If you use eye makeup, you must read this

Since the dawn of time, both men and women have applied cosmetics, especially eye makeup, mostly to make themselves more attractive, but also to protect themselves from the environment (like the sun), clean themselves, claim social status, or to conceal scars and blemishes. Cosmetics were also used in religious rituals and to promote good health.

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Many different cosmetics are available today but eye makeup is arguably the most popular of all cosmetics.  Perhaps it's because eyes are so central to the face, or that we consider eyes as the 'window to the soul'.  Whatever the reason, many women, in particular, feel that they cannot face the day without applying eye makeup.

But if putting on eye cosmetics is part of your daily ritual, you should know about some potential dangers to your eyes.

Your eyes are delicate organs. An understanding of eyelid, eyelash, and eyebrow cosmetics is important because the eye area contains some of the most sensitive skin on the body.

The tender tissues that your eyes are made of are vulnerable to infection and irritation from all sorts of natural irritants, like dust and sunlight.

But they are also vulnerable to things you put on or near your eyes.  Eye cosmetics include eye shadow, eyeliner, mascara, face creams, makeup remover, dyes, and adhesives. Petrosyan () points out that most eye cosmetic users don't consider the ingredients of their makeup, nor if and when it expires.

Ocular anatomy and physiology: steps towards safe use of eye makeup

To understand how cosmetics affect the eye, it is useful to be familiar with the parts of the eye.

Eyelids

Eyelids have five layers. These are:

• skin (epidermis and dermis),
• subcutaneous tissue,
• muscular layer,
• tarsal plate, and

The eyelids have several functions, including maintaining the position of your eyeball, adjusting the light entering your eyes, and also keeping foreign objects out of the eye using the eyelashes.

Through blinking, they help maintain the integrity of the cornea and tear film, producing the outermost lipid or oily layer, as well as spreading tears, and moving tears to the tear duct (the puncta are the openings of the tear duct) to drain out of the eye.

Cilia or Eyelashes

Each eyelid has two to three layers of lashes.  Lashes protect the eyes from foreign objects, as well as providing some shade to the eyeball.

Each lash is associated with a gland of Zeis (a sebaceous or oil gland) and a gland of Moll (a sweat gland).

Meibomian Glands

The Meibomian glands are located just inside the tarsal plate of the eyelids, opening just inside the eyelash line.  They produce the outermost oily layer of the tear film, which helps protect the cornea.

Cornea

The cornea is the clear, protective, dome shaped outermost layer of the eyeball which plays an important role as a barrier against outside particles and in focusing the light entering the eye onto the retina.

The outermost layer of the cornea, the epithelium, in conjunction with the conjunctiva, produces the innermost mucous layer of the tear film.

Conjunctiva

The conjunctiva is a transparent that is well provided with blood vessel tissue, and which lines the inside of the eyelids (palpebral conjunctiva) and covers the white sclera (bulbar conjunctiva).

The conjunctiva contributes to the immune protection, oxygen supply, as well as lubrication of the eyes.

The goblet cells in the bulbar conjunctiva, along with the corneal epithelium, produce the innermost mucous layer of the tear film.

Tear Film

The tear film coats the cornea and conjunctiva and is composed of three layers, with each component of the tear film serving a critical purpose.

Each tear component is produced by different glands on or near the eye:

1. The oily component is produced by Meibomian glands in the eyelids. The oil layer prevents the tear film from evaporating as well as forming a hydrophobic barrier at the eyelid margin.

1. The aqueous or watery component is produced by lacrimal glands located behind the outer aspect of the upper eyelids. The aqueous layer provides oxygen and nutrients to the cornea and conjunctiva and has some antibacterial properties.
2. The mucin component is produced by goblet cells in the conjunctiva that covers the white of the eye (sclera). It allows the tears to spread evenly over the cornea and conjunctiva.

Nasolacrimal Duct

The nasolacrimal duct provides a drainage point for any excess tears or debris on the ocular surface. As the eyes blink, they wipe and push the tears into the two small openings in the nasal upper and lower eyelids called the puncta, and they eventually find their way to the nasal cavity for expulsion.

Eye Cosmetics

Eye cosmetics are generally safe materials, as long as they are used properly. As an eye surgeon and ophthalmologist, I've noticed that many who wear eye make-up are unaware of some of the potential negative effects.

Eye cosmetics commonly used today include the following.

• Mascara. Often available in waterproof, volumising or lengthening versions, they can contain irritating substances, or flake off, causing inflammation and injury to the cornea. Sometimes mascara can create an accumulation and obstruction of the lacrimal drainage system, most commonly in the lacrimal sac or nasolacrimal duct, leading to inflammation and infection.  Additionally, it is possible to damage the cornea through accidentally poking it during application.
• Eyeliner. This is also available in a waterproof version. As it is usually applied to the base of the eyelashes, it is difficult to remove and can harbour bacteria.  Also, if it is used on the inside of the eyelids, it can block the Meibomian glands and contribute to dry eye disease.  Cadmium is a heavy metal often used in eyeliner, and it can cause damage to the corneal endothelium cells, resulting in corneal swelling and potential permanent scarring.
• Eye shadow. Any powdered eyeshadow, and even face powders, can enter the eyes.  Particularly dangerous are those powders which contain glitter.  Pigments used in eye shadows can embed themselves in the skin or palpebral conjunctiva (the conjunctiva that lines the inside of the upper and lower eyelids).
• Lash growth products are widely used. They often contain prostaglandins and are pro-inflammatory, also causing problems with the Meibomian glands and contributing to dry eye.
• Eye creams. Preservatives and fragrances should be minimised in this area, and retinoids should be avoided completely.  These will also aggravate dry eye disease.

• False eyelashes and eyelash extensions. These are very popular at the moment.  Not only can some individuals be allergic to the glue, but it can obstruct the eyelid closing, and thus increase tear evaporation and Meibomian gland secretion.  Furthermore, glue on the ocular surface can cause abrasions, bacterial infections which can lead to scars and potentially permanent visual damage which may require (laser) surgery to restore vision
• Eyelash and eyebrow tints. These have been known to cause serious eye injuries, including blindness.
• Micropigmentation or permanent makeup. Sometimes known as cosmetic tattooing, permanent makeup has become popular as it is seen to have benefits of cost, time, consistency of appearance, and convenience.  Permanent makeup commonly includes eyeliner, eyebrow definition, lips, and even eyeshadow and blush. Like a tattoo, usually a local anaesthetic is used, then a vibrating needle deposits the pigment granules under the upper layer of skin.

Problems with permanent makeup

It is a misconception that cosmetic tattooing is permanent, the pigment only lasts several years and will then fade.

The dangers with this procedure are twofold: they may be performed by somebody with very little training, and the colours used may not have been tested for safe use under the skin, and are usually a mixture of substances.

Other risks include the risk of infection (for example, Pseudomonas aeruginosa, Staphylococcus aureus, and Candida albicans), not to mention HIV or other viruses.  These can occur during non-sterile procedures and reusing ink and needles over several patients.

In addition, there is the risk of blisters and scarring, development of granulomas (bumps under the skin) and keloids, or the overgrowth of scar tissue.

Of course, anyone could be allergic to the ink, especially if it contains iron oxide.

Pigment migration can occur over time, as well, and it is difficult to remove.  Usually the removal process will leave a scar.

Eye Problems Associated with Eye Makeup

Let's take a look at the eye problems that can be caused by using eye cosmetics.

Entropion

False eyelashes can cause entropion, a condition in which your eyelid turns inward so that your eyelashes and skin rub against the eye surface, causing irritation.

Eyelid dermatitis

Eyelid dermatitis and ocular surface irritation can also occur in response to several ingredients used in eye cosmetics, including fragrances, preservatives, antioxidants, emollients, resins, nickel-containing pigments, and pearlescent additives.

Corneal trauma

Corneal trauma is the result of mechanical injury caused, for example, by mascara wands.  The mascara or eyeliner applicator almost always has bacteria on it, and therefore there is potential for infection if the cornea is scratched.

Ocular or eye infections

There is an increased risk of your eyes becoming infected if you use eye cosmetics regularly, as they might be contaminated with bacteria through manufacture, poor storage or use.

Conjunctivitis or pink eye is a common eye infection which has different varieties, notably viral and bacterial. Conjunctivitis typically does not threaten vision, but infections of the cornea or inside the eye are serious threats and require immediate referral to an ophthalmologist.

Corneal infection (keratitis) is less common but poses a serious risk to vision. Bacterial infection is the most common cause of infectious keratitis.

Meibomitis

Blepharitis and meibomitis are conditions of the eyelashes and eyelids that can cause itching, redness, irritation, burning, blurred vision and/or eye pain. Both are associated with dry eye disease.

Meibomitis is a chronic inflammation of the Meibomian oil glands, which leads to ocular surface inflammation and conjunctivitis.

Blepharitis

Blepharitis, or inflammation of the eyelids, and dry eyes often occur together, so it is not clear whether dry eye causes blepharitis or vice versa.  Some ophthalmologists believe that these two conditions may be part of a single chronic eye problem called dry eye blepharitis syndrome (DEBS).

According to this theory, dry eye is simply the late manifestation of blepharitis, and treating blepharitis also will prevent, reduce or eliminate dry eye symptoms.

There are several possible causes of blepharitis, including:

• Meibomian gland dysfunction (MGD)
• Dry eye disease
• Fungal eyelid infection
• Parasites (Demodex eyelash mites)

Blepharitis is associated with an overgrowth of bacteria due to the accumulation of dry and/or dead skin cells in the eyelashes and at their base.  It is can be the result of not removing eye makeup properly.

The bacteria create a biofilm which becomes home to Demodex mites.  Also, the bacteria in the biofilm produce exotoxins that cause inflammation in the Meibomian glands, causing Meibomian gland dysfunction (MGD).

Demodex mites

The Demodex folliculorum mite is a type of parasite that lives on humans, in or around hair follicles, where they feed on dead skin cells. Ocular Demodex mites love oil-rich environments, such as the Meibomian glands.  It is thought that they may also survive in oil-based cosmetic products and applicators.

Most of the time, these mites are harmless and will go unnoticed. But if they multiply, they may cause blepharitis, which in turn causes MGD.

Meibomian gland dysfunction

Meibomian gland dysfunction (MGD) is one of the primary causes of evaporative dry eye. If the Meibomian glands are blocked or otherwise not working properly, the tear film is compromised and tears evaporate too easily.

MGD is a relatively common affliction, and is found is as many as 60 percent of dry-eye sufferers.

MGD is sometimes accompanied by meibomitis, as noted, because of the increase in bacteria in the Meibomian gland and eyelash area.

Eyeliner and eyeshadow, and sometimes mascara, are often the culprits of blocking these glands, leading to MGD and dry eye (which is also discussed more fully below).

Dry Eye Disease

Ophthalmologists come across dry eye disease in their patients very frequently. Sadly, this common eye complaint can have significant effects on vision, ocular comfort, and quality of life. Dry eye can also affect the success of LASIK and cataract surgery.

Furthermore, it only gets worse over time and, if left untreated, can develop from constant eye irritation to significant inflammation, abrasion of the corneal surface and corneal ulcer and, ultimately, even loss of vision.

Dry eye is also known as:

• Keratitis sicca, which describes dryness and inflammation of the cornea.
• Keratoconjunctivitis sicca, indicating dry eye that affects both the cornea and the conjunctiva.
• Dysfunctional tear syndrome, meaning that both the quality and the quantity of tears are insufficient.

Interestingly, dry eye is encountered more frequently amongst females, and it is thought that eye cosmetics are to blame.

What is dry eye?

Dry eye is a condition in which your eyes are unable to produce the proper tears to keep the eye moist. There are many reasons why dry eyes occur. Your tears may be deficient in quantity or quality: your tears may be evaporating too fast, or they may not have the correct balance of oil, water, and mucus to be effective.

Symptoms of dry eye

• Dry and gritty feeling, often accompanied by stinging and burning;
• Itchy eyes;
• Intermittent blurry vision;
• Watering or tearing (surprisingly);
• Eye redness;
• Heavy or tired eyes;
• Sensitivity to light;
• Difficulty wearing contact lenses;
• Sometimes mucus around the eyes.
• Dry eye is a nuisance.  Some of the symptoms include stinging, burning, tearing, redness, foreign body sensation, and fluctuating vision.

Eye makeup makes dry eye worse

Cosmetics can either cause or exacerbate existing dry eye disease.

Eye makeup reduces the stability of the tear film

Eye makeup reduces the stability of the tear film (the membrane covering your eyeball) and the quality of the lipid layer. Both hydrophilic and hydrophobic cosmetic formulations migrate across the eyelid margin and enter the tear film.  This is known as 'tear film contamination'.

Clogging the Meibomian gland openings

The lipid layer is the most important component of the tear film as it reduces evaporation of the tears and gives them surface tension so that they stick to the cornea. Eye cosmetics can clog the meibomian gland openings disrupt the excretion of the oily layer. This occurs more frequently with chronic use of heavy makeup.

Increase the risk of MGD

Eye cosmetic products increase the risk of Meibomian gland dysfunction, aggravating dry eye.

Chronic clogging of the meibomian gland orifices can lead to MGD and atrophy, resulting in irreparable loss of the gland.

The most likely cause is an eye makeup technique called 'inside liner,' which is eyeliner that is applied to the eyelid margins over the Meibomian glands so that the eyes will appear to be larger.

Makeup particles and debris on the tear film

Another cause may be that eyeliner, eye shadow, mascara, and foundation become mixed with sweat and tears over time, and the Meibomian glands, which are positioned just behind the eyelashes, may become obstructed by a thin, oily film mixed with pigments.

Makeup debris and particles can get into the tear film and onto the cornea and conjunctiva. The particles themselves can be an irritant but also disrupt the tear film leading to a faster tear breakup and evaporation time and exposure of the corneal surface to the air.

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Types of makeup and cosmetic remover

Certain makeup, such as eyeliner, can also change the viscosity of the meibum, which will adversely affect tear stability. Cosmetic remover applied to closed eyes may still migrate inside the eye and worsen dry eye by decreasing tear film stability, thinning the tear film, and increasing evaporation.

Makeup debris coating the conjunctiva

Makeup debris and makeup remover can also coat the conjunctiva leading to dysfunction of the goblet cells which help produce the mucin layer of the tear film.

Dangerous Cosmetic Ingredients and Practices

Another very real hazard in wearing eye makeup is posed by the substances used in their formulation.  At best, you might be allergic; at worst, some ingredients could even be carcinogenic.

Most cosmetic products contain hazardous chemicals. The bioaccumulation of these harmful chemicals and metals in the body over time has been associated with cancer, reproductive and developmental disorders, contact dermatitis, hair loss, lung damage, ageing, skin disease and reaction, allergies, and damage of nails.

Sadly, many consumers often have no interest in what ingredients are in their makeup, even though they may be careful about what they eat. And many of the substances used in cosmetics enter into the body by inhalation, absorption and ingestion.

But here's a list to watch out for:

Carbon black

• Carbon black is a powder found in eyeliner, mascara, eye shadow and eyebrow shadow and has been linked to cancer and organ system toxicity.
• It will show up on the label as carbon black, D & C Black No. 2, acetylene black, channel black, furnace black, lamp black and thermal black.

Ethanolamine compounds

• Ethanolamine is a colourless, viscous fluid.  Ethanolamine compounds are used as emulsifying agents, fragrances and pH adjusters in cosmetics.
• They can cause burns and serious damage to eyes. They are harmful by inhalation, in contact with skin and if swallowed, and can also be contaminated with nitrosamines, which are carcinogenic.
• Avoid products that contain ingredients with the letters DEA, TEA and MEA.  DEA (diethanolamine) MEA (monotaholamine) and TEA (tiethanolamine) can cause contact dermatitis, and, because they are easily absorbed through the skin, they accumulate in body organs, including the brain, increasing the likelihood of liver and kidney cancer.

Benzalkonium chloride (BAK)

• Benzalkonium chloride is an organic salt used in cleaning agents, classified as a quaternary ammonium cationic detergent. It is a biocide, preservative and surfactant associated with severe skin, eye, and respiratory irritation and allergies.
• It can be used in eye cosmetic formulations, particularly as a preservative found in eyeliner, mascara and makeup remover.
• It works by reducing surface tension, like a detergent, destabilising the lipid layer and thus reduces tear film stability.  It is both directly and indirectly pro-inflammatory, and toxic to epithelial and goblet cells of the eye.
• It also causes hypoesthesia (or numbness).
• Concentrated solutions are toxic to humans, causing corrosion/irritation to the skin and mucosa, and death if taken internally in sufficient volumes.

Prime yellow carnauba wax

This is used in mascara and eyeliners to stiffen the product and make them waterproof, but it can clog the Meibomian oil glands.

Formaldehyde and formaldehyde-releasing preservatives

• Formaldehyde and preservatives that release the chemical are strongly are used as a preservative in cosmetics. It is a known carcinogen that is linked to asthma, neurotoxicity, and developmental toxicity.
• In addition, it irritates the respiratory system and skin, and can also weaken the immune system, as well as causing other miseries such as headaches, depression and chronic fatigue.
• Formaldehyde might be listed as quaternium-15, DMDM hydantoin and imidazolidinyl urea.

Parabens

• These are the most widely used preservatives in cosmetics, in order to prevent the growth of bacteria in makeup products. They are absorbed through the skin and easily transmitted into the bloodstream. Known endocrine disruptors and are linked to reproductive toxicity, early puberty and breast cancer.
• Parabens can also make dry eye worse since they prohibit the oil glands that line the eyelid from secreting enough oil.
• When reading labels, avoid anything with the suffix 'paraben. Examples include: methylparaben, proplyparaben, isopropylparaben, and isobutylparaben.

Aluminum powder

• Used to give eye makeup its hue, aluminum powder is both a neurotoxin and has been linked to organ system toxicity.
• Makeup labels will list aluminum, LB Pigment 5 or pigment metal.

Retinyl acetate or retinyl palmitate (Vitamin A)

• Two forms of vitamin A, retinyl acetate or retinyl palmitate, have been linked to cancer and reproductive toxicity. They're also found in anti-aging face creams and eye creams.
• Even if you don't have dry eye disease, you should avoid vitamin A in creams used near the eyes.

Heavy metals

• Heavy metals such as lead, mercury, cadmium, arsenic and nickel, as well as aluminium, classified as a light metal, are detected in various types of cosmetics (colour cosmetics, face and body care products, hair cosmetics, herbal cosmetics, etc.). In addition, elements such as copper, iron, chromium and cobalt are also present in cosmetic products.
• Heavy metals are neurotoxins that have been linked to brain damage. Nickel in particular has been associated with lung cancer and respiratory concerns. What's more, up to 17 percent of women have a nickel allergy, which can cause dry, itchy eyelids, a red skin rash and watery blisters.
• Nickel and chrome are two heavy metals found in all types of makeup, especially in green or metallic shadows, as well as makeup brushes, even the expensive types.
• Metals occurring in cosmetics may undergo retention and act directly in the skin or be absorbed through the skin into the blood, accumulate in the body and exert toxic effects in various organs.
• They are found most frequently in eye shadows, where heavy metals are retained as impurities in the pigments.
• Continual exposure to heavy metals may entail adverse health effects.

Titanium dioxide

Typically found in sunscreen, titanium dioxide is safe but when it's in powder form, it can be problematic and is also a possible carcinogen. Titanium dioxide is labeled as such or as TiO2.

Sodium lauryl sulphate and sodium laureth sulphate.

SLS/SLES are foaming agents: they are used to create foam in items like shampoo, and they have sometimes been found to contain the carcinogen dioxane.  Additionally, nitrosamines are common byproducts of the sulphation process, are believed to be carcinogenic

Mineral oil and petroleum jelly.

Baby oil and Vaseline are examples of these, which are sometimes used to remove eye makeup.  Both of these are by-products of the oil industry, and are used in many cosmetics, notably eyeshadows.  Because they effectively cover the skin, blocking its release of toxins, they slow down skin function and normal cell development, causing skin to age prematurely.

Fragrance.

Almost every single conventional skincare and cosmetic product (even 'unscented' ones) contains artificial fragrances. This is arguably the most harmful ingredient used in cosmetics, as many of the compounds used in fragrances are toxic or carcinogenic.  Many people are simply allergic to fragrances, but more seriously, these synthetic fragrances can affect the central nervous system, and cause skin irritation, vomiting and even hyperactivity and depression.

Cyclomethicone and siloxanes.

These are silicone based, and mostly used in moisturisers.  They are toxic and can build up in the liver and gastro-intestinal system.

FD&C colour pigments.

 As colour pigments, they are found in many cosmetics, notably mascara and eyeshadow. They are considered to be carcinogenic, and at the least, often cause skin sensitivity and irritation.

BHT (Butylated Hydroxy Tolulene).

This is a preservative which is known to be carcinogenic, but is still widely used in many cosmetic ranges, including Revlon and L'Occitaine.  It is found, in particular, in eye shadow, as well as lipstick and skin cream.  It penetrates the skin and accumulates in fatty tissue, creating free radicals that can create damage to the cells' DNA, causing cancer.

Note: This list does not include dangerous ingredients that are used in products designed for other parts of the body, such as hair or teeth.  Eyes are the focus here.

Proper makeup application and removal

Proper eye makeup use can significantly decrease the risk of complications or adverse reactions and should be discussed with all patients wearing eye cosmetics. Here are some ways to ensure make-up doesn't affect your eye health.

Review your makeup purchases, change your skin care routine, and use different techniques to apply your eye makeup, and you can still avoid or reduce dry eye or the other issues associated with makeup and eye health.

Application

Avoid cosmetics with hazardous ingredients

• Avoid products that contain the chemicals mentioned above.  These are known to be damaging.
• It's important to pay attention to the ingredient label on your makeup to avoid dangerous substances.
• Avoid products containing fragrances, preservatives, antioxidants, emollients, talc, BHA (butylated hydroxyanisole), urea, sulfates and phthalates resins, nickel-containing pigments, and pearlescent powders.
• Liquid eye make-up remover typically contains high levels of BAK, and it also contains formaldehyde-releasing compounds which disrupt the cells of the eye.
• Test products before use.

Stop using any makeup that causes irritation

• To avoid allergies or irritation, avoid ingredients such as arsenic, beryllium, cadmium, carmine, lead, nickel, selenium, and thallium.
• If any eye cosmetic causes irritation, stop using it immediately. If irritation persists, see a doctor.

Using eye lubricants

If you use an eye lubricant or spray, do this at least 30 minutes before the application of makeup. This will avoid the lubricant from washing the make-up onto the surface of your eye ('tear film contamination').

Limit the number of products you use

Any makeup is damaging to the eye, so try to limit the number of products you use in this area to one or two.

Use makeup appropriately

Don't use any cosmetic in an area where it's not supposed to be used. Don't use any cosmetics near your eyes unless they are intended specifically for that use For example, don't use lipstick as eyeshadow. You will spread bacteria and cause eye infections.

Apply makeup to outside of eyelashes

• Be sure to apply any makeup, including eyeliner and eyeshadow, outside the eyelash line to help avoid blocking the meibomian glands and prevent introduction of bacterial directly into the eye.
• In recent years, it has become fairly popular to apply eyeliner inside on the rim of the eyelid, also called the water line. However, it is best to apply eyeliner to the lash line rather than the water line.
• Studies have shown that those who applied the liner along the lash line experienced a higher volume of particles in their tear film than those who applied it outside the lash line. This increases the chance of infection and irritation.

Mascara application

Apply mascara sparingly, applying it just to the tip of your eyelashes.

Be careful not to scratch your eye

Don't try to apply eye makeup while in a moving vehicle. You can, all too easily, scratch your cornea with an applicator, which could lead to a corneal abrasion. Corneal abrasions are potentially very painful, associated with severe discomfort, tearing and redness but more seriously can lead to bacterial infections of the cornea itself.

Removal

Remove makeup every night

• Remove all makeup every night.
• Cleansing your eye area can also clean away some of the lid margin bacteria and skin cells that contribute to dry eye. The pressure on the lid margin will also help unblock the oil glands, preventing infection.

How to Remove Makeup From Around the Eyes

• Not removing your makeup can have serious consequences.  This is masacara embedded in eyelids'
• Use coconut oil to remove your makeup.  Coconut oil is gentle, natural and effective for removing eye makeup.
• Baby shampoo is an inexpensive and ophthalmologist-recommended product for washing eyelids and the area around the eyes. These 'tear-free' soaps are often recommended to people prone to styes, chalazia and blepharitis,
• Be especially careful with exfoliating scrubs and don't use them around your eyes.

Hygiene

Wash your hands before applying eye makeup

Be aware that there are bacteria on your hands that, if placed in the eye, could cause infections. Wash your hands before applying eye cosmetics.

Keep brushes and applicators clean

Wash your brushes and applicators regularly, as they accumulate bacteria which can then damage your eyes.  And absolutely do not share your makeup or applicators!

Replace applicators regularly

Replace brushes at least every 6-12 months and if used during an eye infection.

Don't share makeup

• Do not share makeup.  No, not even with your sister or boyfriend.
• Don't use tester makeup in shops

Sharpen makeup pencils regularly

Sharpen your makeup pencil before use to remove the top layer of bacteria.

Don't pump the mascara wand

Do not pump the mascara brush in and out of the container since it introduces air and bacteria into the bottle.

Don't use applicators interchangeably

• Do not use the same pencil on different parts of the eyes and face since every part of your face has its own normal group of bacteria which may cause an infection if introduced to another part of the face or eyes.
• Use separate applicators for each type of makeup.

Replace makeup regularly

• All makeup has an expiration time from when it is opened. It can be found on the back label marked in months (6M = 6 month after opening).
• Discard dried-up mascara.  Don't add saliva or water to moisten it. The bacteria from your mouth may grow in the mascara and cause infection. Adding water may introduce bacteria and will dilute the preservative that is intended to protect against microbial growth.

Store cosmetics carefully

Store your cosmetics carefully.  Keep them cool, and away from dirt and moisture. Perhaps the most common eye problem associated with eye makeup is conjunctivitis, or pink eye. This is because eye makeup can easily be host to bacteria and fungi, particularly if it is old or not properly stored.

Don't use eye makeup if you have an eye infection

• Don't use eye makeup if you have an eye infection like pink eye or conjunctivitis.  It is preferable to discard all your old makeup after an eye infection, and buy new.
• Don't wear makeup immediately after eye surgery.  Ask your ophthalmologist for guidelines.

Issues with various makeup types

Color Contacts

• Technically, contact lenses are not cosmetics, they are medical devices. But they are often used for cosmetic purposes and come with considerable risks.
• Poorly fitted contacts can lead to serious complications, including infection, inflammation, trauma, and even damage to the cornea and eyelids. Over-the-counter color contacts or ones purchased online might also not have been kept clean, which adds to the risk of corneal ulcers and conjunctivitis (pink-eye).

What About Latisse?

• Latisse is a prescription eyelash enhancer. Latisse is a prescription eyelash enhancer which is applied to the lash line to promote the growth of longer, thicker eyelashes. There are some possible side-effects to watch out for, which is why it is only available by prescription.
• The best way to ensure safe use of eyelash growth products is to consult with an ophthalmologist before using.

False eyelashes

False eyelashes seem to be very popular at the moment.  Never wear false eyelashes more than once, and save them for the rare, special occasion.  And be careful that you're not allergic to the glue. They will nonetheless affect the health of your natural eyelashes, sometimes causing them to fall out.  They also harbour germs.

Glitter and powder

• Glitter and powder-based shadows and foundations have tiny particles in them that can get into and aggravate the eyes and cause infection.
• Stick with cream-based eye shadow rather than powder to minimise contamination into the eye.
• Don't use makeup with sparkle or glitter.

Avoid volumising and lengthening masacara

Try to avoid 'volumising' and 'lengthening' mascaras as these often include fibres that can irritate the eyes. 'Thickening' mascaras are less likely to flake after drying.

Avoid 'waterproof'

Also avoid waterproof eyeliners and mascaras, as these can contribute to dry eye disease.

Makeup with more water content

Makeup with a higher water content, such as liquid makeup, is more prone to bacteria and fungus buildup. To avoid this potential contamination, these cosmetics require a preservative to be added in by the manufacturer which can be a standalone irritant for the eyes.

Problems for Contact Lens Wearers

In some cases, women who wear contact lenses may be more susceptible to eye problems related to eye makeup. There is always a possibility of makeup debris ruining the integrity of your contact lens or sliding under the surface and irritating your cornea.

Make sure you wash your hands, put in your contacts and then apply makeup to your eyes.  If you apply makeup before putting on contact lenses, some of the oils or bits of makeup can smudge or get stuck on the lens and try to avoid heavy makeup close to the eye to reduce the risk of it flaking.

Put in contact lenses before putting on makeup

• Insert contact lenses before applying makeup. Take them out before you begin makeup removal.
• The makeup removal solution will adhere to the contact lenses if any small amount gets into the tear film and cause contact lens wear discomfort.

Take these steps if makeup gets in your eyes

• Rinse eyes thoroughly with clean tap water or eye-wash solution until you flush out all mascara, eyeliner or makeup flakes. (If you wear contact lenses, remove them before flushing out your eyes).
• Apply moisturizing eye drops to the affected eye after rinsing out makeup.
• If you wear contacts, carefully clean the lens using your cleaning solution.
• Don't re-insert your contacts as long as your eye is still irritated.

Get an eye exam if you have trouble with eye cosmetics

Whether you have symptoms or not, it's always a good idea to see your doctor for an eye exam. Your doctor can detect issues before they become a bigger and give you a list of ingredients in makeup you should avoid.

Make an appointment to see your ophthalmologist if you continue to experience:

• Eye pain.
• Sensitivity to light.
• Persistently blurred vision.
• Swelling.
• Discharge.

References

American Optometric Association.  . Cosmetics and the Eye: How Your Beauty Products Could Be Harming Your Eyes By: Tamara Petrosyan,

Bogus W, Haupert C. Old Makeup Can Cause Serious Eye Infections. (). https://www.urmc.rochester.edu/encyclopedia/content.aspx?ContentTypeID=1&ContentID=724

Eiermann HJ, Larsen W, Maibach HI, Taylor JS. Prospective study of cosmetic reactions: -. North American Contact Dermatitis Group. J Am Acad Dermatol. May;6(5):909-17.

Fisher AA.Allergic contact dermatitis due to rosin (colophony) in eyeshadow and mascara. Cutis. Dec;42(6):507-8.

Mychaskiw M. Everything You Need to Know About Permanent Makeup. (, May 01). http://www.instyle.com/beauty/permanent-makeup-guide

Okereke J. N., Udebuani A. C., Ezeji E. U., Obasi K. O., Nnoli M. C., Possible Health Implications Associated with Cosmetics: A Review, Science Journal of Public Health. Special Issue: Who Is Afraid of the Microbes. Vol. 3, No. 5-1, , pp. 58-63. doi: 10./j.sjph.s..21

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March is 'Save Your Vision' month, encompassing every aspect of eye health. On a daily basis, you must protect your eyes from various potential hazards ' UV rays from the sun, eyestrain from digital screens, and environmental hazards such as projectiles and dust. But there's another potential culprit that many of us apply to our delicate eye area every day. That's right: We're talking about eye makeup.

Most cosmetics from reputable manufacturers are safe when properly applied, but be aware of application injury (ouch!), color additives, and the increased risk of eye infections.

Let's have a 'look-see' at some of the 'Do's and Don'ts' of wearing makeup and keeping your eyes healthy. Makeup trends come and go, but protecting your precious sense of vision is forever.

1. Clean Up Your Act

Misuse of eye cosmetics can be dangerous ' plus there's an 'ick factor' to nasty bacterial or fungal eye infections. Not a good look for your wedding, job interview, or family photo! Remember these safety tips to help reduce the risk of contamination and injury.

• Never share eye cosmetics with anyone ' including 'testers' in department stores. Sharing another person's bacteria is never a good idea. Having a makeup salesperson give you a new look may take on a whole new meaning when they use the same products they used on their last makeover client. Whether it's a friend, family member, or random cosmetic shopper, it is hazardous to swap or share makeup.
• Don't use old or outdated mascara. After three months of use, pitch it. And don't ever attempt to remoisten dried-out mascara with water or saliva. That's a bacterial disaster waiting to happen!
• Store cosmetics at room temperature. Higher temps cause deterioration of the preservatives, so leaving cosmetics in your hot car or beach bag is a definite no-no!
• Your hands are a playground for bacteria. Always wash your hands with soap and water (not hand sanitizer) before applying cosmetics. It's a good idea to cleanse your face as well. Transfer of bacteria from hand to eye is one of the most common avenues of inflammation, injury, and infection.
• Liquid or creamy eye makeup is especially susceptible to bacterial growth. Be extra-careful with such formulations.
• Use cosmetics for their intended purpose. While it can be tempting to use a lip liner as an eyeliner, you risk cross-contamination. Also, color additives not intended for the eye area can cause inflammation or irritation.

2. Don't Move

As convenient as applying makeup 'on the go' may be ' don't risk it! On the bus, in the car, or on a subway is not the ideal scenario to hold a pointy mascara wand near your eyes. A pothole, sudden stop, or rear-end collision could cause you to scratch your cornea, causing a painful injury or infection. Even a grazing scratch with a mascara wand, eyeliner, or tweezer can cause eye injury. It's not worth the risk.

3. False Eyelashes and Extensions

False eyelashes and extensions are trendy but can affect your vision when misused. The FDA considers these products, including lash adhesives, as cosmetic products. Therefore, they must adhere to FDA labeling and safety requirements. However, adhesives can be properly labeled and still cause problems with the eyes and the delicate skin surrounding them. After all, it's glorified glue! Reactions may be allergic in nature, or the glue may cause irritation that can be very uncomfortable. If you experience a particularly bad reaction ' one that causes blurry vision, intense itching, or cracked skin ' contact your optometrist for evaluation.

4. Dying and Tinting Eyelashes and Brows

Want dramatic dark lashes and brows that accent your eyes? Lash and brow dying or tinting should be done by a licensed professional using FDA-approved products. Serious eye injury, including blindness, has been reported from the use of non-FDA-approved products.

5. Avoid Glitter Makeup

Corneal irritation and infection can be caused by sparkle powder, glitter or metallic eye makeup. These relatively large particles act like sand or dirt in the eye, irritating and damaging your eye. Contact lens wearers are especially susceptible to this type of eye makeup injury because the glittery flakes can lodge between the eye and the lens, causing prolonged abrasion and injury.

6. Take it Off

The cardinal rule of wearing makeup? Always (always!) remove all makeup before going to sleep. It's that simple. If not removed, eye makeup can cause follicular conjunctivitis and styes, eyelid cysts, and blepharitis (inflammation of the eyelid that affects eyelashes and tear production). To avoid an eye infection, try these gentle eye makeup removers:

• Vaseline is a soothing and lubricating makeup remover, since it prevents pulling and scrubbing as the makeup slides off gently.
• Tear-free baby shampoos are another great choice because of their hypoallergenic, gentle-to-the-eye formulation. Put a small dab on a cotton ball, close your eyes, and gently wipe.
• Out of eye makeup remover? Baby oil, olive oil, almond oil, or coconut oil are great natural options.
• Makeup removers designed specifically for the eyes are a smart choice, too. Be careful to keep the remover from getting into your eyes. After use, thoroughly rinse any remover off your eye and wipe with a clean cotton pad. Be gentle with those delicate eyelashes ' they serve the vital purpose of protecting your eyes from dirt and dust.

Now go out and wow the world with those beautiful, healthy eyes!