Six out of 10 women reported that they never go to work without cosmetics (http://hiddeninmakeup.weebly.com/statistics.html ). In fact, in 2019, 104.72 million women in the United States reported using mascara (Statista, 2019). Interestingly, the Federal Food, Drug and Cosmetic Act does not require cosmetic products and ingredients to be approved by U.S. Food and Drug Administration (FDA) before they go to market. Companies and individuals who market cosmetics have a legal responsibility for the safety of their products and ingredients. However, cosmetic eye product components can migrate to the ocular surface, destabilize the tear/lipid structure, and result in dry eye symptoms and discomfort. Preservatives in cosmetics are top offenders including benzalkonium chloride (BAK), formaldehyde, parabens, and phenoxyethanol. The FDA requires that ingredients be listed in order of greatest to least. However, ingredients less than 1% of the total volume may be listed in any order.

Impact on Contact Lenses

Cosmetics may come into contact with the eye during lens application or removal, by inadequate handwashing, after applying creams or lotions, when washing off makeup while wearing lenses, or by direct interaction such as a mascara wand hitting a lens during mascara application. According to Srinivasan et al (2015), cosmetics can adhere to the lens surface, which may reduce surface wettability. In a study by Luensmann et al (2015), some makeup removers altered lens diameter, sagittal depth, and base curve of silicone hydrogel lenses. In addition, all mascaras decreased optical performance.

A recent study investigated the effect of various cosmetics on three –3.00D power monthly replacement silicone hydrogel lenses (senofilcon C, samfilcon A, and lotrafilcon B+EOBO [polyoxyethylene-polyoxybutylene]) (Luensmann et al, 2020). In this in vitro study, each lens was individually coated with cosmetic products including three hand creams, three makeup removers (MRs), and three mascaras (MAs). Next, the lenses were soaked in phosphate-buffered saline for one hour. The lens diameter, sagittal depth, base curve, power, and optical quality were assessed. Each lens was exposed to a single product at a time, and each lens/cosmetic combination was reproduced six times.

Statistically significant changes were found for lens diameter, base curve, and power. For lens diameters, makeup removers (MR2 and MR3) had the largest impact, with an increase of up to 0.26mm for senofilcon C (MR2) and up to 0.35mm for samfilcon A (MR3). However, lotrafilcon B+EOBO demonstrated a decrease of 0.01mm. All lenses demonstrated increases in sagittal depth after mascara exposure, particularly with MA1, which exhibited the greatest impact; this was followed by MR2 and MR3. MR2 and MR3 also caused increases in base curve for both senofilcon C (up to 0.36mm) and samfilcon A (up to 0.35mm); lotrafilcon B+EOBO was not affected. In general, lens power changes were minor (< 0.25D). The exception was senofilcon C, which demonstrated a significant change of more than 1.00D more minus (–1.18D ± 0.65D) after MA1 exposure. The image quality was most affected by MAs, and all lens types were similarly adversely affected. Hand creams did not affect lens parameters.

Makeup removers and mascaras can alter lens parameters to differing degrees and may affect the fit and overall lens performance. If patients present with contact lens discomfort and/or ocular dryness, it may be helpful to inquire about their product regimen. Have patients bring in all products to verify that the ingredients are non-toxic. If patients are heavy makeup users, consider prescribing daily disposables (if parameters allow). When patients inquire about which products to use, it is beneficial to have specific recommendations of eye and facial products for use with lenses. CLS

For references, please visit www.clspectrum.com/references and click on document #296.