to specific beauty treatments have been reviewed below.

Beauty Treatment Safety Considerations

The main risks associated with beauty treatments often arise from the combination of nourishing (microbe-promoting) ingredients, harsh chemical agents, antimicrobial-resistant bacteria, and inadequate hygiene practices. Considerations for minimizing the above risks are discussed below:

Minimizing Chemical Exposures. Most of the above health risks linked with beauty products pertain to their chemical content and the degree of exposure. The level of chemical exposure differs from salon to salon,^[10] with education likely to play a large role in the quality of the services and products offered. Some salons make use of safer chemical products and may be able to offer their clients better alternatives to standard treatments. Commonly known chemicals are discussed in the following section in the context of their respective beauty treatments.

Maximal Ventilation. Over and above the treatment itself, chemical exposure can be greatly exacerbated through breathing in large quantities while at the salon. The less it smells of chemicals inside a beauty salon, the less likely the treatments will lead to side effects, including respiratory problems and allergic reactions. Better salons take strict chemical safety precautions, such as keeping products sealed and the premise well-ventilated. Optimal ventilation can help to lower respiratory exposure to cosmetic chemicals^[11], which has proven to improve the health of both beauty salon workers and those receiving treatments. Fans, open windows, and air purifiers have been proven to reduce chemical levels sufficiently to ensure safety. Frequent cleaning of air conditioning units may also help.

Considerations that may detract from safe ventilation include:

• The Premises Itself. A lack of windows coupled with a small area can quickly become a health hazard, particularly with regard to chemical exposure. A high ceiling, larger floor space, well-positioned air ventilating units, and more windows are all indications of better ventilation.
• Pollution. Some studies have shown that outdoor pollution prevents adequate ventilation of salons in built-up cities^[12], which suggests that beauty salons located in non-polluted areas are likely to be safer.
• Extreme Weather Conditions. The time of year also affects the air quality inside buildings, as extreme weather conditions often detract from adequate ventilation. Where possible, it may be best to conserve beauty treatments for times of the year when optimal ventilation can be achieved. If living in a region subject to extreme weather conditions year-round, it is advisable to opt for a salon that makes use of an industrial air purifier.

Safe Storage. The overall composition of many beauty products lends itself to increased microbial growth. Many skin-nourishing ingredients provide optimal growth mediums for bacteria, including water, starches, sugars, proteins, and organic acids. The chemicals added into these formulations aim to preserve the integrity of the product yet may promote the growth of highly resistant bacteria. Any oils present in these products can eventually oxidize, leading to rancidity and the potential for skin irritation or infection. Light and temperature control of beauty products are  prime concerns for safe storage.

Salon Sanitation Standards. Despite the high volume of chemicals used in most beauty salons, hygiene is still an important consideration. The propensity for infections and other symptoms is higher on average among beauty salon workers due to the chemicals they work with, as well as being in close contact with many clients on a daily basis. The chemicals may contribute towards promoting resistant bacteria, highlighting the greater need for consistent cleaning of the equipment and all areas of the salon. 

Beautician Hygiene. One ought to opt for a salon with beauty workers that prioritize both hygiene and their own health. Many risks can be minimized if beauticians wash their hands between clients, keep their hair tied up, and use personal protective equipment. Workers with symptoms are more prone to making mistakes, which can lead to accidentally infecting their customers (e.g., nicking a cuticle during a manicure). It was shown that beauty salon workers who wear masks and gloves report fewer symptoms related to cosmetic chemical exposure.^[13] This practice is considered more hygienic and could reduce the risk of contamination between the client and the beautician.

Client Awareness. Leading a healthier lifestyle, informing oneself of the risk involved, and taking precautions can help to protect against potential long-term health consequences linked with frequent beauty treatments. It should be noted that nearly all methods for sterilizing equipment do not get rid of all microbes. Depending on the type of treatment received, individuals who frequent the beauty salon could benefit from washing after their visit and supporting their immune system. As discussed below in more detail, the type of treatment may be contraindicated for the individual. Selecting safer treatments and opting for sessions at optimal times can significantly lower the risk for getting sick. Tips for minimizing the risks involved with regard to specific beauty treatments are mentioned later on.

Timing of Treatments. As the most common side effects of beauty treatment constitute infection, chemical sensitivity, and allergy, their occurrence will also depend on the state of the individual’s immune system and overall health. Those who opt for beauty treatments can theoretically minimize the risk by choosing their timing well, in accordance with their current state of health. If you are severely stressed, running an infection, suffering from an acute allergic reaction, or dealing with any other symptoms of illness, then it is advisable to postpone a beauty appointment till you feel better.

Health Concerns of Specific Beauty Treatments

General considerations aside, the majority of beauty treatments offered each pose their own set of unique health challenges, some of which are reviewed below.

Manicures and Pedicures

The nail salon appears to be a risky workplace for beauty salon workers in general due to the large volume of chemicals used to treat nails. Regular nail treatments are associated with the following health effects:

Nail Weakness. Despite how it might seem, manicures and pedicures have been reported to weaken nails in women who frequent nail salons. After removal of the polish from a manicure, nails appear weaker, more brittle, thinner,^[14] and more susceptible to damage.^[15]

Nail Growth Abnormalities. Long-term gel nail polish application has been associated with the occurrence of PIU (Pterygium Inversum Unguis)^[16], a skin condition in which skin under the nail abnormally adheres to the nail and grows beyond the edge of the finger with the nail. This can be aesthetically displeasing and cause pain when cutting the nail. PIU has been shown to resolve when switching over to ordinary nail polish from gel nail polish.

Increased Infection Risk. Fake nails may be less hygienic than natural nails as they provide an optimal surface for bacterial growth. In a study conducted on nurses in a hospital environment, it was shown that gel nails were more resistant to sterilization when washed with an alcohol hand gel.^[17] Further studies reveal that healthcare workers with fake nails increase the risk of passing infections on to their patients since these are more difficult to clean and can tear gloves more often.^[18] Women who opt for fake nails may also be at risk for contracting recurrent infections, particularly if they work in close contact with many people.

Skin and Respiratory Reactions. Nail hardening, acrylic or gel nail and nail polish application, as well as polish removal, all make use of several chemical agents that can promote contact dermatitis, respiratory difficulties, and other allergic skin reactions. These chemicals include formaldehyde, acrylates and toluene. They are known to perfuse the air of nail salons during treatment and linger on the fingers of the customers afterward.

Cancer Risk. UV-A lamps are used to cure gel-based nail polish and may be linked with the occurrence of skin cancer around the nails of those who frequently use them.^[19] Limited data suggest that UV-A gel nail curing may increase the risk in susceptible individuals, which may be elevated if formaldehyde-containing products are used. ^[20] The levels of potentially carcinogenic chemicals in the air of several tested salons in the US exceeded safety standards with regard to several types of cancer.^[21] While the incidence of cancer in nail salon workers is low, their risk is known to be higher than that of the general population.

Hair Treatments and Dyes

Hairdressing may be seen as one of the safest beauty treatments to opt for. Nonetheless, chemical exposures from hair care products have been observed to exceed safety standards in premises that lack adequate ventilation.

Common Chemicals in Hair Salons. Hair treatments have been associated with air concentrations of xylene and formaldehyde, while hair dying was especially associated with benzene and toluene.^[22] Other chemicals include ammonia and persulfate salts. All of these can promote respiratory, eye, and skin irritation when released into the air at large enough concentrations.^[23]

Hair Dye is known to contain many harsh chemicals in comparison to other types of hair treatment. While permanent hair dye is known to contain a larger degree of heavy chemicals that sink deeper into the hair shaft, impermanent and semi-permanent hair dyes also contain chemicals and are associated with similar risks. These include:

• Allergies. Allergenic chemicals in hair dye can cause severe allergic reactions in under 3% of the general population. Paraphenylenediamine (PPD) is one of the most common hair dye ingredients known to trigger an allergic reaction, with studies reporting a reaction in 77.1% of sensitive individuals who suffered from dermatitis as a result of receiving hair treatment.^[24] A handful of other hair dye ingredients can promote similar allergic reactions. Semi-permanent and permanent dyes pose an additional risk of skin reactivity due to being weakly bound to the hair and have a greater potential for rubbing off onto the skin. Sensitive individuals may want to avoid permanent hair dyes, as well as dyes free from PPD and ammonia.
• Lower Hair Quality. On top of promoting allergy in some, permanent dyes have been shown to substantially affect the quality of hair. Split ends, dry and lustreless hair, slowed hair growth and loss, as well as hair greying were common reports in women that frequently made use of permanent hair dyes.^[25]
• Cancer Risk. Many of the basic ingredients in any kind of hair dye have proven to induce cancer in mice at higher concentrations. Frequent and lifelong use of permanent dyes and dyes of a dark colour has been linked to subtle risk elevation for various cancer types, including lymphomas, leukaemia, multiple myeloma, and brain, breast and ovarian tumours^{[26] [27]}. The risk is worse for hairdressers continuously exposed to such chemicals^[28], as well as for clientele that frequently opts for such treatments in a hair salon, where chemicals may concentrate in the air^[29].
• Other Potential Health Concerns. Animal studies have shown that several other toxic elements in all hair dye types can increase the risk of a number of other health concerns. These include reproductive disorders, developmental deficits, iron deficiency, eye irritation, hypothyroidism, and the discolouration of other organs, such as the thyroid.^[30] The amounts used in these studies were much higher than those that would be applied to the scalp during hair dying. However, caution is advised with respect to multiple hair dye treatments.

Hair Treatments May Exacerbate Skin Symptoms. Those with skin conditions such as eczema may want to avoid frequent hairdressing appointments. Hairdressers report some of the highest levels of contact dermatitis and eczema^[31] by comparison to other salon workers. Frequent exposure to similar chemicals, particularly in premises that are not well-ventilated, may increase the risk for adverse reactions in these susceptible individuals.

Safer Products May Improve Outcomes. In a small sample of 50 women that used PPD-free and ammonia-free permanent hair dye, dermatologists compared the results to PPD and ammonia-containing equivalents. They ranked these chemical-free dyes as being much healthier for hair, offering between 87-90% improvements in hair sheen, moisture retention, colouration, and overall quality.^[32]

Tattoos and Permanent Makeup

Tattoos have become an extremely popular cosmetic treatment over the last couple of decades. As a procedure, tattooing involves the penetration and delivery of ink to deeper layers of the skin in order to achieve a long-lasting image. Some people get tattoos to emulate permanent makeup, to which complications are similar.

Common Complications of Tattooing are similar to those of other cosmetic procedures and include skin reactions and infections. Skin reactions have been shown to be far more frequent with the use of colour inks as opposed to only black ink.^[33] Out of the colours available, reactions occur regularly with the administration of red ink, yet have also been observed with the use of green, purple, and blue inks.^{[34] [35]} Those with pre-existing skin conditions ought to avoid getting a tattoo as it may increase symptom severity.^[36]

Tattoo-Induced Skin Infections. As skin infections are a well-known complication of getting a tattoo, it is a standard practice for tattoo artists to disinfect the skin before applying ink. While this may lower the risk of infection, it may only do so for the top layer of the skin, which may prove to be ineffective in light of ink contamination. Analysis of various ink samples has shown that it is rather common for the ink to become infected with common pathogenic bacteria similar to those found in beauty salons. The occurrence of these pathogens was noted even in the presence of preservatives and heavy chemical agents, hinting at microbial resistance.^[37] It may be in the best interest of the client to avoid getting a tattoo if fighting an active infection. It is also important to watch for signs of infection after receiving one.

Possible Long-Term Toxicity and Other Tattoo-Related Concerns. Despite being so popular, there is limited information on the potential long-term toxicity of tattoos. Preliminary studies suggest that they may be more toxic than previously thought due to the following:

• Heavy Metals and Other Toxic Components of Tattoo Ink. Tattoo ink contains many potentially toxic compounds, including heavy metals, polyaromatic hydrocarbons, and dyes. All of these are known to promote free radical formation and oxidative stress in the skin and other bodily tissues. In tattoos, these compounds may accelerate skin aging and promote scarring or abnormal skin growth and regeneration. Heavy metal toxicity, in particular, is linked with increasing the risk for neurological and musculoskeletal disorders. Some inks were shown to contain heavy metals above safe limits^[38]. Even inks that have been tested and approved for safety may be contaminated with heavy metals at later points in the manufacturing process. Other formulations that make use of more natural dyes are still prone to chemical transformation in the skin, which can substantially increase their resultant toxic potential.^[39] These results suggest that a tattoo can be a vector for chronic low-grade inflammation throughout their lifespan.
• Nanoparticles and Organ Deposition. It has been speculated for several years that tattoo inks, and their toxic components, may accumulate in other tissues and organs. Studies have confirmed that traces of ink leave the tattoo site and migrate to nearby lymph nodes, colouring them as well. A closer investigation has revealed that tattoo inks contain nanoparticles that can easily pass through cell membranes, further supporting the view that tattoos may contribute towards health problems by increasing body toxicity.^[40]

Tattoo Cancer Risk. In light of the above findings, more research is required to understand the toxicity of tattoos and the degree to which they may contribute to carcinogenesis. Several small reports have indicated that tattoos may be responsible for elevating the risk of developing certain types of skin cancer, including melanomas and basal carcinomas.^[41] Blue, black, and red inks were more frequently associated with skin cancer than other colours.^[42] These types of cancers are usually ascribed to UV radiation and sun exposure. It is interesting to note that tattoos can cause heightened skin sensitivity toward light in some individuals. This may be related to ink-induced changes in skin pigmentation, which could interfere with the skin’s ability to protect against UV.

Are Natural Temporary Tattoos Safer? Natural temporary tattoos may be safer alternatives due to a lower degree of reported adverse events. The most common side effects associated with natural tattoos include allergic reactions to the phytochemical constituents, the severity of which may be increased by the presence of heavy metals. Same as with synthetic inks, natural products that were dyed in different colours from their original ones proved to have higher levels of potentially toxic heavy metals. In one study, it was revealed that antioxidant metal levels were higher than heavy metal counterparts, including zinc and manganese.^[43] However, the forms and quantities of these metals may still promote adverse reactions in susceptible individuals if tattoos are frequently applied.

Dermal Fillers

Cosmetic centers typically offer fillers for minor facial augmentation and for reducing the appearance of wrinkles. There are many different types of fillers offered to achieve the wishes of the client.

Filler Risks. Despite the hype, fillers ought to be treated as minor surgical procedures. None of these treatments are risk-free, with many of the complications necessitating corrective surgery. Most risks pertain to postoperative infections, which are often subcutaneous and difficult to treat, particularly with respect to synthetic filler types. Cross-reactions with the filler can induce bruising, inflammation, rashes, permanent scarring, and/or growths at or near the injection site. Preliminary evidence suggests that implants and filler injections may promote the incidence of autoimmune diseases.^[44]

Client Safety. While the associated risks are severe, they are generally thought to be rare in those who follow safety precautions. The following guidelines help to reduce the risk of complications substantially^[45] and tend to make for standard practice:

• Filler Choice. The risk for complications varies across filler types (between <1-40%) and on an interindividual basis. Opting for temporary, less synthetic fillers (e.g., hyaluronic acid) poses a far lower risk than permanent, synthetic fillers and botox.
• Avoidance of Blood Thinning Substances (including alcohol, medications, and herbal formulations) for 7-10 days prior to the procedure helps reduce the risk of complications.
• Contraindications. Opting for a procedure when fighting an active infection or suffering from an acute allergy is not advisable. Individuals who have a history of severe allergies or autoimmune diseases may also wish to avoid dermal fillers as the chance for cross-reactivity is typically higher.^[46] Reactivity is also noted frequently in patients undergoing chemotherapy.^[47]

A comparison of dermal fillers, facial treatments, and hair removal therapies can be viewed here.

Cosmetological Preventive Measures. It is advisable to discuss the risks involved and their respective prevention measures with your cosmetologist before opting for filler treatments. The cosmetologist can reduce the risk by using smaller needles, disinfecting the skin before applying the filler, avoiding inflamed skin and splitting up the treatment into smaller applications that make use of less filler at a time. If irregularities occur, skilled practitioners will further massage the area and make use of heat and compression in order to shape the filler properly. Multiple appointments may be the most optimal.^[48]

General Beauty Risk Prevention Measures

Aside from choosing a hygienic beauty salon with optimal ventilation and health-conscious products, the following precautions can also greatly help to lower any potential beauty treatment risks:

• Supporting Immune Function. Many beauty treatments can be regarded as miniature surgical procedures, such as tattoos and dermal fillers. In this regard, the immune system ought to be stable in order to reduce the risk of complications. Appointments ought to be postponed in the event of sudden illness, injury, or major stress. Safety precautions ought to be considered if indicated for the procedure, such as avoiding blood thinning substances for 1-2 weeks prior to the appointment. A healthy diet plan, low in inflammation-promoting, highly processed foods, should also be considered both prior to and after the appointment until full recovery. These tips can also be applied to minor beauty treatments, which also come with a risk of infection or triggering an allergic reaction, for which a strong immune system is the best protection.
• Washing Before and After an Appointment. Irrespective of the kind of beauty treatment one opts for, infection is one of the top risks. It is important to keep clean before attending a beauty appointment, as well as to wash afterward. Special attention ought to be paid to the body area that came into closer contact with a beautician, such as the scalp, nails, or treated skin. It is worthwhile to consider more natural hygiene products that are gentler on the skin, such as hypoallergenic soap.
• Minimizing Potential Damage with Antioxidants. Every single beauty treatment offered in a salon makes use of harsh chemical agents that can evoke oxidative stress in skin cells and potentially evoke an inflammatory or allergic reaction. Antioxidants can be employed to minimize potential harm. Many natural essential oils, vitamins and plant-based nutrients offer a wealth of antioxidants that can help to protect against oxidation and lower inflammation. Applying cream or oils to the area before a beauty treatment may provide a buffer against any unwarranted chemical side effects and applying these after the treatment may help to neutralize any residual chemical agents in the skin. Oil-based agents are ideal as they can be rubbed into or allowed to sink into the skin. Hands should be clean when applying antioxidants to the skin and washed after the application.

Conclusion

Beauty treatments pose unintentional risks as a result of microbial and chemical exposure, such as immune reactions, respiratory problems, and infections. Recent research shows that frequenting beauty salons can pose a greater lifetime risk of cancer, as highlighted in beauty salon workers who suffer from multiple chemical exposure, chronic allergy, and recurrent infections. Proper safety and sanitation standards in aspects such as adequate ventilation, product storage, and personal hygiene are vital for the client and the salon worker. In addition to opting for a salon that values chemical safety, one can lower the risks further by washing before and after treatments, making use of antioxidant skin-moisturizing oils, and supporting immune function as best as possible.

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