The primary lesion of acne is comedone which is caused by obstruction of the infundibulum of the hair follicles and increased secretion of sebum, and an increase of Cutibacterium acnes (C. acnes) within the comedones and following inflammation cause reddish papules, pustules, and cysts. Adapalene, benzoyl peroxide (BPO) and oral/topical antibiotics are strongly recommended in the Japanese guidelines for the treatment of acne. Adapalene mainly works on comedones, BPO works on comedones and C. acnes, and antibiotics work on C. acnes and inflammations. In the Japanese guidelines for the treatment of acne, combination therapies with adapalene, BPO and antibiotics are strongly recommended.

Skin care is also important to prevent and reduce acne eruptions. The role of cosmetics in acne care is 1) to reduce eruptions by skin care products, 2) to reduce the side effects of topical comedonal treatments with adapalene and BPO, 3) to improve quality of life by camouflage the eruption using make-up products. Using non-comedogenic cosmetics and adequate face wash with soap are also important for acne prone skin.

Since acne is a common disease, we should recommend the best treatment and skin care based on evidence.

It is difficult to treat the facial symptoms of adult patients with atopic dermatitis, and both patients and dermatologists tend to think that cosmetic behavior aggravates the skin symptoms. However, daily life without makeup sometimes deteriorates the patient’s quality of life. From the experience of treating many patients with atopic dermatitis, we believe that basic makeup for moisturizing and light shielding to protect from the outside air is rather useful for stabilizing skin symptoms and deserves treatment. If it is suspected that cosmetics are an aggravating factor, a dermatologist should guide the selection of appropriate cosmetics without irritation by performing a patch test.

With the spread of nail art, the number of people who enjoy dressing up their nails daily with nail cosmetics such as gel nail polish is increasing. However, the popularity of nail art has led to an increase in the number of patients with allergic contact dermatitis due to the acrylic resin in nail cosmetics. Acrylic resins are known to cause occupational allergies in nail artists, dental technicians, printers and fiberglass workers. Allergic contact dermatitis also occurs when unpolymerized acrylic resin adheres to the skin during gel nail or nail tip application. A typical clinical symptom of allergic contact dermatitis caused by nail cosmetics, such as gel nails, is dermatitis around the nail and finger pads, presenting as intense itching and burning in the finger. Acrylic resin might also cause airborne contact dermatitis on the patient’s face and neck. There have also been reports of cases in which gingivitis was induced by dental treatment involving the use of acrylic resin.

We performed patch tests to identify the causative agent for allergic contact dermatitis induced by acrylic resin. The most frequent allergen was found to be 2-hydroxyethyl methacrylate. Although acrylic resins are strong sensitizers, allergies can be avoided by their proper and safe use.

Makeup products, body care products and fragrance can cause skin disorders such as contact dermatitis. To identify the cause, patch testing is most useful. Based on results of the test, we can advise patients to avoid the causative products and provide daily life guidance.

Here, we will provide 6 cases of contact dermatitis to makeup products, body care products and fragrance.

Case 1: Allergic contact dermatitis due to the ethylhexyl methoxycinnamate of sunscreen base.

Case 2: Allergic contact dermatitis due to the diisostearyl malate of lipstick.

Case 3: Semiopen patch test was positive for mascara and mascara remover, but the patch testing of the ingredients could not be performed.

Case 4: Allergic contact dermatiits due to the cetanol of the hand cream.

Case 5: Irritant contact dermatitis due to the body soap.

Case 6: Photoallergic contact dermatitis due to the perfume.

Skin disorders caused by skin care products and cleansers, especially allergic contact dermatitis, are described from 2 cases, interviews, symptoms, examination, diagnosis, and daily life guidance until the identification of the causative agent.

A detailed medical interview is necessary in order to perform an accurate examination, identify the causative allergen, make a diagnosis, and provide daily life guidance. If allergic contact dermatitis caused by skin care products or detergents is suspected from the interview, a skin test is performed to identify the causative allergen. Daily life guidance is to provide information on avoidance of causative allergens, methods of confirming causative allergens, and alternatives. Prevention of recurrence is of utmost importance.

Case 1 was diagnosed as allergic contact dermatitis due to beeswax, methylisothiazolinone, propynyl butylcarbamate iodide, and perfume during cleanser. Case 2 was diagnosed as paraben-induced allergic contact dermatitis.

Allergic contact dermatitis from products used on the scalp causes symptoms not only on the scalp, but also on the face, neck, and back. Some products, such as oxidative hair dye, produce a generalized contact dermatitis syndrome. It is difficult for dermatologists to recognize that dermatitis on the face is allergic contact dermatitis caused by products used on the head. The continued treatment with topical tacrolimus ointment or topical steroids, without excluding the causes of the exacerbation, may lead to the development of additional skin diseases such as rosacea-like dermatitis. There are also cases of delayed allergic contact dermatitis caused by oxidative hair dye, which may lead to anaphylactic symptoms after repeated exposure. It is extremely important to diagnose allergic contact dermatitis before it becomes severe and to eliminate allergens from the patient’s life.

Patch testing is most useful in finding the cause. Even if the patch test is positive for a product, if the causative allergen cannot be determined, there remains the possibility that symptoms will not improve even if the patient changes the products they use. In addition, patch testing with the product may give false-negative results, so it is advisable to patch test the allergen at the same time along with the product. Japanese baseline series and cosmetics-related allergens are applied, but it is difficult to obtain cosmetics-related patch test allergens in Japan. Even commercially available allergens may give false-negative results depending on the reagent. It would be more diagnostic if raw materials could be provided by the manufacturer of the product that tested positive in the patch test.

In this paper, we will provide specific examples of cases of contact dermatitis caused by products used on the scalp and describe the problems involved in diagnosing allergic contact dermatitis and determining its cause.

After melanosis faciei femina, two outbreaks of severe side effects caused by cosmetics have occurred since 2009. One is an immediate wheat allergy percutaneously sensitized to hydrolyzed wheat protein contained in facial soaps (HWP-IWA) that included 0.3% of a specific type of HWP, Glupearl 19S. A total of 2,111 cases developed allergic contact urticaria, anaphylaxis, and/or wheat-dependent exercise-induced anaphylaxis (WDEIA) after using the soaps.

The other one is Rhododenol-induced leukoderma (RDL) due to a skin-whitening agent rhododendrol (Rhododenol) (RD) approved by the Ministry of Health, Labour and Welfare as a quasi-drug. A total of 19,609 individuals developed leukoderma, that is about 2.4% of those who used whitening cosmetics (cosmetics) containing 2% RD.

The author served as chairpersons of the special committee of the Japanese Society of Allergology for HWP-IWA, and of the Japanese Dermatological Association for RDL. Both committees carried out epidemiological studies, established diagnostic criteria and provided practical guidance to treat and care the patients. Both committees performed and reviewed clinical, basic, and genetic research on the pathomechanism, and provided information to the medical doctors and the patients.

In this article, HWP-IWA and RDL are reviewed from a viewpoint of a dermatologist and the chairpersons of the special committees.

Adverse effects to cosmetics are multifactorial; of these, contact dermatitis is the most common, and shows eczematous reactions such as papules, erythema, and vesicles at contact sites with the causative agent. Contact dermatitis is classified into three types: irritant contact dermatitis, allergic contact dermatitis, and photocontact dermatitis. All are initiated by the penetration of a chemical. Its epicutaneous stimulus make keratinocytes secrete cytokines, and inflammation depending on the innate immune system. Allergic contact dermatitis is a delayed-type hypersensitivity reaction mainly involving T cells and antigen-presenting dendric cells. Recent studies demonstrated that the innate immune system plays an important role for its sensitization and expression of eczema phases. Photocontact dermatitis is produced from the combination of a skin contact with a compound together with ultraviolet light. Contact urticaria patients develop localized wheal immediately after direct contact with a causative substance. It is divided into three types: immunological, non-immunological, and one with unclear mechanism. Immunological contact urticaria is a type I sensitivity immunological reaction, and this type can produce anaphylactoid reactions. The mechanism of leukoderma due to rhododendrol is thought caused by the metabolite that is a product of rhododenol bound to tyrosinase. The metabolite produces reactive oxygen species and depletes the intracellular antioxidant glutathione, which to be responsible for melanocytes death. Cosmetics occasionally lead to exacerbation of skin diseases: e.g., atopic dermatitis and acne vulgaris. In such cases, most are produced by inadequate choice of cosmetics, respectively.

Cosmetics can cause allergic contact dermatitis, irritant contact dermatitis, contact urticaria, depigmentation, and other skin disorders. The skin testing methods for allergic contact dermatitis and allergic contact urticaria are described in this paper. A 48-h closed patch test, open test, or repeated open application test (ROAT) is used to diagnose allergic contact dermatitis, which is a delayed allergy. A photopatch test is required to test photoallergic contact dermatitis. Rinse-off cosmetic products should be diluted with 1% aqueous solution and applied for 48-h closed patch test, while powder products should be mixed with approximately 30% petrolatum and applied. Hair coloring agents and permanent wave agents with irritant properties should not be subjected to closed patch test but instead undergo an open test. It is also useful to perform a ROAT to diagnose allergic contact dermatitis. On the other hand, a prick test should be performed to diagnose contact urticaria, which is an immediate allergy.

There are various types of side effects caused by cosmetics; mostly they are believed to be not serious. Further, there are not a few cases at present that it is difficult to identify which ingredients in cosmetic products caused; even it was certainly caused by cosmetics which had been used. Table 1 shows not only the actual cases which were implemented some measures by MHLW (Ministry of Health, Labour and Welfare of Japan) under the jurisdiction of Pharmaceutical Affairs Law or JCIA (Japan Cosmetic Industry Association) as a representative of cosmetic industries, taking into account the cases must be caused by cosmetics (including quasi-drugs such as medicated cosmetics), but also covers the background and history of cosmetics regulation under the Pharmaceutical Affairs Law in considering the safety of cosmetics.

In this article, simple consideration is done on Melanosis Faciei Feminea which has developed social problem that health damage is caused by cosmetics. The process in pigeonholing a part of this case is investigated from an ethologic perspective. Furthermore, a lawsuit on melanosis and simple description on Berlocq Dermatitis are mentioned.

For those who deal with cosmetics, it is recommended to know the normal structure and function of the skin to ensure safe and effective use of cosmetics and cosmetological treatments. The skin is not just a membrane that separates the human body from the outside but has various functions for maintaining homeostasis of the human body. In this paper, we have outlined the normal structure of the skin, touching on the pathological structures related to cosmetology.

The skin consists of three layers: epidermis, dermis, and subcutaneous fat. The epidermis contains four layers: horny layer, granular layer, spinous layer, and basal layer. The horny layer plays a major role of barrier function at the forefront. When the stratum corneum is deficient in intercellular lipids, horny cells become compact and their water retention function is reduced, resulting in “asteatotic eczema,” which is a very common pruritic skin lesion in elderly. With aging, elastic fibers are denatured by long-term exposure to ultraviolet rays, and cause solar elastosis resulting in deep wrinkles. As skin appendages of the dermis, there are hair follicles, sebaceous glands, and sweat glands, which are sites of androgenic alopecia, acne, hyperhidrosis, and osmidrosis, respectively, and exhibit morphological and functional changes. All pathological conditions treated cosmetologically are closely associated with changes in skin structure and function.

The aim of this lecture series is to provide basic knowledge on skin troubles induced by cosmetics, as well as usefulness of cosmetics on skin disorders. Articles of this series, described by expertized dermatologists and planned for three years, will include various aspects of skin troubles of cosmetics and use of cosmetics by subjects with troubled skin. I hope that this lecture series will be helpful, not only for cosmetic scientists, but also for clinical dermatologists.

Background: Secreted protein acidic and rich in cysteine (SPARC) regulates extracellular matrix (ECM) production, interaction of cells with ECM and growth factor-dependent cell signaling. Here we examined SPARC’s effects on production and pericellular organization of type I collagen and hyaluronan (HA) in normal human dermal fibroblasts.

Methods: Production of procollagen I and HA, and gene expression were analyzed by ELISA and quantitative real-time PCR, respectively. The pericellular deposition of mature collagen I and HA was examined by immunocytochemistry.

Results: SPARC enhanced production of procollagen I and HA in fibroblasts by up-regulating mRNA expression of COL1A1 (collagen α-1(I)) and HAS (HA synthase) 2/3, respectively. SPARC also increased the deposition of mature collagen fibrils on the cell surface of fibroblasts, accompanying the increased mRNA expression of procollagen C-proteinase (BMP1) and N-proteinase (ADAMTS2). The pericellular deposition of newly produced HA was also enhanced on the cell surface of SPARC-treated fibroblasts. Furthermore, SPARC up-regulated TGF-β1 production in fibroblasts, and SPARC-induced procollagen I and HA production was abolished by blockade of TGF-β/Smad2/3 signaling.

Conclusion: SPARC simultaneously up-regulates production of procollagen I and HA in fibroblasts by up-regulating Smad2/3-dependent TGF-β signaling, and also promotes the pericellular organization of mature collagen I fibrils and HA.

It is important for us to spend our daily lives comfortably and lively. To that end, cosmetic behavior in daily life has the power to modestly enrich and revitalize the mind as well as the skin. It is not only because it has a functional value to the skin, but also because it has an emotional or affective value that resonates the mind through the skin. Grounded in this belief, we have been studying the effects of cosmetics on the mind and the body for about 40 years. By demonstrating and quantifying these effects in a scientific manner, our aim is to lead development of ever better cosmetics and maximize the satisfaction of the user. This paper summarizes research findings on how skin care, makeup, and fragrance affect the mind and body through tactile, visual, and olfactory sensations by means of psychophysiological and affective engineering measurement techniques.

In sensitive skin such as atopic dermatitis, seborrheic dermatitis and rosacea, it is necessary to continue skin care on a daily basis, but it is also necessary to mask the disease with makeup. Looking at the yearly change in the number of annual outpatients in our department, it can be seen that the number of female patients in their 40s is increasing. I think that the number of medical examinations is increasing at her age when makeup is required. I think that the instruction of their face washing is most important for sensitive skin with reduced barrier function. Patients with seborrheic dermatitis may also have sensitive skin, so is easy to get irritant contact dermatitis due to her constitution. Patients with rosacea and rosacea-like dermatitis have almost same sensitive skin condition. Rosacea-like dermatitis is caused by topical ointments, so discontinuation of topical therapy is the most effective treatment. Internal diseases such as liver or kidney disorders and visceral cancer often impair the health of the skin. Even if you think that it is healthy skin, the skin may become fragile due to menopause, aging and changes over time, and skin damage due to makeup may occur. Participation in society is required even if you have a disease, but being able to do so also leads to a desire to live. Makeup should be useful as a means to hide aging and pathological conditions of mind and body because it makes it easier to participate in society. Specialists need to be able to identify sensitive skin and provide proper makeup instruction.

Methods for treating bruises, vitiligo, and scars are improving year by year, but they often take a long time to work and are not always effective. In those cases, the use of cover makeup can improve the patient’s QOL (quality of life). While cover makeup cannot treat the issue itself, it causes no discomfort and can boost users’ confidence with its high coverage. It can also be used whenever and wherever. Early versions of cover makeup had a thick, powdery finish, but advances in powder and emulsification technology have led to the development of foundations that can sustain a natural finish over a long time. Patients can easily apply cover makeup at home if they learn techniques from a professional beauty consultant. This paper briefly covers the history of cover makeup in Japan, the latest types and features of foundation, and techniques for different kinds of cases.

Skin problems caused by cosmetics include not only irritant and allergic contact dermatitis, but also leukoderma caused by application of active brightening materials and immediate type wheat allergy due to hydrolyzed wheat protein. These skin problems have characteristic clinical symptoms and causative components and require specific testing methods. This article describes the skin problems caused by cosmetics for each site where symptoms are induced. On the scalp and face, allergic contact dermatitis is induced by ingredients present in cosmetics and daily hygiene products and hair coloring agents, especially preservatives such as isothiazolinones. Allergic contact dermatitis on the face also occurs due to chemicals used in eyelash extensions and components in lipstick. In Japan, the number of cases of leukoderma caused by ingredients contained in whitening cosmetics has rapidly increased and has become a social problem. Skin problems caused by cosmetics involve not only delayed allergic reactions but also immediate type reactions. After sensitization of the skin to the protein component contained in cosmetics, ingestion of foods containing the protein induces immediate type allergy. We have already experienced about the case of anaphylactic shock induced in immediate type allergy by hydrolyzed wheat protein or cochineal. The most useful test for identifying allergic contact dermatitis is the patch test. Repeated open application test (ROAT) using the cosmetic product is also a useful skin test. Additionally, the skin prick test is performed for immediate allergy. The Skin Safety Case Information Network (SSCI-Net) was established to quickly collect cases of contact dermatitis caused by cosmetics and daily use products, and to share the information with organizations such as cosmetic companies, relevant government agencies, and academia. It is hoped that skin troubles caused by cosmetics will be minimized through the efforts of the SSCI-Net.

Life expectancy has increased significantly. It was 50.06 and 53.96 years in 1947, and 79.64 and 86.39 years in 2010 for male and female respectively. Birth rate per 1,000 population showed a decrease from 39.3 in 1945 to 7.6 in 2017. An aging society is progressing rapidly in Japan. Baby boomers have become older than 65, and their health anxiety, prevention of skin aging and skin diseases, has become major matter for health care world.

One of the biggest factors of skin-aging is ultraviolet rays. Since it is not necessarily aging due to biological time, the word “photoaging” is established. Photoaging include not only cosmetic problems like wrinkles and freckles, but also skin cancers like actinic keratosis. To prevent photo-aging, sunscreen is the most convenient and reliable method. In addition to the photo-aging skin condition and skin diseases, there are many skin diseases which are common in elderly people or are associated with internal diseases. For bedridden old people, bedsore is the largest problem.

Cosmetics can prevent many skin diseases and help treatments, although they cannot treat by themselves. They have many possibilities of cosmetics in elderly society.

The skin concentration of topically applied cosmetic active ingredients is very important for evaluating cosmetics. However, a large variation is often observed in finite dose experiments due to the evaporation of volatile components in the formulation and difficulties for applying formulation uniformly. In addition, steady-state skin concentration could not be attained even after several hours of application. In this verification report, we conducted in vitro skin permeation experiment with an infinite dose to confirm whether formulation with the highest skin permeation would also show the highest skin concentration. Three formulations, lotion, milk, and cream, and the mixture of these formulations containing isopropyl methyl phenol (IPMP) as a model ingredient were applied to excised human skin in eight research facilities. The present experiment was conducted with receptor solution containing 1.0% of Brij 98 in order to increase solubility of IPMP in the receptor fluid without changing skin integrity. The obtained results were consistent among the facilities in the following order of skin permeation (lotion>milk>cream≅the mixture) and corresponded with that of the skin concentration. This result showed that evaluation of topical formulations with in vitro skin permeation experiment with an infinite dose could identify the formulation which exhibited the highest steady-state skin concentration of cosmetic active ingredients. In addition, experiment with mixture formulation might reveal changes in skin permeability associated with changes in thermodynamic activity of IPMP after co-application of several formulations on the skin.

The skin concentration of topically applied cosmetic active ingredients is very important for evaluating cosmetics. However, a large variation is often observed in finite dose experiments due to the evaporation of volatile components in the formulation and difficulty in applying the formulations uniformly. In addition, steady-state skin concentration could not be attained even after several hours of application. In our previous report, three formulations, lotion, milk, and cream, and the mixture of these formulations containing isopropyl methyl phenol (IPMP) as a model ingredient were applied to excised human skin with infinite dose (ten to one hundred higher application dose against actual amount of application of personal cosmetic products) in eight research facilities. As the result, the formulation with the highest skin permeation also showed the highest skin concentration. In the present study, the same experiment with the previous report was conducted using a hydrophilic compound, caffeine (CAF). The skin permeation of CAF increased with a decrease in skin electrical resistivity, whereas no relationship was observed in IPMP. Since a large variation of skin permeation of CAF was observed in low skin resistance (<10 kΩcm²), the skin having larger than 10 kΩcm² skin resistance was used in three facilities in the additional test. The obtained results were consistent among the facilities in the following order of skin permeation (lotion>milk) and corresponded with that of the skin concentration. These results suggest that skin resistance should be considered when a hydrophilic compound is applied in in vitro skin permeation test. In addition, the present and the previous results show that topical formulations with in vitro skin permeation experiment with an infinite dose could identify the formulation which exhibited the highest steady-state skin concentration of cosmetic active ingredients.