Can Pregnancy Make You Sensitive To Makeup
Int J Environ Res Public Health. 2016 Apr; 13(four): 383.
Changes in Cosmetics Use during Pregnancy and Risk Perception by Women
Sophie Cabut
2Department of Public Health and Environment, Kinesthesia of Pharmacy, University of Auvergne, 28 Place Henri-Dunant BP 38, Clermont-Ferrand 63001, French republic; ten.etsopal@tubac.eihpos
Françoise Vendittelli
oneEA 4681, PEPRADE (Périnatalité, Grossesse, Environnement, PRAtiques médicales et Developement), Academy of Auvergne, 28 Place Henri-Dunant BP 38, Clermont-Ferrand 63001, French republic; rf.dnarreftnomrelc-uhc@illettidnevf (F.Five.); rf.liamadu@tahcor-tnavuas.erreip-yard (G.-P.S.-R.)
threeDepartment of Obstetrics and Gynecology, Clermont-Ferrand University Hospital Heart, 58 Rue Montalembert, Clermont-Ferrand Cedex 1 63003, French republic
ivAUDIPOG (Association des Utilisateurs de Dossiers informatisés en Pédiatrie, Obstétrique et Gynécologie), RTH Laennec Medical University, 7 Rue Guillaume Paradin, Lyon Cedex 08 69372, French republic
Marie-Pierre Sauvant-Rochat
1EA 4681, PEPRADE (Périnatalité, Grossesse, Environnement, PRAtiques médicales et Developement), University of Auvergne, 28 Identify Henri-Dunant BP 38, Clermont-Ferrand 63001, French republic; rf.dnarreftnomrelc-uhc@illettidnevf (F.Five.); rf.liamadu@tahcor-tnavuas.erreip-m (Grand.-P.Due south.-R.)
2Department of Public Health and Surroundings, Kinesthesia of Pharmacy, University of Auvergne, 28 Place Henri-Dunant BP 38, Clermont-Ferrand 63001, France; 10.etsopal@tubac.eihpos
Paul B. Tchounwou, Academic Editor
Received 2016 Feb 19; Accepted 2016 Mar 23.
Abstract
Cosmetic products incorporate various chemical substances that may be potential carcinogen and endocrine disruptors. Women's changes in cosmetics use during pregnancy and their adventure perception of these products accept not been extensively investigated. The main objective of this study was to depict the proportion of pregnant women irresolute cosmetics use and the proportion of not-pregnant women intending to do so if they became significant. The secondary objectives were to compare, among the pregnant women, the proportions of those using cosmetics before and during pregnancy, and to draw among meaning and non-significant women, the risk perception of these products. A cross-sectional study was carried out in a gynaecology dispensary and four community pharmacies. Ane hundred and twenty-eight women (lx non-pregnant and 68 pregnant women) replied to a self-administered questionnaire. Cosmetics use was identified for 28 products. The results showed that few women intended to modify or had changed cosmetics use during pregnancy. Nail polish was used past fewer significant women compared to the catamenia before pregnancy (p < 0.05). 50-five percent of the women considered cosmetics use every bit a run a risk during pregnancy and 65% would take appreciated advice about these products. Our findings bespeak that all perinatal health professionals should be ready to suggest women about the benefits and risks of using cosmetics during pregnancy.
Keywords: cosmetics, personal care products, pregnancy, adventure perception, health educational activity, endocrine disruptors
i. Introduction
The Eu Cosmetics Directive defines a cosmetic product or personal care product (PCP) as "any substance or mixture intended to be placed in contact with the external parts of the homo body (epidermis, hair organisation, nails, lips and external genital organs) or with the teeth and the mucous membranes of the rima oris with a view exclusively or mainly to cleaning them, perfuming them, changing their advent, protecting them, keeping them in skillful condition or correcting trunk odors" [1]. Cosmetic products are widely used in daily life. They comprise various chemical substances such as phthalates and other plasticizers, bisphenol A, parabens, benzophenones (ultraviolet filters), polycyclic musks, triclosan (antimicrobials), dioxane, organic solvents, pigments, formaldehyde, and heavy metals that serve as active ingredients, solvents, preservatives and additives to better their efficacy and increase the duration of their effect [2,3,4,5]. Some of these chemicals have a articulate benefit. For example, ultraviolet filters protect human pare from direct exposure to deleterious ultraviolet radiation.
However, these molecules can enter humans via different routes of exposure. Most cosmetic products are directly practical on the skin and their ingredients tin cantankerous the cutaneous barrier to reach the systemic circulation. Exposure can also occur by contact with the mucous membranes, by ingestion (every bit with lipstick, for example) and by inhalation (for cosmetics in the form of aerosols, or during application of a varnish) [vi,7]. Numerous authors have shown that the apply of cosmetics is associated with increased levels of exposure to phenols including benzophenone-three [eight,9], parabens [8,10,eleven,12,thirteen] and triclosan [xiii], and plasticizers, peculiarly diethyl phthalate (DEP) [8,x,11,14,15,xvi,17] and triphenyl phosphate (TPHP) [18] in humans.
To our knowledge, in that location is no current evidence that these furnishings are directly linked to the use of cosmetics [three]. Nonetheless, the endocrine confusing effects of some of these molecules have been shown in numerous experimental models [19,20,21,22,23,24,25,26,27] and in human being studies [28,29,thirty,31,32,33].
Pregnant women are particularly vulnerable to the potential risks of the endocrine disruptors independent in cosmetics. First, cosmetics employ is far more than mutual among women than men [34,35]. 2nd, pregnancy is a vulnerable time for the development of the embryo and fetus because of their young metabolism. Finally, exposure to endocrine disruptors tin be changed during this period by changes in life habits such as a different diet and utilise of cosmetics. Some studies accept been conducted in the USA and in Canada on the use of cosmetics during pregnancy [11,sixteen,17,36,37] but none, yet, dealt with changes in habits such as stopping, decreasing or increasing the use of a production because of pregnancy. Nor has at that place been any assessment of women'south risk perception of cosmetics use during pregnancy. Barrett et al. (2014) showed that meaning women who believe that ecology chemicals are dangerous had healthy behaviors, especially food behaviors, and chose "eco-friendly" PCPs [38]. Still, their study assessed the perception of chemical products "in general" (including products in food, for instance) and not specifically those contained in PCPs.
To our knowledge, at that place exist no reports on what communication, if any, is given by health professionals to women virtually cosmetic use during pregnancy. Changes in apply habits of cosmetic products during pregnancy, risk perception of these products, and support and advice from perinatal health professionals (obstetricians, midwives, general practitioners, community pharmacists) are essential to whatsoever prevention and awareness strategy aimed at limiting the exposure of meaning women to endocrine disruptors. In France, corrective products are oft sold in community pharmacies, and pharmacists can therefore play an important role in advising and informing meaning women.
The primary objective of this report was to describe the proportion of pregnant women who changed their utilize of corrective products, and the proportion of non-meaning women who would expect to do so if they became pregnant. The secondary objectives were to compare, among the pregnant women, the proportions of those using cosmetics earlier and during their pregnancy, and to depict, amid pregnant and non-pregnant women, the criteria for deciding to employ cosmetics before and during pregnancy, the risk perception of the use of these products, and the provision of communication past health professionals.
2. Subjects and Method
two.1. Subjects
The report population was fabricated up of pregnant women and young women of childbearing age. The report was conducted in 4 community pharmacies and a private gynaecology clinic located in two adjacent French departments (Loire and Haute-Loire). To be eligible for inclusion, the women had to be aged between 18 and 45 years (≥18 years and <45 years), take a good command of French and give informed consent to take part. Ane hundred and twenty-eight women were included (60 non-significant women (NPW) and 68 pregnant women (PW)).
In accordance with French human inquiry law, this study was exempt from Institutional Review approval because our database included no nominative data and the survey was not an interventional research study.
ii.2. Method
A cantankerous-sectional study was performed betwixt 31 March 2015 and 1 July 2015. The women were informed of the aim of the survey and what it would entail (completion of an anonymous self-administered questionnaire) by a health professional taking function in the report, either a community chemist or a gynaecologist.
Information were nerveless by a standardized, anonymous, cocky-administered questionnaire. They comprised the socio-demographic and obstetrical characteristics of the women enrolled, their apply of cosmetics outside of pregnancy (products used and criteria of choice), changes in utilize following pregnancy (Pw subgroup) or intended changes in the event of pregnancy (NPW subgroup), risk perception of the use of cosmetic products, and previous advice almost these products given by a health professional person. The suggested criteria of choice were: price, ingredients, olfactory property, appearance, recommendation of a professional or friend, habit, and preference for a range or brand. Utilize habits were established for 28 cosmetics: ix PCPs for general hygiene (shower gel, solid soap, dermatological soap, intimate hygiene product, body scrub, trunk lotion or cream, deodorant (spray or non-spray), perfume and bronzers), five PCPs for face hygiene (facial cleanser, day face cream, night face cream, facial scrub and facial mask), 3 PCPs for hair hygiene (shampoo, hair mask and hair dye (professional person and home hair dye without stardom)) and eleven make-up products (foundation, blush, mascara, eye-liner, eye pencil, eye shadow, lipstick, lip pencil, make-up remover, nail polish and nail polish remover). The use of cosmetics outside of pregnancy was assessed on the basis of the women's full general apply habits (and not use during the 24 or 48 h before they completed the questionnaire) in gild to characterize cosmetics such as nail shine and hair dye that are not necessarily used daily. For instance, use of shower gel was assessed by the following question "Exterior of pregnancy, exercise you regularly utilise shower gel?" (Yes/No). The aforementioned question was asked for the other 27 PCPs. For each product, women who spontaneously responded "Yes" were considered every bit using the product regularly, irrespective of the frequency of utilize. The changes in use during pregnancy (Prisoner of war subgroup) or intended changes in the event of pregnancy (NPW subgroup) were assessed by the post-obit question: "Since the beginning of pregnancy (or in the event of pregnancy), have you changed (or volition you modify) the use of…?" (Yes/No). This question was asked for the 28 PCPs. The questionnaire addressed to the PW group as well concerned changes in cosmetics use during pregnancy, such as giving up the apply of a product, decreasing the use, replacing a product by something considered less harmful, increasing use of a product and using a new one.
In the subgroup of PW, the proportions of women having used cosmetics before their pregnancy and the proportions of those using cosmetics during pregnancy were compared.
2.three. Statistical Assay
The qualitative variables were compared in the Prisoner of war and NPW subgroups with Pearson'south Chi-square or Fisher'southward exact test, every bit advisable. The quantitative variables were compared with Student'southward t-examination or a Isle of mann–Whitney test, every bit advisable.
A cross-over analysis using McNemar's Chi-squared examination (with continuity correction if appropriate) was performed in the PW subgroup to compare the proportions of cosmetics users before and after pregnancy.
Significance was divers as p < 0.05. Statistical analyses were performed with R statistical software, version ii.fifteen.2 (R Evolution Core Team, Vienna, Austria, 2012).
3. Results
iii.1. Women's Characteristics
The mean age of the women in our sample was 30.5 ± 5.eight years and more than than one-half of them had (51.two%) already had one pregnancy (Table one). In both subgroups (NPW and Pw), most women had attended university (74.8%) and were mainly working in the intermediate professions (35.9%) or as salaried employees (31.3%). Compared with the NPW, Prisoner of war were more than probable to live in a boondocks of fewer than 5000 inhabitants (p < 0.01) and less likely to have received chronic handling earlier pregnancy (p = 0.05) (Table one). In the Pw subgroup (northward = 68), the mean gestational historic period of the pregnancy was 26.three ± eight.ii weeks: ten.three% of the women were in the first trimester of pregnancy, 44.one% in the second and 45.vi% in the 3rd.
Table 1
Socio-demographic and obstetric characteristics of women (n = 128).
| Personal Information | Full Due north = 128 (%) (k ± SD) a | NPW Group Due north = 60 (%) (yard ± SD) a | PW Grouping N = 68 (%) (m ± SD) a | p-Value |
|---|---|---|---|---|
| Age | due north = 127 | due north = lx | northward = 67 | - |
| in years | 30.5 ± 5.8 | 30.7 ± seven.4 | thirty.2 ± three.9 | 0.67 |
| Boondocks of residence | n = 124 | n = 57 | due north = 67 | - |
| ≤5000 inhabitants | 82 (66.i) | 30 (52.half-dozen) | 52 (77.6) | <0.01 |
| >5000 inhabitants | 42 (33.9) | 27 (47.four) | 15 (22.iv) | - |
| Educational level | n = 127 | n = 59 | n = 68 | - |
| Inferior school | viii (vi.iii) | five (eight.5) | 3 (iv.4) | 0.lxx |
| High school | 24 (18.ix) | 11 (18.half-dozen) | 13 (19.1) | - |
| University level | 95 (74.8) | 43 (72.9) | 52 (76.5) | - |
| Socioprofessional category b | north = 128 | n = 60 | n = 68 | - |
| Executive and intellectual professions | 28 (21.ix) | 13 (21.7) | 15 (22.1) | 1.00 |
| Intermediate professions c | 46 (35.9) | 21 (35.0) | 25 (36.viii) | - |
| Employees | 40 (31.3) | xix (31.7) | 21 (xxx.ix) | - |
| Others d | 4 (3.1) | ii (iii.3) | 2 (ii.nine) | - |
| No occupation | 10 (7.8) | 5 (8.3) | five (7.4) | - |
| Previous pregnancy | northward = 127 | n = 60 | due north = 67 | - |
| ≥1 | 65 (51.2) | 32 (53.3) | 33 (49.3) | 0.78 |
| Chronic handling e | northward = 128 | n = 60 | n = 68 | - |
| Exterior of pregnancy | xix (14.eight) | xiii (21.7) | 6 (8.8) | 0.05 |
iii.ii. Proportion of Women Using Cosmetics Exterior of Pregnancy
The proportions of women using cosmetics exterior of pregnancy are given in Table two for PCPs and in Table 3 for make-up products. The proportions varied widely according to the type of cosmetic product. The use of dermatological lather was significantly greater amid NPW (25.9%) than among PW (x.3%) (p = 0.03). The use of other cosmetics earlier pregnancy did non differ betwixt the two subgroups.
Table 2
Proportion of women reporting regular apply of personal care products outside of pregnancy (n = 128).
| Personal Care Product | Full north = 128 (%) | NPW Grouping n = 60 (%) | Prisoner of war Grouping n = 68 (%) | p-Value |
|---|---|---|---|---|
| Full general hygiene | ||||
| Shower gel | 120 (93.vii) | 54 (xc.0) | 66 (97.1) | 0.fifteen |
| Solid soap | 45 (32.5) | 24 (xl.0) | 21 (xxx.9) | 0.37 |
| Dermatological soap a | 22 (17.5) | 15 (25.nine) | 7 (10.3) | 0.03 |
| Intimate hygiene production a | 58 (46.0) | 27 (45.8) | 31 (46.3) | 1 |
| Body scrub | 51 (39.viii) | 25 (41.7) | 26 (38.2) | 0.83 |
| Body lotion | 92 (71.nine) | 46 (76.7) | 47 (69.ane) | 0.45 |
| Deodorant b | 117 (92.1) | 55 (91.seven) | 62 (92.v) | 1 |
| Perfume b | 116 (91.3) | 56 (93.3) | 61 (91.0) | 0.75 |
| Bronzers | 1 (0.8) | 0 | i (1.5) | |
| Face up hygiene | ||||
| Facial cleanser a | 77 (60.6) | 39 (66.1) | 38 (55.9) | 0.32 |
| Day face cream | 105 (82.0) | 52 (86.7) | 53 (77.ix) | 0.25 |
| Night face foam | 24 (eighteen.7) | 12 (twenty.0) | 12 (17.7) | 0.91 |
| Facial scrub | 56 (43.seven) | 30 (50.0) | 26 (38.2) | 0.25 |
| Facial mask | 45 (35.2) | 21 (35.0) | 24 (35.3) | 1 |
| Hair hygiene | ||||
| Shampoo | 126 (98.four) | 59 (98.3) | 67 (98.5) | one |
| Hair mask | 55 (43.0) | 22 (36.7) | 33 (48.5) | 0.24 |
| Hair dye a | 43 (34.1) | 18 (thirty.5) | 25 (37.3) | 0.55 |
Table iii
Proportion of women reporting regular employ of make-up products exterior of pregnancy (n = 128).
| Make-Up Product | Total n = 128 (%) | NPW Group n = 60 (%) | Pow Group n = 68 (%) | p-Value |
|---|---|---|---|---|
| Brand-upwards foundation | 74 (57.eight) | 32 (53.3) | 42 (61.8) | 0.43 |
| Blush | 36 (28.1) | 19 (31.7) | 17 (25.0) | 0.52 |
| Mascara | 110 (85.9) | 52 (86.7) | 58 (85.iii) | 1 |
| Eye-liner | 43 (33.6) | 23 (38.three) | 20 (29.4) | 0.35 |
| Middle pencil | 93 (72.vii) | 41 (68.3) | 52 (76.5) | 0.41 |
| Eye shadow | 88 (68.seven) | 41 (68.3) | 47 (69.ane) | i |
| Lipstick | 58 (45.3) | 25 (41.7) | 33 (48.5) | 0.55 |
| Lip pencil a | 12 (9.iv) | half-dozen (10.2) | 7 (x.5) | ane |
| Brand-upwardly remover | 104 (81.3) | 51 (85.0) | 53 (77.9) | 0.38 |
| Smash smoothen | 96 (75.0) | 41 (68.3) | 55 (80.9) | 0.xv |
| Boom smoothen remover b | 92 (73.6) | 41 (68.iii) | 51 (78.five) | 0.28 |
3.3. Criteria of Selection of Cosmetics Outside of Pregnancy
For general hygiene PCPs, the first criterion of selection in both subgroups (NPW and PW) was odor (except for intimate hygiene products and dermatological lather), followed past price and ingredients (Figure 1). For hair and face up PCPs, the criteria of choice varied overall, with a slight predominance of ingredients and price, apart from hair dyes, for which professional communication was the most common deciding factor (33% of the women). For make-upwards products, toll, appearance and habit were the decisive criteria in both subgroups (Figure 1). Cosmetics for which the ingredients were most often cited as the benchmark of selection were dermatological soap (71.4%), night facial cream (58.three%), shower gel (40.9%) and deodorant (40.three%). Cosmetics for which the ingredients were the to the lowest degree often cited as the benchmark of option (less than ten% of the women) were perfume, smash smoothen and centre pencil. There was no divergence between the subgroups in the proportions of women who cited ingredients as the benchmark of choice (results not shown).
Criteria of choice of products outside of pregnancy. (A) PCPs for general hygiene; (B) PCPs for hair and face up; (C) make-up products. Abbreviations: NPW, not-pregnant women; PCP: personal care product; PW: pregnant women.
iii.4. Proportion of Women Intending to Modify (NPW) and Having Changed (Prisoner of war) Cosmetics Use during Pregnancy
The intention of changing deodorant use was significantly more than common among the NPW than amidst the Pow subgroup (20.three% vs. 7.4%) (p = 0.04). Changes or intended changes in the use of other PCPs and make-upward products during pregnancy did not differ between the 2 subgroups. The near frequent changes in use were of torso lotion, smash polish, nail polish remover and pilus dye (Figure two).
Proportion of women intending to alter (NPW) or having changed (Prisoner of war) the apply of cosmetics during pregnancy. (A) PCPs for general hygiene; (B) PCPs for hair and face; (C) make-up products. * p = 0.04. Abbreviations: Center brand-upwardly, eyeliner, eye shadow, eye pencil and mascara; Face brand-up, foundation make-up and chroma; Lip make-up, lip pencil and lipstick; NPW: non-significant women; Pow: pregnant women.
3.5. Types of Changes Made during Pregnancy
Changes in cosmetics use in the PW subgroup during pregnancy are shown in Figure 3. There were significantly fewer women in this subgroup using nail polish (p = 0.02) and nail smooth remover (p = 0.04) during pregnancy compared with the proportions of users before pregnancy. The products most commonly given upwardly by PW were blast shine (10.three%), smash polish remover (7.iv%) and pilus dye (7.4%) while perfume was the one whose use was the most often decreased (10.3%). Cosmetics most often replaced by others considered to be less harmful were shower gel (10.iii%), body balm (7.iv%) and hair dye (7.4%). Some women used products that they had not previously used: body lotion, intimate hygiene product (4.four% each), day face foam, dermatological lather, and solid soap and brand-up foundation (i.5% each). Body lotion was the only cosmetic whose use increased (13.4%) (Effigy 3).
Proportion of pregnant women (Pow, n = 68) using cosmetics outside and during pregnancy. * p < 0.05; ** p ≤ 0.ane; Abbreviations: Prisoner of war: pregnant women.
For other cosmetics ordinarily used during pregnancy, the proportions of NPW intending to utilise massage oil and gel for tired agonized legs in the issue of pregnancy (54.4% and 57.1%, respectively) were significantly higher than those of the PW actually using the products (26.2% and 11.3%, respectively) (p < 0.001). There was no deviation between the 2 subgroups in the use or intended apply of striae gravidarum cream (75.ii%).
3.6. Criteria of Selection of Cosmetics during Pregancy
Few in the PW subgroup inverse their cosmetics utilize, and, if so, the new criteria of choice were mainly safe product ingredients and odor. In the outcome of pregnancy, the NPW stated that any intended modify would be governed by ingredients and professional person advice (Figure 4).
Criteria of selection of cosmetics during pregnancy. The percentages were calculated only in the subgroups of NPW who declared an intention to change cosmetics use during pregnancy. Shower gel (n = 7), solid soap and dermatological soap (n = 4), intimate hygiene production (north = viii), body balm (north = xiii), perfume (due north = seven), deodorant (n = 12), face PCP (n = 9), shampoo and pilus mask (n = vi), hair dye (n = 11), blast smooth (n = 12) and nail smooth remover (n = 13). The percentages were calculated only in the subgroup of Pow having inverse cosmetics use during pregnancy. Shower gel (n = ten), solid lather and dermatological soap (northward = iii), intimate hygiene product (north = seven), trunk lotion (northward = 22), perfume (north = 10), deodorant (due north = five), face up PCP (northward = 9), shampoo and hair mask (n = 3), pilus dye (n = 10), nail polish (n = 9) and blast polish remover (north = 10). * Face PCP corresponds to facial cleanser, day face foam, nighttime face cream, facial scrub, make-up remover and foundation. Abbreviations: NPW: not-pregnant women, PW: significant women.
3.vii. Take a chance Perception and Advice from Health Professionals
The women in the study had contrasting perceptions of chance related to cosmetics. Outside of pregnancy, cosmetics were by and large seen as "fairly safe" (39.5%) or "not really rubber" (37.seven%). More than half of the women (54.viii%), with no significant difference between the subgroups, thought that there was a risk in using cosmetics during pregnancy (Figure five).
Risk perception related to cosmetic products. (A) Outside of pregnancy; (B) During pregnancy. All p-values >0.05. Abbreviations: NPW: non-pregnant women; PW: meaning women.
Figure half dozen shows the proportion of women who had received advice from a health professional person nigh the utilise of cosmetics outside of and during pregnancy. Exterior of pregnancy, only a minority of women had received communication about PCPs (23.iv%) or make-upwardly products (18.9%). During pregnancy, 16.two% of the PW had received advice most PCPs and 5.ix% about make-upward products. Amidst the women who had non received advice, half would have liked some guidance outside of pregnancy (51.0% about PCPs and 49.v% most make-up products), and greater numbers would take appreciated advice during pregnancy itself (78.8% near PCPs and 66.1% about brand-up products) (Effigy 6).
Advice received from wellness professionals about cosmetics. Exterior of pregnancy: proportion of women having received advice (NPW and PW). During pregnancy: proportion of women wishing to receive advice (NPW) or having received advice (PW). All p-values > 0.05. Abbreviations: NPW: non-pregnant women; PCPs: personal care products; PW: pregnant women.
4. Discussion
4.1. Utilise of Cosmetics Exterior of Pregnancy
The cosmetics apply habits outside of pregnancy of the women in our study are overall similar to those reported in other studies of adult women in Europe [34,35] and the USA [39]. All the same, the women in our study declared a greater utilize of make-upward products (foundation, eye make-up, nail polish and nail smooth remover) than in the Dutch study of Biesterbos et al. [34] and greater utilise of perfume and shower gel than in the American study of Wu et al. [39]. In contrast with women in other studies, all the same, they used less body lotion [35,39], dark facial cream [34], and pilus dye [34,39].
4.2. Use of Cosmetics during Pregnancy
In our written report, the cosmetics utilise habits of the PW were comparable to those of pregnant women in other studies performed in the USA and in Canada for body lotion [16,36,37], deodorant [16,36], make-up foundation [xvi,17], facial cleanser [17,37] and lipstick [xvi]. In contrast, more meaning women in our written report, compared to those in these other studies, used perfume, shampoo, shower gel, face up creams, hair dye, eye make-up products, blast smoothen and blast polish remover [eleven,sixteen,17,36,37]. The data collected in the other studies concerned cosmetics use during the 24 h [11,16] or 48 h [17,36] before the participants replied to the survey questionnaire, whereas our information represented overall employ habits. The proportions of women using cosmetics in the studies carried out in the USA and in Canada may have been underestimated, in particular with regard to products not used daily such equally hair products, blast shine and perfume. In add-on, the life habits of American women differ from those of their counterparts in France and the residue of Europe. Caution should therefore be taken when making direct comparisons of the different findings. The proportion of women in our study using preventive treatment of striae gravidarum (75%) was comparable to that of some other French study [40].
4.3. Perception of Risk Related to Cosmetics and Their Ingredients
Virtually one-half of the women (45%) in our study considered that there was no adventure in using cosmetics during pregnancy. However, it is now recognized that these products contain numerous potentially harmful chemical substances including plasticizers, bisphenol A, parabens, synthetic dyes, benzophenones, antimicrobials, dioxane, formaldehyde and heavy metals [1,two,3,4,5,6]. Some of these molecules, such as formaldehyde and dioxane, are known carcinogens or probably carcinogenic [41,42], and certain synthetic dyes are suspected of being carcinogenic [43]. In Europe, a red azo dye (colour index number 18050), suspected of being carcinogenic and genotoxic, has been banned for use in food [44] just not in cosmetics [1]. Other molecules are endocrine disruptors in humans. Exposure in utero to phthalates and phenols has been related to impaired male person genital evolution [28,29,45]. Exposure to TPHP, a plasticizer found peculiarly in nail shine [xviii], has been related to a decrease in sperm concentration [30]. Cosmetics users are largely unaware of these findings. Our study shows that outside of pregnancy, product ingredients, except for a few PCPs (dermatological soap and night facial foam, shower gel and deodorant), were non our participants' main criterion of choice of cosmetics. During pregnancy, in contrast, changes in use were in most cases dictated by the ingredients of the cosmetics. However, the value of these conclusions is limited by the small number of women who made changes to their employ habits.
iv.4. Touch on of Pregnancy on the Gamble Perception of Cosmetics
Our study participants inverse their use habits during pregnancy for only five out of 28 cosmetics (hair dye, deodorant, nail polish, blast polish remover and perfume). In the Pow subgroup, the changes consisted mainly in replacing certain PCPs with other less harmful products and in stopping or reducing the use of brand-up products. But two products, boom smoothen and boom polish remover, were used significantly less past the Pow during pregnancy than earlier. A review of the literature showed that no other study has investigated the change in cosmetics use during pregnancy (compared to the menstruum earlier pregnancy). Our written report shows the affect of pregnancy on the perception of risk related to cosmetics. In a recent study, Lang et al. (2016) [37] found that apply of corrective and hair styling products decreased equally pregnancy progressed, whereas that of general hygiene and skincare products was consequent across time periods. However, they had no information on the prevalence of apply of these products before pregnancy.
Our written report is novel in its comparison of corrective use and the perception of risk of corrective products in two subgroups of women (Prisoner of war and NPW). Some other study concurrently performed on the same subgroups of Prisoner of war and NPW showed that the erstwhile had a more considered approach to cocky-medication [46]. They did not prove a like circumspection, however, when it came to cosmetics since subjects in the NPW subgroup would exist more than inclined to change their deodorant use in the event of pregnancy and also stated that they intended to use massage oils and gel for tired aching legs more frequently. These discrepancies in beliefs could be due to a lack of sensation nigh these PCPs. Indeed, our study shows that informing and advising women about products used during pregnancy would take an overall beneficial result on wellness.
iv.5. Need of Communication from Health Professionals about the Safe Apply of Cosmetics
Few women taking part in the written report had been given advice by a health professional near the use of cosmetics either before or during pregnancy (16% for PCPs and six% for brand-up products). However, more than 65% of women would have liked to receive data, in particular during pregnancy. These results reflect the desire and demand of women to be brash well-nigh their exposure when pregnant to the chemical substances contained in cosmetics. All perinatal health professionals should be aware of the potential risks of the apply of these products during pregnancy and exist ready to give appropriate advice. A recent study on household chemicals reported that pregnant women had greater conviction in information given to them by a physician than in manufactures on Net or the opinions of friends [47]. Cosmetics are increasingly sold in pharmacies, and customs pharmacists are therefore in a unique position to inform and advise meaning clients. In French republic, moreover, their educational role in health and prevention is acknowledged by police, a role recently strengthened by the Hospital, Patients, Health and Territories (HPST) Law [48,49].
In some European countries (in particular French republic and Kingdom of denmark), the health regime inform women about exposure to chemicals resulting from the use of cosmetics during pregnancy [50,51]. To avoid unnecessary and potentially unsafe use of cosmetics women should be encouraged to use them less oftentimes and to subtract the amounts applied. Certain beauty products such as nail smooth, nail shine remover and hair dye could be eliminated altogether during pregnancy. Others could be replaced by products that comprise fewer chemic substances or are less readily captivated. For example, Delmaar et al. observed that utilise of spray deodorants led to greater exposure to phthalates than that of non-spray deodorants [52]. The aggregating of assimilation routes (inhalation and cutaneous assimilation in the use of spray deodorants) could besides increase the exposure levels of some other substances and not specifically phthalates. Farther studies are needed to confirm this hypothesis. Finally, creams purporting to limit the occurrence of striae gravidarum have non had their efficacy and safety tested and proven. These products should non be recommended for all women, therefore, only reserved for those with risk factors such as a family history of striae, prepregnancy overweight and increased weight gain during pregnancy [40,53].
4.vi. Limitations
Our study has several limitations. It carries a risk of choice bias because the participants were volunteers and may therefore have been more alarm to the issues involved. No record was fabricated of the number of women who declined to take function. The women in our written report, compared to those in a French perinatal survey in 2010 [54] or in a French perinatal database in 2011 [55], had a higher level of education (university level: 75% vs. 52%) and more than jobs in executive and intellectual professions (22% vs. 16.5%) or intermediate professions (36% vs. 28%). However, the proportion of women in French republic with higher education qualifications and positions in intellectual and intermediate professions had increased over fourth dimension [54,55]. Information technology is likely that this trend connected up to 2015 (the yr of our study), which would thus minimize the differences observed. Level of education and income had an influence on the prevalence of utilise of many PCPs [34,35,37,39]. For instance, the use of body lotion, hand cream, pilus spray and deodorant decreased with increasing levels of instruction, whereas that of make-up products, facial cleansers and sunscreens increased [34,35,39]. The perception of take a chance of environmental chemicals by meaning women is also related to educational level [38]. Thus, our results are to be treated with caution and further studies more representative of the general population are needed earlier any general conclusions can be drawn. Social desirability bias may accept afflicted the women's cocky-reported use of PCPs, in item for the questions about changes in use during pregnancy. Although this bias is more than frequent for sensitive areas such as illicit drug use and sexual behavior [56], it is possible that our participants were more likely to declare that they had changed or decreased their use of PCPs as evidence of responsible behavior and proper care of their unborn child. This bias seemed to exist limited in our report, notwithstanding, since few women alleged they had inverse cosmetics use during pregnancy. Conversely, the possibility of nether-reporting of increased use of products cannot be excluded. In addition, our cantankerous-exclusive blueprint did not appraise the use of drugs and other products throughout pregnancy. In that location is therefore potentially a risk of recall bias concerning these habits, specially for pregnant women at a gestational age shut to term. This bias could pb to an under-estimation of the use of some products. It is also possible that at the commencement of pregnancy women do not consume the same products as women in their 2nd or third trimester (e.yard., cream for striae gravidarum, gel for tired agonized legs). Still, 90% of the Pw subgroup were in their second or third trimester of pregnancy, which could limit the differences in use.
5. Conclusions
To our knowledge, this study is the first to investigate changes in cosmetics employ during pregnancy. The results showed that few women stopped use during pregnancy, with the exception of boom polish and nail polish remover. Virtually half of the participants considered the use of cosmetics without chance during pregnancy, and few had received advice on the affair by a health professional. Studies involving samples more than representative of the general population of meaning women are needed to confirm our findings. However, our observations would be useful in making perinatal health professionals more aware of the problems raised by cosmetics use during pregnancy. All health professionals should be prepare to inform and advise women nearly the potential risks and the safety of use of these products.
Acknowledgments
We thank the community pharmacists and the physicians in the gynecology dispensary for their participation in the recruitment of women for the study.
Abbreviations
The following abbreviations are used in this manuscript:
| EU | European Union |
| NPW | non-meaning women |
| PCP | personal intendance products |
| Pw | significant women |
| TPHP | Triphenyl phosphate |
Author Contributions
Cécile Marie contributed to information analysis and estimation and wrote the manuscript. Sophie Cabut nerveless data and contributed to data analysis and interpretation. Françoise Vendittelli wrote the manuscript. Marie-Pierre Sauvant-Rochat designed and coordinated the study and wrote the manuscript. All the authors have reviewed, revised and approved the concluding manuscript.
Conflicts of Interest
The authors declare no conflict of interest.
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