There are several types of chemical peels. [ 1 ]


Alpha hydroxy acids  (AHAs) are naturally occurring  carboxylic acids  such as  glycolic acid , a natural constituent of sugar cane juice, and  lactic acid , found in sour milk and tomato juice as well as being produced  endogenously  during normal  metabolism  and  exercise . [ 2 ]  This is the mildest of the peel formulas and produces light peels for treatment of fine wrinkles, areas of dryness, uneven pigmentation and acne. Alpha hydroxy acids can also be mixed with facial washes, serums or creams in lesser concentrations as part of a daily skin-care regimen to improve the skin's texture.


There are five usual fruit acids:  citric acid ,  glycolic acid ,  lactic acid ,  malic acid  and  tartaric acid . Many other alpha hydroxy acids exist and are used.


AHA peels are not indicated for treating wrinkles. [ 3 ] [ 4 ]


AHA peels may cause stinging,  skin redness , mild skin irritation, and  dryness .


Higher pH levels and lower percentages of hydroxy acids are commonly used as home peels. These will not work as quickly as an in-office procedure, but can be economical for many people.


Salicylic acid  is a beta hydroxy acid. It is antibacterial (mostly bacteriostatic, except in high concentrations when it is more frequently bactericidal) and anti-inflammatory which helps treat acne.. Salicylic acid also has the ability to reduce the spots and bumps associated with acne. [ 5 ]  It is becoming common for  beta hydroxy acid  (BHA) peels to be used instead of the stronger alpha hydroxy acid (AHA) peels due to BHA's being oil soluble. [ 6 ]  Studies show that BHA peels control sebum excretion, acne as well as remove dead skin cells to a certain extent better than AHAs [ citation needed ]  due to AHAs only working on the surface of the skin.


Retinoic acid  is a  retinoid . This type of facial peel is also performed in the office of a plastic surgeon, oral and maxillofacial surgeon, or a provider in a  medical spa  setting. This is a deeper peel than the beta hydroxy acid peel and is used to treat scars, wrinkles, and pigment.


It is usually performed in conjunction with a  Jessner ; which is performed right before, in order to open up the skin, so the retinoic acid can penetrate deeper into the skin. The client leaves with the chemical peel solution on their face. The peeling process takes place on the third day. More dramatic changes to the skin require multiple peels over time. [ citation needed ]


A  phenol - croton oil  is a type of chemical peel. [ 7 ]  The term "phenol-croton oil peel" has replaced the vague term "phenol peel" in medical literature. It was originally used on a clandestine basis by early Hollywood stars in the 1920s and was incorporated into mainstream practice in the 1960s by Thomas Baker and Howard Gordon. [ 8 ]  The active ingredient is  croton oil , which causes an intense caustic exfoliating reaction in the skin. [ 9 ] [ 10 ] [ 11 ]


Resurfacing and restoring skin with chemical peel was introduced in the second half of the 19th century by the Austrian dermatologist  Ferdinand Ritter von Hebra  (1816–1880), founder of the Vienna School of Dermatology. He used exfoliative agents, like phenol, croton oil, nitric acid in various caustic combinations for treating freckles and skin irregularities. [ 12 ]


The deeper the peel, the more complications that can arise. [ 1 ]  Professional strength chemical peels are typically administered by certified dermatologists or licensed estheticians. Professional peels and lower-concentration DIY home peel kits can pose health risks, including injury and scarring of the skin.  Possible complications include photosensitivity, prolonged  erythema , pigmentary changes,  milia , skin atrophy, and textural changes. [ 1 ]  Many individuals report professional chemical peels leave a minor yellowish tinge on their skin due to the retinol elements in the peel. This is expected to last 2–3 hours maximum. Varying mild to moderate redness after the procedure is expected.


Light chemical peels like AHA and  BHA are usually done in medical offices or Med Spas.  There is minimal  discomfort  so usually no  anesthetic  is given because the patient feels only a slight stinging when the  solution  is applied. [ citation needed ]


Medium peels such as  trichloroacetic acid  (TCA) are also performed in the doctor's office or in an  ambulatory surgery center  as an outpatient procedure and can cause more discomfort. Frequently, the combination of a  tranquilizer  such as  diazepam  and an oral analgesic is administered. TCA peels often do not require anesthesia even if the solution itself has - at the contrary of phenol - no numbing effect on the skin. [ clarification needed ]  The  patient  usually feels a warm or burning sensation. [ 13 ]


Phenol  used to be a deep chemical peel. Early phenol peel solutions were very painful and most practitioners would perform it under either  general anesthesia , administered by an anesthesiologist or nurse anesthetist. Today it is more correctly referred to as a  croton oil  peel, since that has proven to be the active ingredient responsible for most of its effects. [ citation needed ]  Recent formulations allow more variation in the depth of treatment, and allow its use under  sedation  either orally or intravenously, usually in conjunction with local anesthetic injections.


Clarisonic , or Pacific Bioscience Laboratories, Inc., was a company based in  Redmond, Washington  that produced the Clarisonic line of skin care devices. The company was sold to  L'Oreal  in 2011. [ 1 ]  In 2018, Clarisonic devices made up 14% of the skin care device market. In July 2020, L'Oréal announced it would discontinue the Clarisonic brand and products, choosing instead to focus on other core business offerings. It is speculated that the actual cause was increasing competition from cheaper alternatives as the skin care device market grew. [ 2 ]  As of September 30, 2020, the business and brand were discontinued.


During its peak days, Clarisonic products were available to spa owners, physicians and consumers, and the brand was available in over 50 countries. [ citation needed ]


Clarisonic was founded by David Giuliani, Robb Akridge, Steve Meginniss, Ward Harris, and Ken Pilcher in 2000. Giuliani, Clarisonic's CEO, is the former co-founder and CEO of Optiva, which developed the  Sonicare  line of toothbrushes. Giuliani sold Optiva to  Philips  Oral Healthcare in 2000. [ 3 ]


Akridge was a scientist at Optiva Corporation before co-founding Clarisonic. He holds a bachelor's degree from University of Texas, a Master of Science degree in biology from  Texas State University–San Marcos  and a doctorate in microbiology from  Texas A&M University .


Ken Pilcher is the lead inventor of Clarisonic's skin care systems. In the past, he has developed avionics for the  NASA   Space Shuttle , as well as medical electronics.


Clarisonic was backed by angel groups including  Keiretsu Forum  who provided the seed capital for the company


The term  cleanser  refers to a product that cleans or removes dirt or other substances. A cleanser could be a  detergent , and there are many types of cleansers that are produced with a specific objective or focus. For instance, a  degreaser  or  carburetor  cleanser used in automotive mechanics for cleaning certain engine and car parts.


Other varieties include the ones used in  cosmetology ,  dermatology  or general  skin care . In this case, a cleanser is a  facial  care product that is used to remove  make-up , skin care product residue, microbes, dead  skin cells , oils, sweat, dirt and other types of daily pollutants from the face. These washing aids help prevent filth-accumulation, infections, clogged pores, irritation and cosmetic issues like dullness from dead skin buildup & excessive skin shine from sebum buildup. This can also aid in preventing or treating certain skin conditions; such as  acne . Cleansing is the first step in a skin care regimen and can be used in addition of a  toner  and  moisturizer , following cleansing or using makeup remover cotton and makeup remover.


Sometimes "double cleansing" before moving on to any other skincare product is encouraged to ensure the full  dissolution & removal of residues that might be more resistant to cleansing, such as; waterproof makeup, water-resistant  sunscreen , the excess  sebum  of oily skin-type individuals and air pollution particles. Double cleansing usually involves applying a  lipid-soluble  cleanser (e.g. cleansing balm, cleansing oil, micellar cleansing water) to dry skin and massaging it around the face for a length of time, then the area may or may not be splashed with water. Any type of aqueous cleanser is then emulsified with water and used as the main cleanser that removes the first cleanser and further cleans the skin. Then the face is finally thoroughly rinsed with water until no filth or product residue remains.


Using a cleanser designated for the facial skin to remove dirt is considered to be a better alternative to bar  soap  or another form of skin cleanser not specifically formulated for the face for the following reasons:


Facial cleansers include the following:


Cleansers that have active ingredients are more suitable for oily skins to prevent breakouts. [ citation needed ]  But they may overdry and irritate dry skin, this may make the skin appear and feel worse. Dehydrated skin may require a creamy lotion-type cleanser. These are normally too gentle to be effective on oily or even normal skin, but dry skin requires much less cleansing power. It may be a good idea to select a cleanser that is alcohol-free for use on dry, sensitive, or dehydrated skin.


Some cleansers may incorporate fragrance or essential oils. However, for some people, these cleansers may irritate the skin and often provoke allergic responses. People with such sensitivity should find cleansers that are pH-balanced cosmetic balanced, contain fewer irritants, suit many variating skin types, and do not make the skin feel dehydrated directly after cleansing. Tight, uncomfortable skin is often dehydrated and may appear shiny after cleansing, even when no sebum is present. This is due to the taughtening and 'stripping' effect some cleaners can have on the skin. One should discontinue use of a cleanser that upsets the balance of the skin; cleansers should work with the skin not against it. Finding the right cleanser can involve some trial-and-error.


Clindamycin/benzoyl peroxide , sold under the brand name  Benzaclin  among others, is a topical gel used for the treatment of  acne . [ 7 ]  It is a  fixed-dose combination  of  clindamycin , as the phosphate, an  antibiotic ; and  benzoyl peroxide , an  antiseptic . [ 7 ]


Common side effects include peeling, itching, and dryness of the skin where the gel was applied. [ 7 ]


Clindamycin/benzoyl peroxide was approved for medical use in the United States in December 2000. [ 12 ] [ 13 ] [ 14 ]  It is available as a generic medication. [ 15 ]


The gel is used on the skin to treat light to medium  acne vulgaris  in people 12 years and older. [ 16 ]


There is an average 52% decrease in inflammatory acne lesions by week 12. [ 17 ]


The combination is less effective than benzoyl peroxide/ salicylic acid  after short-term treatment of two to four weeks, but the two treatments showed similar effectiveness after ten to twelve weeks. [ 18 ]


Studies on whether or not the use of clindamycin/benzoyl peroxide gels is  teratogenic  or has adverse effects on nursing infants have not been performed. While oral clindamycin passes into breast milk, no such data are available for clindamycin in gel form. Limited data regarding topical clindamycin and benzoyl peroxide have shown no safety problems. [ 16 ] [ 7 ]


The gel is not recommended for those who are allergic to clindamycin, benzoyl peroxide, any components of the formulation, or  lincomycin . [ 16 ] [ 19 ]  Individuals previously diagnosed with  regional enteritis ,  ulcerative colitis , or antibiotic-associated colitis are also recommended not to use it. [ 9 ]


Common side effects are peeling, itching, redness, dryness, burning, and  dermatitis . Benzoyl peroxide bleaches hair, clothes, towels, bedclothing, and the like. Prolonged exposure to natural or artificial sun light ( UV rays ) is not recommended because the gel may cause  photosensitivity . [ 16 ] [ 19 ]  Irritation due to benzoyl peroxide can be reduced by avoiding harsh facial cleansers and wearing  sunscreen  prior to sun exposure. [ 20 ]


Clinical studies have shown systemic absorption of clindamycin through topical application, in some cases leading to diarrhea, bloody diarrhea, and  colitis . Reports of  anaphylaxis  were also seen. However, the sources of these reports were personal accounts without controls and of an unknown population, thus it is difficult to attribute their cause to the clindamycin/benzoyl peroxide gel. [ 19 ]


No formal interaction studies have been done. Combination with topical products containing alcohol or  astringents , as well as  skin peelings , may increase the irritant effect of clindamycin/benzoyl peroxide. Topical  erythromycin  may antagonise the effect of clindamycin, although this has only be demonstrated in  in vitro  studies. Topical  tretinoin  and other  retinoids  may be inactivated by benzoyl peroxide or increase its irritant effect. [ 16 ] [ 19 ]


Clindamycin phosphate is a water-soluble  ester  of the semi-synthetic antibiotic clindamycin, which is synthesized from lincomycin. Like the  macrolide  antibiotics, it acts as a  bacteriostatic  agent by interfering with the  50S  subunit of the  ribosome  of  Cutibacterium acnes , inhibiting bacterial protein synthesis and preventing bacteria from replicating. [ 16 ] [ 21 ]   C. acnes  plays a role in the development of acne. [ 22 ]


Benzoyl peroxide also kills  C. acnes , but by releasing free radical oxygen species, thus oxidizing bacterial proteins. Also, it dries out the area by reducing  sebum  production, prevents  clogged pores , and is a  keratolytic  agent. [ 16 ]  Since benzoyl peroxide is an oxidizer, not an antibiotic, it is not subject to  C. acnes  resistance unlike clindamycin. [ 18 ] [ 23 ]


Both ingredients have been shown to reduce the number of acne lesions with statistical significance. [ 18 ]


Clindamycin phosphate is an inactive  prodrug . It is quickly activated to clindamycin by  hydrolysis . After four weeks of application during a study, 0.043% of the used clindamycin dose were found in the blood. Benzoyl peroxide is only absorbed through the skin after reduction to  benzoic acid , which is subsequently metabolized to  hippuric acid  and eliminated via the kidneys. [ 16 ]


The combination is sold under various brand names including Acanya, [ 8 ]  Benzaclin, [ 7 ]  Duac, [ 10 ]  and Onexton. [ 9 ]


Dow Pharmaceuticals filed the patent for Onexton, and the  United States Patent and Trademark Office  issued the patent on 16 October 2012. On 24 November 2014, the US  Food and Drug Administration  (FDA) approved the  new drug application  (NDA) No. 050819 for Onexton, with Dow Pharmaceutical as the holder. [ 24 ]  The patent is set to expire on 5 August 2029. [ 25 ]


On 12 January 2016, [ 26 ]   Dow Pharmaceutical Sciences  and Valeant Pharmaceuticals North America LLC filed a lawsuit against  Taro  USA and Taro Industries, an Israel-based corporation. The lawsuit was filed for infringement upon their Onexton patent, by Taro attempting to submit an  abbreviated new drug application  (ANDA) to the  Food and Drug Administration  (FDA) for its generic 3.75% benzoyl peroxide and 1.2% clindamycin phosphate  topical gel . The court concluded that Taro was guilty of attempting to submit an ANDA patent request before the Onexton patent expired. [ 24 ]  Perrigo settled its patent litigation with Valeant and Dow. [ 27 ]


Collagen induction therapy  ( CIT ), also known as  microneedling ,  dermarolling , or  skin needling , is a  cosmetic  procedure that involves repeatedly puncturing the  skin  with tiny, sterile needles (microneedling the skin). CIT should be separated from other contexts in which microneedling devices are used on the skin (e.g.,  transdermal  drug delivery,  vaccination ).


It is a technique for which research is ongoing, but has been used for a number of skin problems including scarring and  acne . [ 1 ]  Some studies have also shown that when combined with  minoxidil  treatment, microneedling is able to treat hair loss more effectively than minoxidil treatment alone. [ 2 ]


Platelet-rich plasma  (PRP) can be combined with collagen induction therapy treatment in a form of  dermatologic   autologous blood therapy . PRP is derived from the patient's own blood and may contain  growth factors  that increase collagen production. [ 3 ]  It can be applied topically to the entire treatment area during and after collagen induction therapy treatments or injected intradermally to scars. Efficacy of the combined treatments remains in question pending scientific studies. [ 4 ] [ 5 ]


More serious safety concerns have been cited for these treatments, popularly known as  vampire facials , when performed in non-medical settings by people untrained in  infection control . [ 6 ] [ 7 ]  The New Mexico Department of Health issued a statement that at least one such business offering vampire facials "could potentially spread blood-borne infections such as  HIV ,  hepatitis B  and  hepatitis C  to clients". [ 6 ]


In April 2024, the CDC announced that three women who had been patients at the Albuquerque, New Mexico, VIP Spa had been diagnosed with HIV after getting "vampire facials" there. Another almost 200 former clients and their sexual partners were also tested but were found to not have HIV. No mention was made of any testing for other possible blood-borne infections. [ 8 ]


A  concealer  or  color corrector  is a type of  cosmetic  that is used to mask imperfections on the skin. These imperfections can include dark circles under the eyes, blemishes, and hyperpigmentation. Concealer is similar to, and can be used in conjunction with  foundation , a lighter cosmetic that is used to even out the  skin tone . Both concealer and foundation are typically used to make skin appear smoother and more uniform in color. These two types of cosmetics differ in that concealers tend to be more heavily  pigmented , though concealer and foundation are both available in a wide range of colors and  opacities .


To use a concealer, an individual typically applies a small amount of product to the area of the skin that they want to cover. The concealer is then blended into the surrounding skin using a brush, sponge, or the fingertips to create a seamless finish. Concealers can be applied before or after foundation, depending on the desired effect. Applying concealer before foundation can help to create a more even canvas for the foundation, while applying concealer after foundation can help to touch up any areas that still require coverage.


Concealers comes in different forms such as liquid, cream, stick, pencil, and powder. The first commercially available concealer was  Max Factor 's  Erace , launched in 1954. [ 1 ]  Camouflage makeup is a much heavier pigmented form of concealer. It is used to cover serious skin discolorations such as birthmarks, scars and  vitiligo .


Concealer is available in a variety of shades. When picking a concealer, people tend to choose one or two shades lighter than their skin tone to better hide their blemishes and dark circles under the eye; once blended out and then set with a powder, it will be smooth and resemble more youthful skin. Some colors are intended to look like a natural skin tone, while others are meant to cancel out the color of a particular type of blemish. Concealers with yellow undertones are used to hide dark circles. Green and blue can counteract red patches on the skin, such as those caused by pimples, broken veins, or  rosacea . A purple-tinted concealer can make sallow (yellowish) complexions look brighter.


Each type of concealer is unique and has qualities that are better suited for different skin types.


These are some common ingredients found in all concealer products: [ 6 ]


Cosmetics  are composed of mixtures of  chemical compounds  derived from either  natural sources  or synthetically created ones. [ 1 ]  Cosmetics have various purposes, including  personal  and  skin care . They can also be used to conceal blemishes and enhance natural features (such as the  eyebrows  and  eyelashes ). Makeup can also add colour to a person's face, enhance a person's features or change the appearance of the face entirely to resemble a different person, creature, or object. [ 2 ]


People have used cosmetics for thousands of years for skin care and appearance enhancement. Visible cosmetics for women and men have gone in and out of fashion over the centuries.


Some early forms of cosmetics used harmful ingredients such as lead that caused serious health problems and sometimes resulted in death. Modern commercial cosmetics are generally tested for safety but may contain controversial ingredients, such as  per- and polyfluoroalkyl substances  (PFAS),  formaldehyde releasers , and ingredients that cause allergic reactions.


The European Union and regulatory agencies around the world have stringent regulations for cosmetics. In the United States, cosmetic products and ingredients do not require FDA approval. Some countries have banned using animals for cosmetic testing.


The word  cosmetics  is derived from the  Greek   κοσμητικὴ τέχνη  ( kosmetikē tekhnē ), meaning "technique of dress and ornament,"  from  κοσμητικός  ( kosmētikos ), "skilled in ordering or arranging," [ 3 ]  and from  κόσμος  ( kosmos ), meaning "order" and "ornament.". [ 4 ]


Though the legal definition of cosmetics in most countries is broader, in some  Western countries , [ which? ]  cosmetics are commonly taken to mean only makeup products, such as  lipstick ,  mascara ,  eye shadow ,  foundation ,  blush ,  highlighter ,  bronzer ,  fake eyelashes ,  eyeliner ,  concealer ,  lip gloss , and several other product types. [ clarification needed ]


In the United States, the  Food and Drug Administration  (FDA), which regulates cosmetics, [ 5 ]  defines cosmetics as products "intended to be applied to the human body for cleansing, beautifying, promoting attractiveness, or altering the appearance without affecting the body's structure or functions." This broad definition includes any material intended for use as an  ingredient  in a cosmetic product, with the FDA specifically excluding pure  soap  from this category. [ 6 ]


Cosmetics designed for  skin care   may be used to cleanse,  exfoliate  and protect the skin, as well as replenish it, using  body lotions ,  cleansers ,  toners , serums,  moisturizers , eye creams,  retinol , and balms. Cosmetics designed for more general  personal care , such as  shampoo , soap, and  body wash , can be used to clean the body.


Cosmetics designed to enhance one's appearance (makeup) can be used to conceal blemishes, enhance one's natural features, or add color to a person's face. In some cases, more extreme forms of makeup are used for performances,  fashion shows , and people in  costume  and can change the appearance of the face entirely to resemble a different person, creature, or object. Techniques for changing appearance include  contouring , which aims to give shape to an area of the face.


Cosmetics can also be designed to add  fragrance  to the body.


Products used for  haircare , such as permanent waves,  hair colors , and  hairsprays , are classified as cosmetic products as well. [ 7 ]


Cosmetics have been in use for thousands of years, with  ancient Egyptians  and  Sumerians  using them. In Europe, the use of cosmetics continued into the  Middle Ages —where the face was whitened and the cheeks rouged— [ 8 ]  though attitudes towards cosmetics varied throughout time, with the use of cosmetics being openly frowned upon at many points in Western history. [ 9 ]  Regardless of the changes in social attitudes towards cosmetics, many occasionally achieved ideals of appearance through cosmetics.


According to one source, early major developments in cosmetics include: [ 1 ]


Historically, the absence of regulation of the manufacture and use of cosmetics, as well as the absence of scientific knowledge regarding the effects of various compounds on the human body for much of this time period, led to a number of negative  effects  upon those who used cosmetics, including  deformities , blindness, and, in some cases, death.  Although harmless products were used, such as berries, and  beetroot , many cosmetic products available at this time were still chemically dubious and even poisonous. Examples of the prevalent usage of harmful cosmetics include the use of  ceruse  (white lead) throughout a number of different cultures, such as during the  Renaissance  in the West, and blindness caused by the mascara  Lash Lure  during the early 20th century. During the 19th century, there were numerous incidents of  lead poisoning  due to the fashion for red and white lead makeup and powder, leading to swelling and inflammation of the eyes, weakened tooth enamel, and blackened skin, with heavy use known to lead to death. [ 10 ]  Usage of white lead was not confined only to the West, with the white Japanese face makeup known as  oshiroi  also produced using white lead. In the second part of the 19th century, scientific advances in the production of makeup lead to the creation of makeup free of hazardous substances such as  lead . [ citation needed ]


Throughout the late 19th and early 20th centuries, changes in the prevailing attitudes towards cosmetics led to a wider expansion of the cosmetics industry. In 1882, English actress and socialite  Lillie Langtry  became the poster girl for  Pears  of London, making her the first celebrity to endorse a commercial product. [ 11 ]  She allowed her name to be used on face powders and skin products. [ 12 ]  During the 1910s, the market in the US was developed by figures such as  Elizabeth Arden ,  Helena Rubinstein , and  Max Factor . These firms were joined by  Revlon  just before  World War II  and  Estée Lauder  just after. By the middle of the 20th century, cosmetics were in widespread use by women in nearly all  industrial societies  around the world, with the cosmetics industry becoming a multibillion-dollar enterprise by the beginning of the 21st century. [ 13 ]  The wider acceptance of the use of cosmetics led some to see makeup as a tool used in the oppression and subjection of women to unfair societal standards. In 1968, at the feminist  Miss America protest , protesters symbolically threw a number of feminine products into a "Freedom Trash Can", [ 14 ]  with cosmetics among the items the protesters called "instruments of female torture" [ 15 ]  and accoutrements of what they perceived to be enforced  femininity .


As of 2016 [update] , the world's largest cosmetics company is  L'Oréal , founded by  Eugène Schueller  in 1909 as the French Harmless Hair Colouring Company (now owned by  Liliane Bettencourt  26% and  Nestlé  28%; the remaining 46% is traded publicly).


Although modern makeup has been traditionally used mainly by women, men also use makeup to enhance their own facial features or cover blemishes and dark circles. The negative stigma of men wearing makeup in countries such as the United States has weakened over the years, with the number of men using makeup increasing in the 21st century. [ 16 ]  Cosmetics brands have increasingly targeted men in the sale of cosmetics, with some products targeted  specifically at men . [ 17 ] [ 18 ]


Lead has been used as a makeup product since the 18th century. It is said to be lethal to women who apply it daily to achieve a pale complexion representing nobility, as tanner skin represents the working class. Lead can be detrimental to people's health and cause death if mixed with  vinegar  which it allows lead to be absorbed through the skin. [ 19 ]


Though there are a large number of different cosmetics used for a variety of different purposes, all cosmetics are typically intended to be applied externally. These products can be applied to the face (on the skin, lips, eyebrows, and eyes), to the body (on the skin, particularly the hands and nails), and to the hair. These products may be intended for use as skincare, personal care, or to alter the appearance, with the subset of cosmetics known as makeup primarily referring to products containing colour pigments intended for the purpose of altering the wearer's appearance; some manufacturers will distinguish only between "decorative" cosmetics intended to alter the appearance and "care" cosmetics designed for skincare and personal care.


Most cosmetics are also distinguished by the area of the body intended for application, with cosmetics designed to be used on the face and eye area usually applied with a brush, a makeup sponge, or the fingertips. Cosmetics can also be described by the physical composition of the product. Cosmetics can be liquid or cream  emulsions , powders (pressed or loose), dispersions, or  anhydrous  creams or sticks.


Cleansing is a standard step in skin care routines. Skin cleansing includes some or all of these steps or cosmetics:


Hair care  is a category of cosmetics devoted to products which are used to improve the appearance of hair. [ 28 ]


Perfumes  or fragrances, are liquids that can be sprayed or applied to produce a long-lasting smell. [ 30 ]  They are created by mixing different compounds together. There are different groups of perfumes which are categorised according to their concentration. [ 30 ]


The difference between  Eau de parfum  and  Eau de toilette  is more about the perfume oil concentration.  Eau de parfum  has a higher concentration of perfume than  Eau de toilette .


Various tools are used to apply cosmetics.


In addition to brushes, a  makeup sponge  is a popular applicator. Makeup sponges can be used to apply foundation, blend concealer, and apply powder or highlighter.


Loofahs ,  microfiber  cloths, natural sponges, or brushes may be used to exfoliate skin simply by rubbing them over the face in a circular motion. Gels, creams, or lotions may contain an acid to encourage dead skin cells to loosen, and an abrasive such as  microbeads , sea salt and sugar, ground nut shells, rice bran, or ground apricot kernels to scrub the dead cells off the skin. Salt and sugar scrubs tend to be the harshest, while scrubs containing beads or rice bran are typically very gentle.


A variety of  organic compounds  and  inorganic compounds  comprise typical cosmetics. Typical organic compounds are modified natural oils and fats as well as a variety of petrochemically derived agents. Inorganic compounds are processed minerals such as  iron oxides ,  talc , and  zinc oxide . The oxides of zinc and iron are classified as  pigments , i.e., colorants that have no solubility in solvents. Cosmetic companies have become more transparent in the ingredients of their products because consumers are interested in the formula of their products. [ 32 ]


Handmade and  certified organic  products are becoming more mainstream due to consumer concerns that certain chemicals in some  skincare  products may be harmful if absorbed through the skin. The  FDA , which regulates the US cosmetic industry, says "FDA has not defined the term “natural” and has not established a regulatory definition for this term in cosmetic labeling." [ 33 ]   It goes on to warn consumers, "choosing ingredients from sources you consider “organic” or “natural” is no guarantee that they are safe."


The term "mineral makeup" applies to a category of face makeup, including foundation, eye shadow, blush, and bronzer, made with loose, dry mineral powders. These powders are often mixed with oil-water  emulsions . Lipsticks, liquid foundations, and other liquid cosmetics, as well as compressed makeups such as eye shadow and blush in compacts, are often called mineral makeup if they have the same primary ingredients as dry mineral makeups. Liquid makeups must contain preservatives, and compressed makeups must contain binders, which dry mineral makeups do not. Mineral makeup usually does not contain synthetic fragrances, preservatives, parabens, mineral oil, or chemical dyes. For this reason, dermatologists may consider mineral makeup to be gentler on the skin than makeup that contains those ingredients. [ 34 ]  Some minerals are nacreous or pearlescent, giving the skin a shining or sparking appearance. One example is  bismuth oxychloride . [ 1 ]  There are various mineral-based makeup brands, including: Bare Minerals,  Tarte ,  Bobbi Brown , and  Stila .


The term  cosmetic packaging  is used for  primary packaging  and secondary packaging of cosmetic products. [ citation needed ]


Primary packaging, also called cosmetic containers, houses the cosmetic product. It is in direct contact with the cosmetic product. Secondary packaging is the outer wrapping of one or several cosmetic container(s). An important difference between primary and secondary packaging is that any information that is necessary to clarify the safety of the product must appear on the primary package. Otherwise, much of the required information can appear on just the secondary packaging. [ 35 ]


Cosmetic packaging is standardized by  ISO 22715 , set by the  International Organization for Standardization [ 36 ]  and regulated by national or regional regulations such as those issued by the  EU  or the  FDA . Marketers and manufacturers of cosmetic products must be compliant to these regulations to be able to market their cosmetic products in the corresponding  areas of jurisdiction . [ 37 ]


The manufacture of cosmetics is dominated by a small number of  multinational corporations  that originated in the early 20th century, but the distribution and sales of cosmetics are spread among a wide range of businesses. The world's largest cosmetic companies are  L'Oréal ,  Procter & Gamble ,  Unilever ,  Shiseido , and  Estée Lauder . [ 38 ]  In 2005, the market volume of the cosmetics industry in the US, Europe, and Japan was about EUR 70 Billion/a year. [ 1 ]  In Germany, the cosmetic industry generated €12.6 billion of  retail  sales in 2008, [ 39 ]  which makes the German cosmetic industry the third largest in the world, after Japan and the United States. German  exports  of cosmetics reached €5.8 billion in 2008, whereas imports of cosmetics totaled €3 billion. [ 39 ]


The worldwide cosmetics and perfume industry currently generates an estimated annual turnover of US$170 billion (according to Eurostaf, May 2007). Europe is the leading market, representing approximately €63 billion, while sales in France reached €6.5 billion in 2006, according to FIPAR (Fédération des Industries de la Parfumerie – the French federation for the perfume industry). [ 40 ] [ unreliable source? ]  France is another country in which the cosmetic industry plays an important role, both nationally and internationally. According to data from 2008, the cosmetic industry has grown constantly in France for 40 consecutive years. In 2006, this industrial sector reached a record level of €6.5 billion. Famous cosmetic brands produced in France include Vichy,  Yves Saint Laurent ,  Yves Rocher , and many others.


The Italian cosmetic industry is also an important player in the European cosmetic market. Although not as large as in other  European countries , the cosmetic industry in Italy was estimated to reach €9 billion in 2007. [ citation needed ]  The Italian cosmetic industry is dominated by  hair  and body products and not makeup as in many other European countries. In Italy, hair and body products make up approximately 30% of the cosmetic market. Makeup and facial care are the most common cosmetic products exported to the United States.


According to Euromonitor International, the market for cosmetics in  China  is expected to be $7.4 billion in 2021 up from $4.3 billion in 2016. The increase is due to  social media  and the changing attitudes of people in the 18-to-30-year age bracket. [ 41 ]


Due to the popularity of cosmetics, especially fragrances, many designers who are not necessarily involved in the cosmetic industry came up with perfumes bearing their names. Moreover, some actors and  singers  (such as  Celine Dion ) have their own perfume line. Designer perfumes are, like any other designer products, the most expensive in the industry as the consumer pays for the product and the brand. Famous Italian fragrances are produced by  Giorgio Armani ,  Dolce & Gabbana , and others.


Procter & Gamble , which sells  CoverGirl  and  Dolce & Gabbana  makeup, funded a study [ 42 ]  concluding that makeup makes women seem more competent. [ 43 ]  Due to the source of funding, the quality of this  Boston University  study is questioned.


Cosmetics products may be retailed in  beauty stores ,  department stores  and  hypermarkets ,  drugstores ,  variety stores ,  grocery stores , beauty supply stores, and many other formats, and in similar types of online stores or the online presence of these types of physical stores.


Cosmetic companies have changed their traditional methods of marketing by using social media influencers and brand ambassadors to market their products. [ 32 ]


During the 20th century, the popularity of cosmetics increased rapidly. [ 44 ]  Cosmetics are used by girls at increasingly young ages, especially in the United States. Because of the fast-decreasing age of makeup users, many companies, from drugstore brands like Rimmel to higher-end products like Estee Lauder, cater to this expanding market by introducing flavored lipsticks and glosses, cosmetics packaged in glittery and sparkly packaging, and marketing and advertising using young  models . [ 45 ]  The social consequences of younger and younger cosmetics use have had much attention in the media over the last few years.


Criticism  of cosmetics has come from a wide variety of sources including some  feminists , [ 46 ]   religious groups ,  animal rights activists ,  authors , and public interest groups. It has also faced criticism from men, some of whom describe it as a form of deception or  fakeup . [ 47 ]


The new generation has been more accepting of males wearing makeup, and having a "soft pretty boy" look in South Korea has become more widespread in recent years, particularly among younger generations. This trend is known as "K-beauty," and it has been popularized by K-pop idols, actors, and social media influencers. Many of these idols have become beauty icons and have allowed many men to access beauty products and to feel comfortable using them. While there may still be some societal pressure to conform to traditional gender norms, there is also a growing acceptance of individual expression and breaking free from traditional gender roles. [ 48 ] [ 49 ]


"The  Sephora Kids  are the generation alpha (the cohort born roughly between 2010 and 2025) and is growing up in a very different environment compared to previous generations, and several factors contribute to their heightened interest in skincare and makeup. [ 50 ]  Platforms like TikTok have also popularized short, fun videos about skincare and makeup tips, making beauty routines seem exciting and achievable. Social media platforms have made it easier for celebrities and influencers to become role models for Gen Alpha, and as a result, many celebrities and influencers actively promote skincare routines or collaborate with beauty brands, making skincare and makeup more aspirational Alpha is also inspired by the "clean beauty" movement and inclusive beauty brands that champion self-expression, allowing them to feel more confident in exploring skincare and makeup." [ 51 ]


In 2023 and 2024, many people posting on social media have reported seeing girls, ranging from 10 to 12 in age in popular cosmetic stores, such as the likes of Boots and Sephora. [ 50 ]  This is most commonly reported in western countries, specifically America, Australia and the United Kingdom. This has garnered attention because it bring awareness to the growing need for make-up for younger girls and women, many criticize this claiming it's connected to western beauty standards which in recent years have become an increasingly controversial topic in many medias revolving around politics and women's rights. [ 52 ]  It's also a hot topic in medical spaces such as dermatology, due to the increase of young girls using anti-aging cream, despite only being around 11 years old. [ 53 ]


In the United States, "Under the law, cosmetic products and ingredients do not need FDA premarket approval." [ 56 ]  The EU and other regulatory agencies around the world have more stringent regulations. [ 57 ]  The FDA does not have to approve or review cosmetics, or what goes in them, before they are sold to consumers. The FDA only regulates some colors that can be used in the cosmetics and hair dyes. The cosmetic companies do not have to report any injuries from the products; they also only have voluntary recalls of products. [ 5 ]


There has been a marketing trend towards the sale of cosmetics lacking controversial ingredients, especially those derived from  petroleum ,  sodium lauryl sulfate  (SLS), and  parabens . [ 58 ]   Per- and polyfluoroalkyl substances  (PFAS) are a class of about 9,000 synthetic  organofluorine  compounds that have multiple highly toxic  fluorine  atoms attached to an  alkyl chain . PFAS are used by major  cosmetics industry  companies in a wide range of cosmetics, including such products as  lipstick ,  eye liner ,  mascara ,   foundation ,  concealer ,  lip balm ,   blush ,  nail polish . A 2021 study tested 231  personal care products  and found organic fluorine, a hallmark of PFAS, in more than half of the samples. Substantial levels of fluorine were identified in tested brands of products as follows: 82% of the brands of waterproof mascara, 63% of the brands of foundations, and 62% of liquid lipstick. PFAS compounds are readily absorbed through  human skin  and through  tear ducts , and such products on  lips  are often unwittingly ingested. Manufacturers often fail to label their products as containing PFAS, which makes it difficult for cosmetics consumers to avoid products containing PFAS. [ 59 ]


Formaldehyde  is no longer used in cosmetics but has been replaced by  formaldehyde releasers . Formaldehyde is dangerous to human health, especially when inhaled. [ 60 ] [ 61 ] [ 62 ]  In 2011, the US  National Toxicology Program  described formaldehyde as " known to be a human carcinogen ". [ 63 ] [ 64 ] [ 65 ]


The danger of formaldehyde is a major reason for the development of formaldehyde releasers which release formaldehyde slowly at lower levels. [ 66 ]


Numerous reports have raised concern over the safety of a few  surfactants , including  2-butoxyethanol . In some individuals, SLS may cause a number of skin problems, including  dermatitis . Additionally, some individuals have had an emergence of vitiligo after using cosmetics containing the ingredient rhododendrol. [ 67 ] [ 68 ] [ 69 ] [ 70 ] [ 71 ] [ 72 ]


Parabens  can cause skin irritation and  contact dermatitis  in individuals with paraben  allergies , a small percentage of the general population. [ 73 ]  Animal experiments have shown that parabens have a weak  estrogenic  activity, acting as  xenoestrogens . [ 74 ]


Perfumes  are widely used in consumer products. Studies concluded from  patch testing  show  fragrances  contain some ingredients which may cause  allergic reactions . [ 75 ]


Balsam of Peru  was the main recommended marker for perfume allergy before 1977, which is still advised. The presence of Balsam of Peru in a cosmetic will be denoted by the  INCI  term  Myroxylon pereirae . [ 76 ] [ 77 ]  In some instances, Balsam of Peru is listed on the ingredient label of a product by one of its  various names , but it may not be required to be listed by its name by mandatory labeling conventions (in fragrances, for example, it may simply be covered by an ingredient listing of "fragrance"). [ 77 ] [ 78 ] [ 79 ] [ 80 ]


Some cosmetics companies have made  pseudo-scientific  claims about their products which are misleading or unsupported by scientific evidence. [ 81 ] [ 82 ]


As of 2019, an estimated 50–100 million animals are tested each year in locations such as the United States and China. [ 83 ]  Such tests have involved general toxicity, eye and skin irritants,  phototoxicity  (toxicity triggered by  ultraviolet  light), and  mutagenicity . [ 84 ] [ 85 ]  Due to ethical concerns around animal testing, some nations have legislated against animal testing for cosmetics. An updated list can be found on the Humane Societies website. [ 86 ]  According to the Humane Society of the United States, there are nearly 50 non-animal tests that have been validated for use, and are potentially more efficacious. [ 87 ]  In the United States, mice, rats, rabbits, and cats are the most used animals for testing. [ 88 ]  In 2018, California banned the sale of animal-tested cosmetics. [ 89 ]


Cosmetics testing is banned in the Netherlands, India, Norway, Israel, New Zealand, Belgium, and the UK. In 2002, the European Union agreed to phase in a near-total ban on the sale of animal-tested cosmetics throughout the EU from 2009 and to ban all cosmetics-related animal testing. [ 90 ]  In December 2009, the European Parliament and Council passed  EC Regulation 1223/2009 on cosmetics , a bill to regulate the cosmetic industry in the EU. [ 91 ]  EC Regulation 1223/2009 took effect on July 11, 2013. [ 91 ]  In March 2013, the EU banned the import and sale of cosmetics containing ingredients tested on animals. [ 92 ]  China required animal testing on cosmetic products until 2014, when they waived animal testing requirements for domestically produced products. [ 93 ]  In 2019, China approved nine non-animal testing methods, and in 2020 laws making animal testing compulsory were lifted. [ 94 ]


In June 2017, legislation was proposed in Australia to end animal testing in the cosmetics industry. [ 95 ]  In March 2019, the Australian Senate passed a bill that banned the use of data from animal testing in the cosmetic industry since July 1, 2020. [ 96 ]


In the European Union, the manufacture, labelling, and supply of cosmetics and personal care products are regulated by  Regulation EC 1223/2009 . [ 91 ]  It applies to all the countries of the EU as well as Iceland, Norway, and Switzerland. This regulation applies to single-person companies making or importing just one product as well as to large multinationals. Manufacturers and importers of cosmetic products must comply with the applicable regulations in order to sell their products in the EU. In this industry, it is common fall back on a suitably qualified person, such as an independent third party inspection and testing company, to verify the cosmetics' compliance with the requirements of applicable cosmetic regulations and other relevant legislation, including  REACH ,  GMP ,  hazardous substances , etc. [ 97 ] [ 98 ]


In the European Union, the circulation of cosmetic products and their safety have been the subject of legislation since 1976. One of the newest improvements to the regulation concerning the cosmetic industry is the ban on  animal testing . Testing cosmetic products on animals has been illegal in the European Union since September 2004, and testing the separate ingredients of such products on animals is also prohibited by law, since March 2009 for some endpoints and full since 2013. [ 99 ]


Cosmetic regulations in Europe are often updated to follow the trends of innovations and new technologies while ensuring  product safety . For instance, all annexes of Regulation 1223/2009 were aimed at addressing potential risks to human  health .
Under the EU cosmetic regulation, manufacturers, retailers, and importers of cosmetics in Europe will be designated as "responsible persons.". [ 91 ]  This new status implies that the responsible person has the  legal liability  to ensure that the cosmetics and  brands  they manufacture or sell comply with the current cosmetic regulations and norms. The responsible person is also responsible for the documents contained in the Product Information File (PIF), a list of product information including data such as Cosmetic Product Safety Report, product description,  GMP statement , or product function.


In 1938, the U.S. passed the  Food, Drug, and Cosmetic Act  authorizing the  Food and Drug Administration  (FDA) to oversee safety via legislation in the cosmetic industry and its aspects in the United States. [ 100 ] [ 101 ]  The FDA joined with 13 other federal agencies in forming the Interagency Coordinating Committee on the Validation of Alternative Methods (ICCVAM) in 1997, which is an attempt to ban animal testing and find other methods to test cosmetic products. [ 102 ]


The current law on cosmetics in the U.S. does not require cosmetic products and ingredients to have  FDA  approval before going on the market, except from color additives. [ 103 ]  The Cosmetic Safety Enhancement Act was introduced in December 2019 by Representative  Frank Pallone . [ 104 ]


ANVISA (Agência Nacional de Vigilância Sanitária,  Brazilian Health Surveillance Agency ) is the regulatory body responsible for cosmetic legislation and  directives  in the country. The rules apply to manufacturers, importers, and retailers of cosmetics in Brazil, and most of them have been harmonized so they can apply to the entire  Mercosur .


The current legislation restricts the use of certain substances, such as pyrogallol,  formaldehyde , or paraformaldehyde, and bans the use of others, such as lead  acetate  in cosmetic products. All restricted and forbidden substances and products are listed in the regulation RDC 16/11 and RDC 162, 09/11/01.


More recently, a new cosmetic  Technical Regulation  (RDC 15/2013) was set up to establish a list of authorized and restricted substances for cosmetic use, used in products such as  hair dyes , nail hardeners, or used as product preservatives.


Most Brazilian regulations are optimized, harmonized, or adapted in order to be applicable and extended to the entire Mercosur  economic zone .


The  International Organization for Standardization  (ISO) published new guidelines on the safe manufacturing of cosmetic products under a Good Manufacturing Practices (GMP) regime. Regulators in several countries and regions have adopted this standard, ISO 22716:2007, effectively replacing existing guidance and standards.
ISO 22716 provides a comprehensive approach for a quality management system for those engaged in the manufacturing, packaging, testing, storage, and transportation of cosmetic end products. The standard deals with all aspects of the supply chain, from the early delivery of raw materials and components until the shipment of the final product to the consumer.


The standard is based on other quality management systems, ensuring smooth integration with such systems as ISO 9001 or the British Retail Consortium (BRC) standard for consumer products. Therefore, it combines the benefits of GMP, linking cosmetic product safety with overall business improvement tools that enable organisations to meet global consumer demand for cosmetic product safety certification. [ 105 ]


In July 2012, since microbial contamination is one of the greatest concerns regarding the quality of cosmetic products, the ISO introduced a new standard for evaluating the antimicrobial protection of a cosmetic product by preservation efficacy testing and microbiological risk assessment.


Cucumber juice  is the  juice  derived from  cucumbers  produced by squeezing or pressing it. [ 1 ]  Cucumbers are 98% water. [ 2 ]


Cucumber juice is used in beverages such as  cocktails  like the  Bloody Mary , [ 3 ]  dishes such as  cucumber soup , [ 4 ]  and in dips and salad dressings, such as  green goddess dressing . [ 5 ]  Cucumber juice has significant amounts of  potassium [ 1 ]  and is high in vitamin A. [ 6 ]  It also contains  sterol [ 7 ]  and significant amounts of  silicon . [ 1 ]


Cucumber juice is used as an ingredient in cosmetics, soaps, shampoos, and lotions, [ 11 ] [ 12 ]  and in  eau de toilette  and perfumes. [ 13 ]


It was used in Russian  traditional medicine  to aid in the treatment of respiratory tract inflammation and to reduce lingering cough. [ 14 ]  In other traditions it was used to soothe  heartburn  and reduce acid in the stomach. [ 15 ]  For skin, it has been used to soothe burns and rashes. [ 15 ] [ 14 ] [ 16 ]  Cucumber juice has been described as a repellent against  wood lice  and  fish-moths . [ 16 ]


Dead Sea salt  refers to  salt  and other mineral deposits extracted or taken from the  Dead Sea .  The composition of this material differs significantly from oceanic salt.


Dead Sea salt was used by the peoples of  Ancient Egypt [ 1 ]  and it has been utilized in various unguents, skin creams, and soaps since then. [ 2 ]


The Dead Sea's mineral composition varies with season, rainfall, depth of deposit, and ambient temperature. Most oceanic salt is approximately 85 wt.%  sodium chloride  (the same salt as table salt) while Dead Sea salt is only 30.5 wt.% of this, with the remainder composed of other dried minerals and salts. The concentrations of the major  ions  present in the Dead Sea water are given in the following table: [ 1 ]


The chemical composition of the crystallized Dead Sea salts does not necessarily correspond to the results presented in this table because of composition changes due to the process of  fractional crystallization .


The main detritic minerals present in the Dead Sea mud were carried by runoff streams flowing into the Dead Sea. They constituted large mud deposits intermixed with salt layers during the  Holocene  era. Their elemental composition expressed as equivalent oxides (except for Cl –  and Br – ) is given here below: [ 1 ]


Except for chloride and bromide, the results of the elemental composition of the Dead Sea mud given here above are presented as equivalent oxides for the sake of convenience. [ 3 ]  To illustrate this chemical convention, the neutral  sodium sulfate  (Na 2 SO 4 ) is reported here as basic  sodium oxide  (Na 2 O) and acidic  sulfur trioxide  (SO 3 ), neither of which can naturally occur under these free forms in this mud. However, one will note that the elemental composition given here above is incomplete as a major component is lacking in this table:  carbon dioxide  (CO 2 ) accounting for the significant  carbonate  fraction present in this mud.


Dead Sea salts have been claimed to treat the following conditions:


Rheumatologic conditions  can be treated in the  balneotherapy  of  rheumatoid arthritis ,  psoriatic arthritis , and  osteoarthritis . The minerals are absorbed while soaking, stimulating blood circulation. [ 4 ]


Skin disorders such as  acne  and  psoriasis  may be relieved by regularly soaking the affected area in water with added Dead Sea salt. The  National Psoriasis Foundation  recommends Dead Sea and Dead Sea salts as effective treatments for  psoriasis . [ 5 ] [ 6 ]  High concentration of  magnesium  in Dead Sea salt may be helpful in improving skin hydration and reducing inflammation, [ 7 ]  although  Epsom salt  is a much less expensive salt that also contains high amounts of magnesium and therefore may be equally as useful for this purpose.


The high concentration of  bromide  and  magnesium  in the Dead Sea salt may help relieve  allergic reactions  of the skin by reducing inflammation. [ 7 ]


Dead Sea salt may reduce the depth of skin wrinkling, a form of  skin ageing . [ 7 ]


A  destination spa  or  health resort  is a  resort  centered on a  spa , such as a  mineral spa . Historically, many such spas were developed at the location of natural  hot springs  or  mineral springs . In the era before modern  biochemistry  and  pharmacotherapy , "taking the waters" was often believed to have great medicinal powers. Even without such mystic powers, the  stress relief  and  health education  of spas also often has some degree of positive effect on  health . Destination spas offer  day spa  facilities, but what sets them apart is that they also offer hotel facilities so that people can stay multiple nights.


Typically, over a seven-day stay, they provide a comprehensive program that includes spa services, physical fitness activities, wellness education, healthy cuisine, and special interest programming.


A special subgroup are the medical spas who offer treatments that are paid back by the national health insurance program.


Some destination spas offer an all-inclusive program that includes facilitated fitness classes, healthy cuisine, educational classes and seminars, as well as similar to a  beauty salon  or a  day spa . Guests reside and participate in the program at a destination spa instead of just visiting for a treatment or pure vacation. Some destination spas are in tropical locations or in  spa towns .


Destination spas have been in use for a considerable time, and some are no longer used but are rather  preserved as elements of earlier history; for example,  Gilroy Yamato Hot Springs  in  California  is such a historically used spa whose peak patronage occurred in the late 19th and early 20th century.


Resort spas are generally located in  resorts , and offer similar services via rooms with services, meals, body treatments, and fitness a la carte.


Typical medical services offered at destination spas include:


Medical Spas - provide treatments and revalidation therapies paid back by the national health insurance, have to comply to the ISO 21426:2018 on tourism and related service requirements for medical spas [ 1 ]  and have a medical doctor on site who supervises all the treatments.


In 21 of the 27  EU countries  they are very known and they have often state contracts with the ministry of health to provide a certain minimum yearly capacity of treatment places for patients. Another example are the contracts with for example the national public transport operators to help recuperate lung capacity or change unhealthy lifestyle and food consumption behavior. In the latter case, reimbursement by the public health care is only done after people stayed the minimum prescribed 14 to 18 days, the time necessary to provoke behavioral changes and take the healthier lifestyle choices and practices back home. [ 2 ]


It is common for elderly people to take every year a one-week treatment in medical public spas, which offer treatments for patients with syndrome diseases such as  fibromyalgia ,  multiple sclerosis ,  rheumatism , and  arthritis .


Treatment is also offered in  Ministry of Ayush  hospital revalidation centers, in the Middle Eastern Hammam steam bath facilities, as well as Asian or "Traditional Chinese Hot Spring" centers, and Japanese  shinrin-yoku  centres.


Since the  COVID-19 pandemic , medical spas have received additional attention for the treatment of  post-COVID  patients, especially the subgroup with symptoms indicating destroyed neural cells and neural networks in the brain, to undergo specific ergo-therapies during 2–3 weeks to give their body and brain the time to regrow these neural networks. [ 3 ]


Diprobase  is an  emollient , specifically targeted at  eczema  and  dermatitis . It is an occlusive emollient, meaning that it restores the layer of  oil  on the surface of the  skin  to slow water loss. [ 1 ]  This gives its tendency to make the applied area sticky.


Diprobase contains no 'active ingredients'. It is made from a combination of  liquid paraffin ,  white soft paraffin , and water, as well as  cetomacrogol  and  cetostearyl alcohol  as  emulsifying agents ,  chlorocresol  as an  antimicrobial preservative ,  phosphoric acid ,  sodium dihydrogen phosphate , and  sodium hydroxide .


Dry skin results from lack of water in the outer layer of skin cells (the  stratum corneum ). When this layer becomes  dehydrated , it loses its flexibility and becomes cracked, scaly, and sometimes itchy. The stratum corneum contains natural water-holding substances that retain water seeping up from the deeper layers of the skin, and water is also normally retained in the stratum corneum by a surface film of natural oil ( sebum ) and broken-down skin cells, which slow down  evaporation  of water from the skin surface.  Diprobase works by increasing that layer of oil.


Diprobase is a British brand of the American pharmaceutical company  Schering-Plough . Its trademark stems from the now older range of  corticosteroids  the company still manufactures; Diprosone and Diprosalic. The Dipro being suggestive of  betamethasone dipropionate .  Diprobase was originally conceived from the emollient vehicle these products had, Diprobase is purely an emollient which has no steroid component.


EC Regulation 1223/2009 on cosmetics  sets binding requirements for  cosmetic products  that have been made available on the market within the  European Union . Manufacturers of products that fall under the category or cosmetics are required to abide by this regulation as they prepare their initial release of products and while continuing to sell said products within the Member States of the EU. [ 1 ]


EC Regulation  1223/2009 [ 2 ]  was created by the  European Parliament  and  Council  with the intent of establishing  standards  for  cosmetic products  that are available on the market.  Compliance  to these standards helps protect the functioning of the internet market, but most importantly, it provides a high-level of protection for the safety and health of  EU citizens . [ 1 ]  The Regulation was set into force on July 11, 2013. [ 3 ]


In its quest to protect the  health  and  safety  of EU citizens, EC Regulation 1223/2009 regulates a multitude of aspects related to the  manufacturing  and  labeling  of products that are considered to fall into the category of cosmetics. [ 1 ] [ 4 ]


Before a cosmetic product can be released on the market, proof must be provided that it is safe for human health during the course of its intended use or what is considered to be reasonable foreseeable conditions of its use. Article 3 of EC Regulation 1223/2009 builds upon  Directive  87/357/EEC guidelines regarding the safety of the product in reference to its instructions for use, its disposal and most importantly, its labeling. A safety assessment must be performed and a cosmetic product safety report provided to demonstrate compliance with Article 3. Guidelines for the report are found in the Regulations Annex I.


Under Article 4 of the Regulation, a representative of the manufacturer must be named as the “responsible person” for dealing with compliance with EC 1223/2009. This responsible person is responsible for ensuring that the manufacturer remains in compliance before and after bringing their cosmetic product to market.


In the event the cosmetic product does not meet the requirements of compliance under the Regulation, the responsible person must address those issues. If the manufacturer becomes aware that the cosmetic product presents a threat to human health, the responsible person must notify the competent authorities within each Member State where the product is available. The notification would include details of the risks of using the product, non-compliance issues and what corrective actions will be performed. Corrective actions may include withdrawing the product from the market or initiating product recalls. [ 2 ]


Another responsibility of the responsible person is that they must maintain a product information file for each cosmetic product that is put on the market by his or her company under Article 11 of EC 1223/2009. This file must remain accessible to the relevant competent authority and / or government for at least 10 years after the last batch of the product was placed on the market. The product information file at minimum must contain information and data regarding the description of the cosmetic product, safety reports regarding the product, and evidence that the product performs according to manufacturer claims. Additionally, data about any  product testing on animals  that may have been performed by the manufacturer, agents of the manufacturer or suppliers must be included in the information file. [ 2 ]


Under Article 12 of EC 1223/2009 requires that cosmetic products must be sampled and analyzed in a reliable and reproducible manner. If local Community legislation, as what might be found in a Directive is non-existent, the assumption will be that the manufacturer will rely on methods of harmonized standards that have been published in the  Official Journal of the European Union . [ 1 ]


The appointed responsible person must supply information to the EU Commission according to the guidelines provided under Article 13 of the Regulation before their cosmetic product can be placed on the market. This information includes the name and category of the product, contact information for the responsible person, the product’s country of origin, and Member State(s) where the product where be sold. [ 2 ]


Before placing cosmetic products on the market, the manufacturer must comply with container and packaging labeling guidelines under EC 1223/2009. To comply with the Regulation all required information must be presented in a legible and indelible manner.


Information to be included shall include:


The date itself or details of where it appears on the packaging shall be preceded by the symbol shown in point 3 of Annex VII or the words: ‘best used before the end of’.
The date of minimum durability shall be clearly expressed and shall consist of either the month and year or the day, month and year, in that order.
If necessary, this information shall be supplemented by an indication of the conditions which must be satisfied to guarantee the stated durability.
Indication of the date of minimum durability shall not be mandatory for cosmetic products with a minimum durability of more than 30 months. For such products, there shall be an indication of the period of time after opening for which the product is safe and can be used without any harm to the consumer. This information shall be indicated, except where the concept of durability after opening is not relevant, by the symbol shown in point 2 of Annex VII followed by the period (in months and/or years) (Regulation 1223/2009 EU; Chapter VI, Art 19)


Exceptions are made for individual labeling for smaller items that allow for product information to appear as a notice on or nearby the container where the cosmetic product is displayed for sale.
The function, amount, precautions, and warnings must be translated into the language of the destination country.  A full translation of all label elements is requested by Austria, Bulgaria, France, Poland, Portugal and Slovakia.


On 26 July 2023, the EU Commission published Commission Regulation (EU) 2023/1545, which amends the cosmetic regulation 1223/2009 and added extra ingredients to the list of declarable allergens  [ 5 ]


Certain product ingredients are prohibited under Chapter IV of EC 1223/2009 based on their threat to human health. The Annexes are lists of chemical substances that are either banned or restricted for use in specific product types or to certain limits in the final product.  These are as follows:


Annex II List of substances prohibited in cosmetic products


Annex III List of substances which cosmetics should not contain except subject to the restrictions laid down


Annex IV List of  colorants  allowed in cosmetic products


Annex V List of  preservatives  allowed in cosmetic products


Annex VI List of  UV filter  allowed in cosmetic products


Chapter V addresses the prohibition of  animal testing  with the final formulation of cosmetic products, before being placed on the market and when testing methods are other than the alternative methods that have been validated and adopted by the EU Community. [ 2 ] [ 6 ]


As a regulation, EC No 1233/2009 supersedes previous Directives that applied to cosmetic manufacturers throughout the European Union. As of 30 November 2009, all  Member States  are required to adhere to the guidelines for compliance to this regulation. Regulations carry more legal weight than Directives, which generally provide guidance in good practices that should be followed by individual Member States.


In the event of non-compliance, the relevant competent authority will inform the competent authority of the responsible person’s Member State. When there are grounds for concern or certainty exists that the cosmetic product presents a serious risk to human health, the authority will take steps toward instituting appropriate provisional measures to withdraw, recall or restrict the availability of the non-complying product. [ 2 ]


Egg oil  ( CAS No.  8001–17–0,  INCI : egg oil), also known as  egg yolk  oil or ovum oil, is derived from the  yolk  of  chicken  eggs consisting mainly of  triglycerides  with traces of  lecithin ,  cholesterol ,  biotin ,  xanthophylls   lutein  and  zeaxanthin , and immunoglobulins.  It is free of egg proteins [ 1 ]  and hence may be used safely by people who are allergic to eggs, for topical applications such as hair and skin care. The product has several historical references in  Unani  (Greek) medicine for  hair care .  Traditional Chinese medicine  uses egg oil for burns,  eczema ,  dermatitis ,  mouth ulcers ,  skin ulcers , chapped nipples,  tinea capitis ,  ringworm ,  nasal vestibulitis ,  frostbite , and  hemorrhoids . [ 2 ]


In  alchemy , the oil was traditionally extracted from the yolk by a fairly simple process, [ 3 ] [ failed verification ]  by which fifty eggs yielded approximately five ounces of oil. [ 4 ]  Modern methods of production include  liquid–liquid extraction [ 5 ]  using common solvents such as  hexane , [ 6 ]   petroleum ether ,  chloroform , and  ethanol . Unlike traditional egg oil produced by heat, solvent extracted product also contains  immunoglobulins , [ 7 ]  which are destroyed at higher temperatures. There are only a few commercial producers globally.


The  fatty acid  composition of egg oil is rich in long-chain  polyunsaturated fatty acids  (LCPUFA) such as  omega-3 fatty acids  (including  docosahexaenoic acid ) and  omega-6 fatty acids  (including  arachidonic acid ), and closely resembles the fatty acid profile of  human milk , [ 8 ]  as well as the  lipid profile  of human skin.


Egg yolk has been used in traditional cosmetics since the eleventh century in Jewish, Greek, Arab, and Latin cultures. [ 9 ]  Several popular modern cosmetic brands contain egg oil.


Egg oil is widely used in India for hair care. [ citation needed ]


Egg oil can be used as an excipient/carrier in a variety of cosmetic preparations such as creams, ointments, sun-screen products, or lotions where it acts as an emollient, moisturizer, anti-oxidant, penetration enhancer, occlusive skin conditioner, and anti-bacterial agent. [ 10 ]


For treatment of  scabies  in Spain, oil of egg yolk was used along with oil of castor and roses [ 11 ]  in ancient  Andalusia .


Egg oil was traditionally used in treating  wounds  and injuries. [ 12 ]  In the 16th century,  Ambroise Paré  used a solution of egg yolk, oil of roses, and  turpentine  for war wounds, an old method that the Romans had discovered 1000 years before him. He published his first book  The method of curing wounds caused by  arquebus  and firearms  in 1545.


Egg oil is a potential source of  polyunsaturated fatty acids  such as  docosahexaenoic acid  and  arachidonic acid  for infant nutrition [ 13 ]  or combined with fish oil for infant formula production. [ 14 ]  It is also a source of  vitamin D . [ 15 ] [ unreliable source? ]


Cosmetic electrotherapy  is a range of  beauty treatments  that uses low  electric currents  passed through the  skin  to produce several therapeutic effects [ 2 ] [ unreliable source? ]  such as  muscle toning  in the body [ 3 ] [ unreliable source? ] : 226   and micro-lifting of the face. [ 4 ]  It is based on  electrotherapy , which has been researched and accepted in the field of rehabilitation, [ 5 ]  though the "scientific and medical communities have tended to sideline or dismiss the use of electrotherapy for healthy muscles". [ 6 ]


The use of electricity in cosmetics goes back to the end of the 19th century, [ 7 ] [ 8 ]  almost a hundred years after  Luigi Galvani  discovered that electricity can make the muscle in a frog's leg twitch [ 9 ]  (see  galvanism ). Subsequent research in  electrophysiology  has been carried out by people such as  Robert O. Becker , Dr Björn Nordenström, [ 10 ]  a former chair of the Nobel Selection Committee for Medicine, and Dr Thomas Wing, [ 11 ] [ 12 ]  who invented some of the first micro-current devices.


There are four main types of treatment, that differ in the type of current they use (see  Comparison table, below ), including:


Galvanic treatment in the beauty industry has been described since at least the 1970s [ 15 ]  and earlier. [ 13 ]  Sometimes called  galvanism , the treatment aims to improve the skin in two ways: (1) cleansing: a process called  desincrustation , and (2) nourishing the skin condition, through an electro-chemical process [ 16 ]   called  iontophoresis [ 17 ]   (also called ionisation). [ 18 ]  This is achieved by the application of a small, constant,  direct current . [ 19 ]  The treatment works on the principle that charged  ions  in the  skin  are either attracted or repelled from the  electrodes , resulting in certain chemical effects. [ 20 ]


Galvanic treatment are often used on the face (facial galvanic treatment) and on the body to treat cellulite (galvanic cellulite treatments). [ 22 ]


Faradic treatment has also been described in the beauty industry since the 1970s [ 15 ]  and earlier. [ 13 ]  The treatment tones the muscles by repeatedly contracting them with the electric current, resulting in their firming and toning, and an increase in muscular metabolism aims to remove waste products more readily. [ 23 ]  Faradic treatments are generally used on the face and body, and work by contracting muscles with a short pulse of interrupted direct current. [ 24 ]


The treatment is also called  neuromuscular electrical stimulation  (NMES), [ 25 ]  and some of the manufactures who produce the equipment use their own terms, for example,  Slendertone  calls it electronic muscle stimulation, [ 26 ]  or the treatment is called after the name of the manufacturer, such as Ultratone or Slim Master. [ 3 ] : 264


Microcurrent treatments ( MENS ) have been around since the 1970s in medical applications and are distinguished by their use of  micro-ampere  currents (i.e. millionths of an amp) which are hardly perceptible, but mimic the body's own  bio-electric currents . [ 3 ] : 272   The treatment is designed to soften wrinkles and rejuvenate skin, including skin damaged by  sunburn ,  acne ,  stretch marks ,  cellulite  and  scarring . [ 12 ]


This increased ATP also energizes the facial muscles, similar to how exercise energizes the muscles of our bodies. Unlike anywhere else on the body, the facial muscles are directly connected to the skin, so the result of energizing the muscle is often an improved, lifted appearance. [ 27 ]  When used on the face, the treatment has become known as a "non-surgical facelift" [ 28 ]  and "facial lifting". [ 3 ] : 273


Microcurrent treatment works by passing a very small direct current through muscle tissue to stimulate the  Golgi tendon organ . [ 29 ]  It encourages production of ATP (Adenosine triphosphate) which leads to the creation and stimulation of structural proteins like elastin and collagen.


Different microcurrent characteristics, particular the frequency and shape of the changing voltage (waveform), have different effects on the tissue. [ 3 ] : 273  [ unreliable source? ]


Microcurrent devices have been in the beauty industry for over a decade, the most known being the CACI device. Modern professional and personal use microcurrent devices combine waves of multiple shape and vary in frequencies used.


Since microcurrent treatment uses a low-grade electrical current, there has been health concerns over safety of its use. People with pacemakers or any kind of heart condition should avoid it. Moreover, pregnant women are advised against it as well. It is always recommended to individually consult with doctor or aesthetician before using microcurrent. [ 30 ]


High-frequency treatment uses low-current  high-frequency alternating currents , delivered via a glass electrode. [ 31 ]  Glass electrodes are often filled with either Neon gas which produces pink, orange, or red light or they are filled with  Argon  or rarefied gas which produces violet light. Because of the color of light that is produced when electricity is passed through the gas, they are inaccurately called  ultraviolet  or  infra-red , however no UV rays or infra-red rays are produced, just visible light.  High frequency does current convert some of the  oxygen  in the  air  surrounding the electrodes into  ozone , the treatment has a  germicidal  action, and is also drying and warming. [ 32 ]  Consequently, the treatment is used to aid healing and also to help  desquamation  (the skin's natural exfoliation) and stimulate  sweat  and  sebaceous glands . [ 31 ]   Sparking  may occur when the electrode is close to the skin and then pulled away repeatedly. Some electrodes may contain a metal coil that produces a mechanical vibration, as well as sparking energy that can be felt indirectly when held in one person's hand while another person uses their hands directly on the skin. Because the effect may be pleasurable, similar devices are used in  erotic electrostimulation .


The characteristics of the treatment current include: (a) whether it is ( direct  or  alternating ), (b) current frequency,  (c) size of the current (all very small), and (d) the duration and shape of any pulses.


The origins of the terms "galvanic" and "Faradism" are described in the medical journal,  The Lancet , in 1851. A note reads:


It is noted that:


In  cosmetology ,  exfoliation  is the removal of the surface skin cells and built-up dirt from the skin's surface. The term comes from the  Latin  word  exfoliare  ('to strip off leaves'). [ 1 ]  This is a regular practice within the cosmetic industry, both for its outcome of promoting skin regeneration as well as providing a deep cleanse of the skin barrier. Being used in  facials , this process can be achieved by mechanical or chemical means, such as  microdermabrasion  or  chemical peels . [ 2 ]  Exfoliants are advertised as treatments that enhance beauty and promote a youthful and healthy appearance. [ 3 ]


Exfoliation was first practiced among the ancient Egyptians. [ 4 ] [ 5 ]  This was also used in  Asia , specifically in  China , during the  Qing Dynasty  (1644–1944).


Mechanical exfoliation methods involve physically scrubbing the skin with an  abrasive  material. [ 6 ]  These types of exfoliants include  microfiber  cloths, adhesive exfoliation sheets,  microbead  facial scrubs, crêpe paper, crushed  apricot kernel  or  almond  shells,  sugar  or  salt crystals ,  pumice , and abrasive materials such as  sponges ,  loofahs ,  brushes , and fingernails. [ 3 ] [ 7 ]  A variety of facial scrubs are available in  over-the-counter products  for application by the user. People with  dry skin  should avoid exfoliants which have a significant portion of  pumice , or crushed volcanic rock. Pumice is known as a material to exfoliate the skin of the feet. [ 8 ]


Loofahs are shower accessories that are commonly used for a dual purpose of cleaning and exfoliating the skin. Loofahs are named for the tropical and subtropical gourd within the cucumber family called  luffa  that is used as material to make the shower sponges. As the  luffa plant  matures, its fibers dry out, allowing the shell left over to be used as the spongy material for the exfoliation tool after their seeds are removed and the gourd is sliced and shaped. [ 9 ]


Loofahs offer benefits beyond exfoliation: they effectively spread soap around the body to cleanse and they stimulate blood circulation during use. Because loofahs are porous, they are more susceptible to harboring bacteria and fungal organisms that could be harmful and cause infections. [ 10 ]  Proper care for the loofah includes rinsing and drying the loofah after each use and soaking the loofah in a diluted solution of bleach to clean it weekly. [ 10 ]  It is also recommended to replace a loofah every 3 to 4 weeks. [ 10 ]


Exfoliation nets are shower accessories used for exfoliation and lathering that are composed of nylon material in the form of knotted mesh nets. [ 11 ]  Exfoliation nets are native to Ghana, but they are a familiar shower accessory in numerous countries in West Africa. [ 11 ]  The shape and material allow exfoliation nets to dry quicker than typical sponges, so there is less accumulation of bacteria in the accessory. [ 12 ]


Proper care for exfoliation nets includes leaving the net to hang dry between uses and cleaning it using a washing machine or hand-wash method weekly. [ 11 ] [ 12 ]


Microbead scrubs are cosmetic products that contain small plastic spheres that act as exfoliating components when scrubbed against skin. [ 13 ]  The plastic beads act as alternatives for natural, eco-friendly exfoliating agents such as  pumice ,  oatmeal , and walnut husks. [ 13 ]  Microbeads are commonly composed of the material  polyethylene terephthalate , but can also be made with other plastic materials. [ 13 ]


When scrubbed against the skin, the beads polish the skin by removing the dead skin cells from the top layer of the skin. [ 14 ]  The steps involved to use a micro-bead scrub include softening the skin using lukewarm water, gently scrubbing the product against the skin in circular motions, and rinsing the product off the skin. [ 14 ]


Due to the significant environmental impact and harm caused to marine ecosystems, microplastic beads have been banned by many countries. [ 15 ]


Pumice, an  igneous rock  that is composed of solidified lava that rapidly cools with gas bubbles being trapped inside of it, is commonly used as an exfoliating material. [ 16 ]  Pumice is a decently abrasive material, making it useful as an exfoliating agent. [ 16 ]


Pumice stone can be effectively used as an exfoliation tool on calluses or corns, often found on feet, to remove the dead skin cells. [ 8 ]


To effectively use a pumice stone as an exfoliation tool, soaking the affected area in warm water until the skin begins to soften is a recommended first step. [ 8 ]  The pumice stone then must be wet before rubbing against the affected area with moderate pressure for about 2 to 3 minutes. [ 8 ]


The exfoliating process of dermaplaning requires a single blade razor resembling a scalpel called a  dermatome . [ 17 ]  The dermatome is gently dragged across the skin on the face to remove the top layer of dead skin cells and peach fuzz. [ 18 ]  This process helps the skin to absorb products better and boost the production of  collagen , which improves the texture and tightness of the skin. [ 18 ]


A common misconception is that the  vellus hair  (known as peach fuzz) that is removed via dermaplaning will grow back thicker and darker, giving the appearance of a beard. This has been denied by dermaplaning specialists, who state that the removal of the dead skin and peach fuzz does not impact growth, color, or texture of facial hair. [ 18 ]


The procedure is recommended to be performed by an  aesthetician . [ 17 ]  In most cases, the blade must be used on clean, dry skin and covers the forehead, cheeks, chin, nose, and neck. However, dermaplaning can also be performed on skin that has oil applied to it. [ 19 ]


Some methods of  hair removal  also mechanically exfoliate the skin.


Waxing  functions as an exfoliant, plucking the hair out of the skin. While it can be performed every two to eight weeks, waxing is not carried out as frequently as many exfoliants. Thus, it does not fully substitute for an exfoliation regimen.


Wet shaving  also has exfoliating properties. Gliding a shaving brush vigorously across the face removes dead skin cells and cleanses the skin simultaneously. After applying the lather with a brush, the use of a razor removes dead skin because the razor is dragged closely across the skin. Manual razors exfoliate more effectively than electric razors.


Methods of chemical exfoliation for aesthetic enhancement of the skin have dated back to the time of the Ancient Egyptians, who used a combination of animal oils, alabaster, salt, and sour milk as an exfoliant to improve skin quality. [ 20 ]  Various other chemical exfoliation techniques were developed in multiple other civilizations, such as Greek, Roman, Turkish, Indian, and Hungarian peoples. [ 20 ]


Chemical exfoliation to lessen the appearance of freckles with phenol peeling was a method developed by  Tilbury Fox  in 1871, and from there the use of phenol peeling increased in popularity. [ 20 ]


Chemical exfoliation methods, also known as chemical peeling, utilizes chemical substances in order to remove dead skin cells from the face. These types of exfoliants contain  alpha-hydroxy acids  ( glycolic acid ,  lactic acid ,  mandelic acid ,  malic acid ,  tartaric acid , and  citric acid ),  beta hydroxy acids  ( salicylic acid ), polyhydroxy acids ( lactobionic acid ,  gluconolactone , and  galactose ) or enzymes ( trypsin  or  collagenase ). [ 21 ] [ 22 ] [ 23 ] [ 24 ]  These chemicals weaken cell adhesion, allowing them to ease away. Out of these, only alpha-hydroxyl acids (AHAs) and beta hydroxyl acids (BHAs) are available on the market for daily use. While AHAs are applied to clear the outer layer of the skin, BHAs penetrate and clean it from within. These scrubs may be applied in high concentrations by medical professionals, or provided in lower concentrations via over-the-counter products. This type of exfoliation is recommended for people treating  acne . In Continental European beauty spa treatments, wine-producing grapes are considered to have exfoliating properties and are used in the practice of  vinotherapy .


Though primarily intended for  hair removal ,  chemical depilatory , such as  Nair  and shaving powder, also function as a chemical exfoliant. Such products contain  calcium hydroxide  and/or  thioglycolic acid . They are applied more frequently than waxing (once a week) since they only partially destroy the hair below the skin, rather than pulling up the entire root as waxing does. Using them weekly can substitute for a weekly exfoliant regime. [ citation needed ]


Technological advances in the cosmetics industry have led to innovative exfoliation techniques, such as laser resurfacing.


Most commonly used for facial rejuvenation, this exfoliation process utilizes a laser to treat flaws on the skin surface. This method of exfoliation is most effective for treating wrinkles and discoloration.  Carbon dioxide lasers , erbium lasers, and combinations of these are examples of the types of  ablative lasers  that are used in the resurfacing process. [ 25 ]


The top outer layer of the skin is removed by the laser, which simultaneously heats the layer of skin lying beneath it. This process encourages collagen growth, which will improve the texture and tightness of the skin. The top layer of the skin will continue to heal and grow back to reveal a smoother and tighter appearance. [ 25 ]


Fractional  versions of ablative lasers have also recently been developed. These are designed to leave minimal amounts of untreated tissue on the skin to provide quicker healing time and less side effects. [ 25 ]


Ablative laser resurfacing has multiple risks associated with the exfoliation process. These risks include: redness, swelling, itching, pain, acne, infection, skin discoloration, and scarring. [ 25 ]


To have ablative laser resurfacing performed, one must consult with a doctor to review suitability of the procedure. [ 25 ]


Dermabrasion  is used to reduce the appearance of flaws on facial skin, such as facial lines, wrinkles, scars, and discoloration. In this exfoliation process, a rapidly rotating device is used to remove the outermost layer of facial skin. [ 26 ]


Dermabrasion requires  anesthetics  to numb the skin before the procedure. Depending on the extent of the treatment, further numbing medication might be provided to limit the amount of pain felt from the treatment. [ 26 ]


There are multiple risks associating with dermabrasion. These risks include: redness, swelling, acne, enlarged pores, skin discoloration, infection, scarring, or rashes. In most cases, skin that is treated with dermabrasion will be sensitive with splotches of redness and discoloration for weeks following the procedure. [ 26 ]


According to dermatologists, chemical or manual exfoliation is not medically necessary, as dead skin cells already exfoliate naturally, [ 27 ]  and excessive artificial exfoliation can break the skin's barrier against  microorganisms  and lead to infection, [ 27 ]  as well as tightness and sensitivity in the skin. [ 27 ]  Artificial exfoliation can exacerbate dry, flaky skin, which needs moisturization for repair, [ 27 ]  and can result in some initial redness to the skin. Near the end of chemical peels, the skin frosts, with colors varying from a bright white to grey on the skin surface. [ 5 ]


Microbead  particles used in mechanical exfoliation are too small (less than 1 mm) to be caught by  sewage works , so large amounts of microbeads are released into the environment, which damage marine  ecosystems . [ 28 ]  Consequently, in June 2014,  Illinois  became the first American state to ban the use of microbeads, and cosmetics manufacturers such as  L'Oreal ,  Johnson & Johnson , and  Colgate  agreed to use more natural ingredients. [ 28 ]


Face powder  is a  cosmetic product  applied to the face to serve different functions, typically to beautify the face. Originating from  ancient Egypt , [ citation needed ]  face powder has had different social uses across cultures and in modern times, it is typically used to set makeup, brighten the skin and contour the face. Face powders generally come in two main types. One of which is loose powder, which is used to assist with oily skin in absorbing excess moisture and mattifying the face to reduce shininess. The other is pressed powder which conceals blemishes and maximises coverage. [ 1 ]


The use of face powder has contributed to beauty standards throughout history. In  ancient Europe  and  Asia , a whitened face with a smooth complexion signalled a woman of high status. [ 2 ]  The prevalence of this trend was carried throughout the  Crusades  and  Medieval era.  During this time, women used harmful ingredients as face powder including  bleaches , lead and  lye . [ 3 ]


Archaeological remains and chemical analyses indicate the use of face powder dating back from between 2000 and 1200 BC, and include lead fibres, a common cosmetic ingredient used in ancient Egypt. [ 4 ]   Kohl  jars used to store  eyeliner  as well as stone containers holding face powder were discovered in graves as this promised the ancient Egyptians eternal beauty in the afterlife. [ 4 ]  Men and women used an early form of  rouge  powdered blush for their cheeks which was made from red ochre. [ 5 ]  Greek queen  Cleopatra  heavily influenced the  ancient Egyptian  beauty standard with a distinctive make-up style, inspiring the ancient Egyptians to paint their eyes with green and blue powders. [ 6 ]  Face powder was also considered to have medicinal purposes to protect people from illness. [ 4 ]


Ancient Egyptian beauty trends travelled across the Mediterranean and influenced cosmetic practices in Greece. Using similar ingredients,  ancient Greeks  used  cinnabar  as a powdered  rouge  for the face as well as brightening their  complexion  with  white lead . [ 5 ]  While the desire for a white complexion represented social ideas about race superiority, skin tone also enforced gender as in ancient times, women were paler than men, due to having less haemoglobin. [ 5 ]  A sign of belonging to the upper class was white, unblemished skin free from sun-exposure, as it was the life of wealthy women that involved staying indoors. Traces of the skin-lightening face powder made from white lead have been uncovered from the graves of wealthy ancient Greek women. [ 7 ]  The city of  Athens  was nearby the  Laurion mines , from which the Greeks extracted vast amounts of silver and obtained a great deal of their wealth through trade. White lead was found in the mines as a by-product of the silver, [ 8 ]  from which ancient Greeks produced face powder. The use of face powder also appears in the work of ancient Greek writers. Writer and historian  Xenophon  writes of women who "rubbed in white lead to the face to appear whiter". [ 9 ]  In his book  Oeconominicus , Ancient Greek poet  Eubulus  in his play  Stephanopolides  compares lower class and upper-class women, declaring that poor women "are not plastered over with white lead". [ 10 ]  While it was known the white lead was poisonous, the ancient Greeks were not deterred from applying the face powder to fulfil their beauty standards. [ 11 ]


The ancient Roman use of face powder was centred around the Roman ideal of  femininity  and beauty standards, expressing signs of social and health status. [ 12 ]  The pale complexion was desired by Roman women and is frequently expressed in the poetry of ancient Roman poet  Ovid . [ 2 ]  Small glass jars and  brushes  from archaeological remains suggest the storage and use of face powder. [ 13 ]  Ancient Roman poets  Juvenal  and  Martial  mention a mistress named "Chione" in their works, which literally translates to "snowy" or "cold", [ 12 ]  referring to the desired fair complexion of ancient Roman women. Skin whitening as well as sun-blocking were practiced by applying face powder in the form of  cerussa , which was a mix of white lead shavings and vinegar. [ 12 ]  Roman women wished to conceal blemishes and freckles, as well as smoothing the skin using this powder.  Chalk  was also used to whiten the skin, as well as powdered ash and saffron on the eyes. [ 13 ]


Ancient Chinese women desired whitened skin for beauty as their use of face powder dates back to the  Spring and Autumn period  from 770 to 476 BC. [ 14 ]  An early form of face powder was prepared by grinding fine rice which was applied to the face. [ 15 ]  In addition,  pearls  were crushed to create  pearl powder  that improved facial appearance and was also used as a medicine to treat eye diseases,  acne  and  tuberculosis . [ citation needed ]  Chinese empress  Wu Zetian  used pearl powder to maintain radiant skin. [ 16 ]  Lead was also a common ingredient used for face powder and remained popular for its skin-whitening properties. [ 15 ]


At a time of prevalent disease, beauty in the  Middle Ages  was characterised by having clear, bright skin that signalled fertility and good health. [ 17 ]  Lead based powders were continually used throughout the 16th century by the noble class as  Queen Elizabeth I  was known to use face powder to conceal her smallpox scars. [ 6 ]  The leading cause of her death was blood poisoning, primarily due to her cosmetic practices of using makeup containing toxic materials, including the lead-based face powder. [ 18 ]  During the  Victorian era , noticeable make-up became less popular as women desired to look naturally beautiful and hence, powders derived from  zinc oxides  were used to maintain ivory coloured skin. [ 19 ]  With the outbreak of  smallpox  in 1760, fewer women used face powder due to how it aggravated the skin and revealed facial scarring. [ 19 ]  Works of art from the  Renaissance  reinforced the idealised image of beauty and influenced the use of face powder. The social uses of face powder to maintain whitened, unblemished skin is visible in Renaissance art pieces including  The Birth of Venus  by  Sandro Botticelli . [ 20 ]   Shakespeare's  works comment on femininity and the culture of cosmetic use at the time, specifically with his references to silver, indicative of the desired glistening complexion achieved with the use of pearl face powder. [ 21 ]


During the  Edwardian era , makeup for women was used to enhance natural beauty and many young women applied light face powder on a daily basis. [ citation needed ]  Influenced by traditional beauty standards, women preferred pale, whitened and powdered skin throughout the early 1900s. However, in the 1920s,  Hollywood  became the main inspiration for beauty in America and powdering the face shifted from an  upper-class  practice to that of the social-class as the powdered face look became associated with prostitutes and movie stars. [ 22 ]  Due to growing popularity, the end of the decade saw a rise of cosmetic brands with over 1300 brands of face powder, which eventuated in a 52-million-dollar industry. [ citation needed ]  Early makeup developers including  Elizabeth Arden  and  Helena Rubinstein  produced skin care products and powders that attracted an international market. [ 23 ]  Cosmetics for women of colour during this time were also in production, with the first face powder for African-American women created by  Anthony Overton  in 1898, called the High-Brown Face Powder. [ 24 ]  Overton made multiple darker tones of face powder with product names including "nut-brown", "olive-tone", "brunette" and "soft-pink", [ 25 ]  and by 1920, his sales earned him a Dun and Bradstreet Credit rating of one million dollars. [ 26 ]  Other  African-American  entrepreneurs also marketed cosmetics despite discrimination during the  Jim Crow era , including  Annie Turnbo Malone  who sold face powder in darker shades which developed into a multi-million dollar business. [ 27 ]  Businesswoman  Madam C. J. Walker   retailed face powders  for African American women in  drugstores  despite the controversy caused as skin bleaching for fairer skin was a popular beauty trend at the time. [ 28 ]  Hungarian-American businessman Morton Neumann established his own cosmetic company in 1926,  Valmor Products Co. , and marketed darker-toned face powders for  black women  which retailed for 60 cents each. [ 25 ]