SKIN REACTIONS TO COSMETIC PREPARATIONS 21 deposition of metallic silver after long continued applications of silver pre- parations, e.g. eye drops. Mercury may produce a similar pigmentation in photographic workers. Arsenic produces dappled pigmentation of the shoulders, and keratoses of the palms. Other pigment-producing substances are: Iron, copper, bismuth, lead, gold, quinacrine and mepacrine. Coal tar dyes in face powders have caused orange pigmentation of the face. (5) Vitiligo. A common disorder of unknown origin in which there are depigmentated patches surrounded by hyperpigmented areas. When the exposed parts are affected, the contrasting colours produce a very distressing cosmetic defect which is aggravated by exposure to sunlight. Coloured races are even more affected than the white races. (6) Perfume. Pigmentation may result from the use of any perfumed cosmetic prepara- tion. Hodgson (26) gives the following "scent" content: Perfumes 20% eau de Cologne 5% cologne sticks 2.5% sachet creams 1-10% general cosmetics 0-5% soaps 0.2-2ø/0 sun screens, shampoos and deodorants 0.25ø/0 baby preparations 0.1-2.5ø/o . Localized pigmentation (Berlocque dermatitis) Appears in patches and streaks, usually on the face and neck. The perfumed lotion runs down in pendant form from the original site of application. Diffuse pigmentation Usually of the face and neck, sometimes of forearms and hands due to face creams, hand creams, shaving creams and lotions. Massage of the face with such creams increases the pigmentation. This resembles the chloasma seen in pregnancy. Reticular pigmentation Faint mottled pigmentation of the cheeks and neck similar to that seen in Rhiels melanosis and Civattes poikiloderma has been ascribed by New- comer (27) to the use of cosmetic preparations, the only common ingredient to all being hexachlorophene which has previously been known to produce pigmentation. Newcomer could not reproduce pigmentation by the use of hexachlorophene alone. Pigmentation of the forehead May be produced by scalp preparations containing mineral oils, and is often accompanied by folliculitis.

22 JOURNAL OF THE SOCIETY OF COSMETIC CHEMISTS Tanning agents According to Mumford (28) 2-5% dihydroxyacetone in alcohol applied several times daily produces tanning in 6 to 10 hours, useful for disguising viti!igo. There is probably a combination with the basic amino groups of amino acids, melanin not being formed. Harman (29) reported severe con- tact dermatitis with a 1% solution. Melamidine, an Egyptian plant extract applied in 5% alcoholic solution, followed by cautious exposure to sunlight, produces pigmentation with melanin formation in vitiligo. The extent of pigmentation is difficult to control, and the cosmetic effect is therefore often unsatisfactory, indeed the appearance after treatment may be worse than before. Injudicious exposure to sunlight after painting can produce severe sun- burn. Some preparations claim to reduce the absorption of the U.V.R. reaction producing sunburn erythema which increases the tanning owing to pene- tration of the whole epidermis. Those include mechanical barriers such as inert powders, titanium dioxide, talc, zinc oxide, kaolin, calcium carbonate, magnesium oxide, and Psoralens. According to Stevanov[c (30) sun screens include 5-10% aesculin, 10ø/0 Salol, 5-10•o pyribenzamine, 10-15•o paminobenzoic acid, 5-10•o tannic acid in order of increasing transmission. Bleaching agents Skin irritants which produce peeling can be applied to freckles, e.g. mercurial compounds. N.B.--Mercury itself can produce a grey dis- colouration after being continually used. The monobenzyl ether of hydroquinone, originally observed to depigment the skin of negro rubber workers is used in an emulsifying ointment in 2% strength. Sensitization may result even at 5% especially in lotion form. Bleaching or discolouration of the hair may result from applications of resorcin or by the ingestion of antimalarial drugs, e.g. chloroquin and mephenesin carbamate. Spi]lane (31) reports bleaching of the hair of four women using 1.5-10 g daily of mephenesin carbamate for multiple sclerosis. The colour reappeared when the drug was withdrawn. Skin foods and hormone preparations Women constantly seek the gift of eternally young skin. In order to preserve their skins they are urged to feed them with simple emollients with added moisturizers (glycerine up to 48%), to make the skin feel less dry. Vitamin creams contain vitamin A which, in large dosage, does reduce hyperkeratosis or roughness of the epidermis. Hormone creams are sup- posed to restore plumpness and to reduce the wrinkling of an ageing skin. Fortunately, perhaps, owing to the possible systemic effects from absorption,