Cosmetics: the medicine of beauty.

Abstract

Dermatologists have become accustomed to thinking of cosmetics as substances that scent and adorn the body, but do not alter structure and function. This is in line with the current regulatory approach to cosmetics; however, cosmetics were actually the first drugs designed to treat the mind, body, and soul. The history of human cosmetic use dates back 6000 years and was embraced by almost every society to the far reaches of the earth in some form. If we consider body decoration a form of cosmetics, then cosmetic use began 100 000 years ago during the African Middle Stone Age. From this extensive history, it appears that the human desire to attend to the external body for appearance and ultimately disease purposes is innate. One of the major cosmetics of antiquity was kohl used in ancient Egypt around the eyes. While at first glance it might appear that kohl eyeliner was used to create a fashion statement, kohl actually was important for eye protection. It reduced glare from the sun and prevented cataracts long before UV-protective sunglasses were invented while trapping sand in the desert environment that could cause a corneal pterygium. Kohl is composed of the mineral galena, which is a dark metallic lead-based material known as lead sulfide. The mineral was crushed and mixed with precious stones, frankincense, and medicinal herbs such as saffron, fennel, and neem. This powder was formed into a paste by mixing with oil, gums, and animal fats. When skin is exposed to lead, the lead ions induce nitric oxide gas release, which activates the immune system via vasodilation and macrophage activation accounting for its antibacterial properties. As eye infection was common and serious along the Nile, there was a need to prevent ocular scaring and the resultant blindness. As the kohl seeped into the eye with tears, it would provide continuous antibacterial benefits to both prevent and treat infection. This certainly would classify kohl eyeliner as a topical antibiotic drug in the current regulatory environment. This makes kohl one of the first medicines of beauty. Kohl was also incorporated into Egyptian products to treat wrinkles at the time of Thutmose III. Kohl, red ocher, and sycamore juice were combined to make a paste that was used for adornment, but also for scars and burns. Here again the antibacterial effects of kohl were utilized to prevent wound infection while providing body camouflage. The close relationship between cosmetic adornment and disease prevention/treatment is again demonstrated. However, cosmetics could also be carriers of disease and death. Early rouge to redden the cheeks and lips was made of mulberry and seaweed pigmented with cinnabar, a poisonous red sulfide of mercury. The ingestion of mercury was especially harmful to an unborn fetus, and it is unknown how many miscarriages and stillborn births occurred due to the use of mercury-containing lipsticks. Arsenic was also put in preparations used by the Greeks and Romans as a depilatory for chemical hair removal causing toxicity. The use of cosmetics has been controversial throughout history. The fourth-century Greek historian Xenophon wrote about the deception cosmetics could create when evaluating the suitability of a woman for marriage. He wrote, “When I found her painted, I pointed out that she was being dishonest in attempting to deceive me about her looks as I should be were I to deceive her about my property.” This concern continued into 1770 when the British Parliament considered legislation demanding, “That women of whatever age, rank, or profession who shall seduce or betray into matrimony, by scents, paints, cosmetic washes, artificial teeth, false hair, shall incur the penalty of the law as against witchcraft, and that the marriage shall stand null and void.” (Panati, C. Extraordinary Origins of Everyday Things, Harper & Row, 1987, page 224). At present, we are seeing a resurgence of the medicinal cosmetic. The recent approval of topical prescription drugs to induce vasoconstriction thereby removing the unattractive facial redness associated with rosacea is an example. These temporary products are drugs that fulfill an important cosmetic purpose. The OTC marketplace is full of cosmetic facial foundations that contain salicylic acid to aid in the prevention and treatment of acne while camouflaging the underlying diseased skin. Indeed, we are still on the crossroads where cosmetics represent the medicine of beauty.