INTRODUCTION
“Hispanic” and “Latino” (also known as Mestizo) describe a diverse racial and ethnic group, with a range of cultures, languages, and biological ancestry. It includes individuals of Mexican, Central-to-South American, and Spanish-Caribbean (eg, Cuban, Puerto Rican, and Dominican) descent.1 Individuals of Hispanic/Latino race and ethnicity represent a heterogenous group of people with different skin tones and Fitzpatrick phototypes. Hispanic/Latinos are the fastest growing population in the United States (US) - projected to increase from 55 million in 2014 to 119 million in 2060, an increase of 115%.2 By 2060, more than one-quarter (29%) of the US is projected to be Hispanic/Latino.2
Hispanic/Latinos are also the fastest growing ethnic beauty market segment and represent the “heaviest buyers” in skincare.3,4 They spend more money ($59 vs. $35 per month), use more products (6.5 vs 5), and invest more time in their daily beauty routine (41 vs 34 minutes), compared with other demographic groups in the US.5 Despite this, a majority (69%) of older Latinos (age 50+ years) feel like an “afterthought” in the beauty industry. More than three-quarters (76%) feel underrepresented in advertising, and many do not believe skincare brands create products specifically for their age (38%) or skin tone (17%).5 The peer-reviewed literature confirms that a relative paucity of data exists on the specific aesthetic needs of Hispanic/Latino patients compared with other racial/ethnic groups.1
Exposure to toxic chemicals in skincare products, which can adversely impact health, disproportionally affects Hispanic/Latinos and other consumers with skin-of-color.3 These include phthalates, parabens, phenols, polycyclic aromatic hydrocarbons, siloxanes, formaldehyde-releasing preservatives and metals (mercury, aluminum, lead, arsenic, copper); however, disclosure requirements for cosmetics are limited and inconsistent.3 Exposure to one or more of these compounds, via dermal absorption, inhalation or ingestion, has been linked to endocrine disruption, cancer, reproductive harm and impaired neurodevelopment in children.3 The heavier use of skincare products by Hispanic/Latinos compared with other demographics could lead to disproportionally increased chemical exposure per product per day, with progressive toxic accumulation over the course of a lifetime. Indeed, Hispanic/Latino women have higher levels of endocrine-disrupting chemicals, such as phthalates and parabens, in their bodies compared to white (Caucasian) women in the US, and these racial/ethnic differences are not explained by socioeconomic factors.3 In a study of 108 Mexican women, elevated urinary phthalate levels were associated with increased use of antiaging facial cream, body lotion and other beauty products.6 Even small doses of these compounds at sensitive periods of development could trigger adverse health consequences, and Hispanic/Latino women and their offspring may be particularly vulnerable if toxic skincare products are used during preconception, pregnancy, and/or peripubertal. Three studies in Hispanic/Latino populations in California, Mexico, and Chile have reported an association between prenatal and peripubertal exposure to phthalates, parabens, and phenols with early onset of puberty in girls.7-9 Earlier age at puberty has been linked with increased risk of mental health problems and risk-taking behaviors, as well as increased risk of breast and ovarian cancer.7 However, a definitive causative link between systemic absorption of topical skincare products and endocrine-disrupting effects remains to be proven.
Hispanic/Latinos commonly use skin-lightening compounds to either treat disorders of hyperpigmentation (such as melasma and post-inflammatory hyperpigmentation) or because of a desire to lighten skin for other cosmetic reasons.3 As a result, this population is at particular risk of exposure to toxic chemicals that may be present in these products, including mercury. Mercury is a known suppressor of tyrosinase (the rate-limiting enzyme in the melanin pathway), thereby decreasing melanogenesis and pigment production. However, as it is absorbed through the skin, toxicity can occur following the use of mercury-containing skincare products. The US Food and Drug Administration (FDA) banned the use of mercury in cosmetics in 1973 and has since set a maximum allowable level of 1 ppm (part-per-million). However, skincare products containing mercury remain unregulated and available outside of the US and continue to be imported and used by Hispanic/Latinos within the US. In one study, skin-lightening creams were identified as a source of increased urinary mercury levels in foreign-born Dominican women in New York City.10 In a separate case report, elevated blood mercury levels were linked to use of face creams containing over 20,000 ppm of mercury in a pregnant Mexican American woman in California.11 Many cases of mercury poisoning,
Hispanic/Latinos are also the fastest growing ethnic beauty market segment and represent the “heaviest buyers” in skincare.3,4 They spend more money ($59 vs. $35 per month), use more products (6.5 vs 5), and invest more time in their daily beauty routine (41 vs 34 minutes), compared with other demographic groups in the US.5 Despite this, a majority (69%) of older Latinos (age 50+ years) feel like an “afterthought” in the beauty industry. More than three-quarters (76%) feel underrepresented in advertising, and many do not believe skincare brands create products specifically for their age (38%) or skin tone (17%).5 The peer-reviewed literature confirms that a relative paucity of data exists on the specific aesthetic needs of Hispanic/Latino patients compared with other racial/ethnic groups.1
Exposure to toxic chemicals in skincare products, which can adversely impact health, disproportionally affects Hispanic/Latinos and other consumers with skin-of-color.3 These include phthalates, parabens, phenols, polycyclic aromatic hydrocarbons, siloxanes, formaldehyde-releasing preservatives and metals (mercury, aluminum, lead, arsenic, copper); however, disclosure requirements for cosmetics are limited and inconsistent.3 Exposure to one or more of these compounds, via dermal absorption, inhalation or ingestion, has been linked to endocrine disruption, cancer, reproductive harm and impaired neurodevelopment in children.3 The heavier use of skincare products by Hispanic/Latinos compared with other demographics could lead to disproportionally increased chemical exposure per product per day, with progressive toxic accumulation over the course of a lifetime. Indeed, Hispanic/Latino women have higher levels of endocrine-disrupting chemicals, such as phthalates and parabens, in their bodies compared to white (Caucasian) women in the US, and these racial/ethnic differences are not explained by socioeconomic factors.3 In a study of 108 Mexican women, elevated urinary phthalate levels were associated with increased use of antiaging facial cream, body lotion and other beauty products.6 Even small doses of these compounds at sensitive periods of development could trigger adverse health consequences, and Hispanic/Latino women and their offspring may be particularly vulnerable if toxic skincare products are used during preconception, pregnancy, and/or peripubertal. Three studies in Hispanic/Latino populations in California, Mexico, and Chile have reported an association between prenatal and peripubertal exposure to phthalates, parabens, and phenols with early onset of puberty in girls.7-9 Earlier age at puberty has been linked with increased risk of mental health problems and risk-taking behaviors, as well as increased risk of breast and ovarian cancer.7 However, a definitive causative link between systemic absorption of topical skincare products and endocrine-disrupting effects remains to be proven.
Hispanic/Latinos commonly use skin-lightening compounds to either treat disorders of hyperpigmentation (such as melasma and post-inflammatory hyperpigmentation) or because of a desire to lighten skin for other cosmetic reasons.3 As a result, this population is at particular risk of exposure to toxic chemicals that may be present in these products, including mercury. Mercury is a known suppressor of tyrosinase (the rate-limiting enzyme in the melanin pathway), thereby decreasing melanogenesis and pigment production. However, as it is absorbed through the skin, toxicity can occur following the use of mercury-containing skincare products. The US Food and Drug Administration (FDA) banned the use of mercury in cosmetics in 1973 and has since set a maximum allowable level of 1 ppm (part-per-million). However, skincare products containing mercury remain unregulated and available outside of the US and continue to be imported and used by Hispanic/Latinos within the US. In one study, skin-lightening creams were identified as a source of increased urinary mercury levels in foreign-born Dominican women in New York City.10 In a separate case report, elevated blood mercury levels were linked to use of face creams containing over 20,000 ppm of mercury in a pregnant Mexican American woman in California.11 Many cases of mercury poisoning,
