Dr. Jason Rubin is the founding physician and medical director of Belli Skin Care. After graduating from St. Louis University School of Medicine in 1997, Dr. Rubin completed an internship in Internal Medicine and residency in Family Practice. In 2002, he and his wife developed the Belli Pregnancy collection using an exclusive teratology screening process, which culls millions of published medical studies to weed out ingredients linked to birth defects. Today a board-certified family practitioner and member of the Teratology Society, Dr. Rubin oversees the formulation and safety screening of Belli's products.
As a trained expert in the unique needs of motherhood, Dr. Rubin writes a series of educational articles to enlighten women about caring for their own skin and that of their babies. Working with Belli Skin Care has given Dr. Rubin a deeper understanding of the efficacy claims and health hazards of modern cosmetics. The doctor sat down with TIA to discuss the risks of certain cosmetic ingredients both during and after pregnancy.
What are the risks associated with using unsafe topical products on children or pregnant women?
With any topical product, there is a risk that small amounts of the ingredients will be absorbed into the bloodstream. During pregnancy, the chemicals circulate through the mother’s bloodstream and pass into the fetal circulation. It is during this stage of early brain and organ development that women should avoid exposures to chemicals with links to birth defects. The Belli Pregnancy collection uses a teratology screening process to review the published medical literature and guard against harmful or questionable ingredients.
In children, the major organ systems are already fully developed but the reproductive system continues to mature all the way through puberty. To prevent risk of harm, children should avoid exposures to chemicals which mimic the hormonal effects of estrogen.
How can estrogenic hormones be avoided in skincare products?
Published studies suggest that estrogenic chemicals should be avoided while the reproductive system is still maturing, which includes newborns, children, and prepubescent teens. There’s no evidence that they are problematic in adults or pregnant women.
The only way to avoid estrogenic chemicals is to scan the ingredient lists for known xenoestrogens such as methylparaben, ethylparaben, propylparaben, butylparaben, most of the invisible sunscreens (benzophenone, octyl-methoxycinnamate, PABA), phthalates, and BPA (also known as bisphenol, a type of plastic used in packaging). Or, you can look for a skin care line that specifically excludes all xenoestrogens, such as the Belli Baby collection.
Are there separate risks for nursing mothers?
It is possible that some of the estrogenic chemicals absorbed by the mother’s skin could reach her baby through the breast milk, but the risk is likely to be low. Some chemicals are not secreted into the breast milk at all. Others are broken apart by digestive enzymes in the baby’s stomach. Still, we think it is prudent to avoid ingredients linked to problems during breastfeeding, so we screen all our ingredients through the National Library of Medicine’s Lact-Med database.
What are some ingredients that are typically safe in proper concentrations, but might be dangerous for pregnant women? Their dangers?
After reviewing the published medical literature, we found that roughly one in five common skin care ingredients had remote links to birth defects in published medical studies. Some examples include:
Salicylic acid, a beta-hydroxacid found in many acne products, is linked to higher rates of fetal malformation and fetal death in animal studies. [Cekanova E, Larsson KS, Orck E, Aberg G: Interactions between salicylic acid and pyridyl-3-methanol: Anti-inflammatory and teratogenic effects. Acta Pharmacol Toxicol 35(2):107-118, 1974. Nelson BK, Synder DL, Shaw PB: Developmental toxicity interactions of salicylic acid and radiofrequency radiation or 2-methoxyethanol in rats. Reprod Toxicol 13(2): 137-145, 1999.]
Oxybenzone, a chemical sunscreen ingredient, is linked to reduced numbers of live births in animal studies. [Gulati DK, Mounce R, Chapin RE, Heindel J: Final report on the reproductive toxicity of 2-hydroxy-4-methoxybenzophenone (CAS no. 131-57-7) in CD-1-Swiss mice. NTIS (National Technical Information Service) Report/PB91-158477, 1990.]
Glycolic acid, a chemical exfoliant commonly found in facial peels, is linked in animal studies to increased rates of vertebral and rib malformations, decreased fetal weight, and other skeletal malformations. [Carney EW, Freshour NL, Dittenber DA< Dryzga MD: Ethylene glycol developmental toxicity: unraveling the roles of glycolic acid and metabolic acidosis. Toxicol Sci 50: 117-126, 1999. Fiume MZ: Final report on the safety assessment of glycolic acid, ammonium, calcium, potassium, and sodium glycolates, methyl, ethyl, propyl, and butyl glycolates, and lactic acid, ammonium, calcium, potassium, sodium, and tea-lactates, methyl, ethyl, isopropyl, and butyl lactates, and lauryl, myristyl, and cetyl lactates. Int J Toxicol 17 (Suppl): 1-241, 1998. Munley SM, Kennedy GL, Hurtt ME: Developmental toxicity study of glycolic acid in rats. Drug Chem Toxicol 22(4): 569-582, 1999.]
Benzoyl peroxide, a common ingredient in many over-the-counter acne remedies, is linked to abnormal reproductive system formation in human studies. [Song S, Kim SH, Bae H: Combined Repeated Dose and Reproductive/Developmental Toxicities of Benzoyl Peroxide. Journal of Toxicology and Public Health: 123-31, 2003.]
Do any organic ingredients tend to trigger adverse effects during pregnancy?
Organic ingredients are free of pesticides, but people often don’t realize that the natural ingredients themselves may be harmful. During pregnancy, we recommend avoiding many natural, organically grown ingredients because of links to birth defects. Some examples include:
Aloe vera, an organic botanical ingredient known for its wound healing and anti-irritant effects, is linked to increased frequencies of embryonic death and skeletal anomalies in animal studies. [Nath D, Sethi N, Skingh RK, Jain AK: Commonly used abortifacient plants with special reference to their teratologic effect in rats. J Ethnopharmacol 36: 147-154, 1992.]
Rosemary, an organic herbal ingredient known for its anti-oxidant effect, is linked to increased fetal death in animal studies. [Nusier MK, Bataineh HN, Daradkah HM: Adverse effects of rosemary (Rosmarinus officinalis L.) on reproductive function in adult male rats. Exp Biol Med (Maywood) 232(6):809-813, 2007.]
What are your thoughts on products touting nanotechnology?
Nanoparticles offer interesting benefits to several types of skin care products, but their extremely small size also increases the potential for absorption into live cells. Until their safety has been studied more carefully, we choose to avoid using them in our products.
For more information, check out Part Two of our Interview with Dr. Rubin.