Skin care products and cancer: What manufacturers don’t tell you
October 14, 2009 11:15 by Dr. Lorne Brandes
On a recent visit to a department store cosmetics counter, I was amazed at the number and variety of “rejuvenating” skin creams and lotions for sale -- and not just for women!
“How much did all that cost?” I asked warily as the smiling clerk handed the Visa card back to my wife.
“If they help my skin look younger, it’s worth it,” was all she would say.
It now appears that her faith in the products she bought may have been misplaced: a new report in the Journal of Clinical Oncology (JCO) warns that an ingredient in some skin creams may have serious long-term health consequences for women with, or at risk for, breast and uterine cancer. The offending substance? Estrogen!
The story began with an alert oncologist. He observed that the skin of a woman he was treating for estrogen-driven breast cancer looked more youthful since her previous visit. The doctor quickly ascertained that, starting four weeks earlier, his patient had been applying a new moisturizing skin cream after her daily bath.
His interest was immediately piqued. For years, it has been known that one of the benefits of taking estrogen for relief of menopausal symptoms is younger-looking skin. Could the cream she was putting on her skin contain estrogen? The product information provided no indication that it did.
His suspicion aroused, the oncologist sent a sample of the patient’s skin moisturizer, along with 15 other skin products, to an independent lab for analysis. The price of the creams ranged from $10 to several hundred dollars. Each was chosen based on the manufacturer’s claim that it rejuvenated, or enhanced the youthful appearance, of the skin. None listed estrogen as an ingredient.
The results supported the doctor’s concern: six -- almost 40 per cent -- of the creams contained significant amounts (up to 0.61%) of estriol or estrone, two potent forms of estrogen. As a comparator, Estrase, a vaginal cream prescribed to treat symptoms of vaginal dryness in post-menopausal women, contains up to 60 times less estrogen!
In publishing these results, it was decided not to provide the brand names of the estrogen-containing creams. While I suspect that the authors (or the journal’s editors) may have been concerned about potential lawsuits, an alternative reason was given: “…since cosmetic companies frequently change their formulations, contents of each product may not currently be similar to those obtained [at the time of analysis, in April 2007].”
Cosmetic companies are not currently required to submit their products for regulatory approval to agencies such as the FDA or Health Canada. Rather, as noted in a recent scientific review, complex skin formulations that contain potentially harmful ingredients are largely regulated by the cosmetic manufacturers themselves. And, as we have just learned, these same manufacturers generally do not feel inclined to divulge the presence of “problematical” ingredients like female hormones.
Should we be worried about the estrogen content of facial creams and other skin care products? In short, yes.
While skin absorption of ingredients in topically-applied creams and lotions can vary depending on the formulation and length of exposure, one extreme example has been published. A 93-year-old woman, who had applied an estrogen-containing cream to her skin for seven decades went to her doctor with uterine bleeding and a breast lump. She was found to have a uterus “as large as that of a normal adult menstruating woman,” while the breast lump proved to be malignant. The authors believed that both findings were likely related to prolonged use of the skin cream.
More to the point, women with breast cancer who are under treatment with an estrogen-lowering aromatase inhibitor should be especially concerned about any product that, without their knowing it, could work against this treatment by raising the level of blood estrogen through the skin. Similarly, healthy women at risk for breast or uterine cancer should also beware of the increased exposure to environmental estrogen inherent in some rejuvenating skin preparations.
To quote the authors of the JCO report, “We believe that women, especially patients with a history of breast cancer, should be able to understand the potential risks when exposed to estrogenically active molecules in commercially available topical moisturizers. Because our testing methodology was only intended as a screening process, we strongly encourage the scientific community and the U.S. Food and Drug Administration to repeat and expand on the results of these screening tests.”
I agree. And in light of a new warning just issued by noted scientist, Dr. Samuel Epstein, on the potential cancer-causing hormonal agents in cosmetics, their recommendation for FDA involvement is well-justified.