Cosmetovigilance survey: are cosmetics considered safe by consumers?

Cosmetics are largely diffused substances topically applied to wash, to perfume or to improve the look, nevertheless the number of reported adverse reactions is very low, probably because of underreporting. This could be due to self-diagnosis and self-medication that is common in the presence of not severe reactions. In fact adverse reactions to cosmetics are generally not serious and frequently related to skin alterations. The aim of our study was to assess, through a questionnaire supplied by community pharmacists to the customers, the prevalence and characteristic of adverse cosmetic events (ACEs) reported by interviewed and the consequent measures adopted. To this aim ten Naples' community pharmacies were involved and pharmacists agreed to submit a specific questionnaire to all the customers of the pharmacy for two weeks between 9:00 a.m.-01:00 p.m. and 04:00 p.m.-08:00 p.m. from 1 to 15 June. The subjects interviewed were 4373, of them 845 refused to fill the questionnaire. Females responding to the questionnaire were 2716 and males 812. The 98.5% of the respondents reported to use cosmetics. Cosmetic users who experienced at least one ACE were 848 and 18.2% of them reported more than one event. Total adverse cosmetic events reported were 1507. A significant higher prevalence of adverse cosmetic events in women was observed, since the 26.5% of female cosmetic users experienced an adverse cosmetic event, whereas the percent was 17.4 for males. Concerning the type of adverse event, the 95.9% was a cutaneous event, whereas systemic events accounted for 4.1%. Among cutaneous reactions burning and itching were the most prominent and accounted for 36.3 and 32.9%, respectively. The most frequently reported systemic event was headache (40.3%) followed by nausea (24.2%). Product change (45.7%) and product suspension (39.6%), were the main specific measures adopted in the presence of ACEs. The general practitioner or the pharmacist were consulted only in the 6.8 and 6.3% of the episodes, respectively. In the 56.5% of the episodes consultation was not requested, whereas in the 26% a specialist was consulted. In conclusions our results, although supply information about ACEs and the consequent measures adopted by consumers of a restricted geographical area suggest that, due to the large use of these products and the relative high incidence of reported ACEs, the problem of cosmetic related injuries and the need of a system able to report, collect and evaluate them, cannot be ignored.