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After working in an ophthalmology office handling post-cataract and refractive surgery patients, Dr. Leslie O’Dell became interested in dry eye disease. A dry eye sufferer herself, she often found it challenging to ensure that patients were able to see well after these procedures and also remain comfortable. At that time, there was not much known about dry eye disease, and Dr. O’Dell has since shaped her career around this difficult-to-treat condition.
Early on, she began educating herself about the effects of makeup on the eyes, because this was an important topic to her and many of the women she saw suffering. Wasn’t there a way to both wear makeup and be comfortable? Her efforts in this area are seen in her work with Dry Eye Diva, a movement which has taken a deep dive into makeup ingredients, the research in dry eye disease, and has the ultimate goal of better educating dry eye sufferers about the cosmetics and other body care items that may be causing harm.
Unfortunately, the FDA does not properly regulate cosmetic ingredients in the US, so it’s important to be aware (both as a doctor and a patient) of which chemicals to avoid.
In the US, there are only 11 chemicals that have been banned in cosmetic products. In the EU, that number tops 1300. The following list continues to be researched and is constantly being added to, but it’s a great start in determining whether or not your makeup is a problem.
Often in makeup removers and lotions, alcohol can be very drying for the eyes.
This is a scary chemical, and it’s one that beauty counters will be very happy to share with you. It’s often available in under eye creams and concealers. While it does an amazing job at removing fine lines and undereye bags in the short term, this is a neurotoxin that needs to be avoided.
This is a common preservative that dry eye sufferers are told to avoid in eye drops, but it can also be used in makeup in much higher quantities. It can contribute to keratitis as well as destruction of meibomian glands, and it may even be present in eye makeup removers that claim to be “for sensitive eyes”.
This is a preservative (most commonly used in embalming fluid), and there is some research that shows that this can be destructive to meibomian glands. It can also lead to hair loss (think eyelash dropout). This chemical also goes by other names, such as Quaternium-15, which was present in baby shampoo at one point.
Prostaglandin analogs are most commonly used in glaucoma medications but have recently been used in eyelash growth serums. This chemical is a synthetic prostaglandin, which is proinflammatory and horrible for dry eye disease. Common symptoms are red eyes and eyelids, pigment changes which add to dark circles around your eyes, and a decrease in fat around the eyes (which causes a permanent hollowed-out look to the eyes). Destruction of the meibomian glands is also possible with this chemical.
Another quick note on lash growth serums and even eyelash extensions is that our bodies were designed to work perfectly. When you disrupt the natural lid to lash ratio, by lengthening your lashes, this decreases their ability to deflect wind, debris, and allergens. This creates a wind tunnel effect and can increase your risk of ocular allergies and dry eye.
There is a ton of research on parabens, which are one of many carcinogens. They’re also hormone disruptors and neurotoxins, and they change the way your body functions.
Another preservative, phenoxyethanol is often put in place of parabens, but there is concern for this chemical harming the meibomian glands.
The topical form of vitamin A, this is best known as the anti-ager because it’s often used for wrinkles and crow’s feet. However, putting this by your eyes can be harmful to the glands of the eyelids. Once they’re atrophied, there is not much that can be done.
This is typically in face wash, and it allows the soap to suds up. Even those who don’t wear makeup should be vigilant about looking for this ingredient in their face washes, body care, and other household items (like toothpaste and floor cleaner).
High doses of Vitamin A can be devastating to the meibomian glands.
When using eyeliner on the waterline of your eyelids, you are greatly affecting the meibomian glands. It is strongly recommended to avoid waterlining your eyelids because you are constantly covering up your meibomian gland openings with chemicals, including neurotoxins, waxes, and perfumes. By avoiding makeup application in this way, you can more easily decrease symptoms. In addition to this, choose eyeliner that contains ingredients known to be healthier for the eyes. For example, the new eyeliner from Eyes Are The Story is a great choice.
It is essential to thoroughly remove your makeup every single night. So many women simply forget this important step or wait until the morning to do it. This is a mistake because you’re exposing your ocular surface to chemicals and excess bacteria for longer periods than necessary.
This is a big trend, and eyelash extensions come in many forms. However, this alters the lid/lash ratio and when the lashes are longer, you’re at a greater risk of dry eye issues. In addition to this, you can easily have sensitivities to formaldehyde-laden adhesives. Blepharitis is also very common in these patients, but can be avoided with a hypochlorous acid cleanser.
This procedure is often used by athletes such as surfers or swimmers, but permanent eyeliner contains pigment which can shut down the meibomian glands and cause evaporative dry eye.
Tinting or perming your eyelashes are procedures also becoming more common, and these make use of tons of chemicals in the process. Avoid these!
Try to avoid glitter or sparkle in your eyeshadows, and instead choose a cream-based eyeshadow. Glitter is made from rocks ground into powder, which could get into your eyes and cause abrasions.
Both over-the-counter and prescription, eyelash growth serums are to be avoided. Prostaglandins increase inflammation, which includes redness and pigment changes.
This should go without saying, but you don’t want other people’s bacteria around your eyes.
Waterproof makeup contains more chemicals that could be irritating to your eyes - the main offender is pine tar! You don’t want this around your eyes, so it’s best to avoid waterproof eyeliners and mascara.
There are quite a few things we’ve already mentioned above, but here are just a few tips for successfully wearing eye makeup when you have dry, sensitive eyes. First of all, sharpen your eyeliner pencils with each use to remove the outer shell. This will provide a clean pencil each time.
Replace your moist cosmetics monthly, including concealers, mascara, and eyeliner (among others). In addition to this, make sure to replace all makeup whenever you’re sick, have conjunctivitis, or have an eye infection. Thoroughly remove all makeup nightly, and be careful what you use. Removing makeup with soap and water can cause more eyelash dropout, so use a safe cleanser such as an oil-based one with minimal ingredients.
Lastly, regularly clean your makeup brushes. If you’re consistently using them and never wash them, they can become contaminated very easily. You can simply wash them with a mild soap and water, or spray them with hypochlorous acid, and then let them dry completely before using.
Below you’ll find Dr. O’Dell’s recommendations for safer makeup brands. Many of these companies are helping to bring to light how antiquated the current FDA laws are, which is fantastic. Other resources you can use if you’re unsure about a chemical is the Think Dirty App and the EWG Skin Deep website.
Keep in mind that it’s still important to read labels on every cosmetic you purchase. Although the companies below are following European standards and labeling for sensitive eyes, this only ensures that there is science behind their makeup and the ocular surface. Just because something is organic and natural doesn’t mean it’s completely eye friendly, so follow the recommendations above when looking at your cosmetics.
ÈyesAreTheStory.com is a great resource for clinically-tested formulas that were created through the lens of your eyes. This company has blacklisted toxic ingredients found in mainstream cosmetics and skincare. They not only embrace the safe beauty movement, but they're leading a new conversation about optimal eye protection and endocrine health, informed by a science-based platform. We love them because they develop highly effective products to bring out your boldest beauty without asking you to pay the ultimate price: your health. Click here to check out their mascara.
We believe that the best eye makeup remover is a natural one, but it also needs to be effective in removing stubborn makeup. Because oil dissolves oil, an oil-based cleanser is often the best option. Click here to check out our recommendation.
ÈyesAreTheStory.com also has a nice, bold eyeliner available with the same clean ingredients in mind. Click here to learn more about their eyeliner.
Pharmaca, also found at Whole Foods
Leslie is in the midst of opening a Medical Optometry Clinic in South Central PA. After completing a hospital based residency at the Baltimore VA hospital earlier in her career, she began working with an ophthalmologist, focused on complex ocular diseases such as glaucoma. In this surgical setting in the early 2000’s, much was being learned about the effects of ocular surgery on the eye’s delicate tear film and ocular surface. Managing dry eye disease became Leslie’s focus.
With organizations like TFOS, she was able to surround herself with like-minded people to spark her passion and foster collaboration. In 2015, she began working with the TFOS Dews ii initiative, a global effort to improve the understanding of dry eye disease. Leslie was 1 of 150 participants from around the globe, including 23 countries, and proudly served on the public awareness committee. She is now 1 of 8 US-based TFOS ambassadors, along with Dr. Laura Periman.
As the director of the dry eye center of Pennsylvania, her focus was on early diagnosis of dry eye disease and introducing treatments to restore tear film homeostasis in her patients as well as hope for improved comfort and returning quality of life to her patients.
As a dry eye sufferer herself, Leslie is the perfect candidate for dry eye disease — a female in her forties with a history of hypothyroid disease, having had LASIK corrective surgery over a decade prior. She also has a ‘healthy’ obsession with beauty products and trends that she shares with many of her college girlfriends, many of whom are the new wave of soccer-moms-who-sell-makeup. The search for the best under eye concealer or mascara to help hide the “tired mommy” look was originally based on performance of the cosmetics. However, as Leslie developed a better understanding of the regulations in the US on cosmetics, the focus shifted to cosmetics performance and safety, not an easy feat.
As a mother of two, Anna (11) and William (9), nutrition and balanced diets have been a staple in her house. Teaching her children to read food labels and understand daily allowances for grams of sugar will help them make better food choices. Hence, reading labels for cosmetics much like food labels has also become Leslie's new normal, to protect herself, her family and the patients she serves. This will take time to pass on to her children as many of the ingredients are barely pronounceable. These frankenchemicals pose many health and ocular risks. Educating her peers to the potential harms in the cosmetics consumers are using has been rewarding.
