SKIN REACTIONS TO COSMETIC PREPARATIONS 5 purchases to enhance her beauty should have done this to her! For, no woman ever admits to buying "cheap" cosmetics, if indeed, any such exist. In high dudgeon she will change her brand ehminating what she conceives to be the offending article. If her skin then ceases to irritate for that or any other conceivable reason, the suspicions are confirmed and she will abuse the brand for ever more. If her skin does not clear or gets worse, she may well contact their local agent and she may then receive advice from some consultant the firm retains. Thus most of these cases go to a few con- suitants, mainly those in the West End of London. The few remaining cases will reach many dermatologists scattered throughout the country and a proportion will be found to be constitutional dermatoses or dermatitis due to irritants other than cosmetics, so each specialist sees very few cases genuinely due to cosmetics. It might be expected that those whose skins were blemished or otherwise abnormal would be the greatest consumers of cosmetics. The picture is, however, complicated by the relentless pressure of advertising. Every female to be "with it" must use one or more of these preparations devoted to the improvement of appearance, preferably as many as time and money will permit. Some manufacturers thus tend to cater for the mass consumer with an average indifferent skin. What then of the difficult skins which vary from the normal, without being diseased ? These may be classified as the dry, the greasy and the wet. Normal skin is maintained by nature's skin cream compounded of sebum or grease, sweat and epithelial debris. Any constitutional variation in the supply of these ingredients upsets the formation and efficiency of the cream, and renders the skin difficult or abnormal. The cream contains fatty acids, the "acid mantle" of the skin which protects against infection. Thus there is the simple dry skin which will not tolerate cold weather, wool, soaps (especially strong, medicinal soaps), detergents and degreasing agents. Then the atopic, dry, irritable skin, as above but usually fair, whose owner carries the trait or potentiality of producing eczema, asthma, and hay fever linked with a sensitive, difficult, irritable personality. The dry skin is always worse in cold, dry weather owing to extensive drying and also in conditions which increase sweating, e.g., in hot humid weather or impermeable clothing such as rubber gloves. It is improved under dry conditions by a film of oil, such as is supplied by face and hand creams, lipsticks, and in wet conditions by the addition of the oil in hand creams, to balance the excessive moisture. Hand creams replenish the oil removed by soaps, detergents and degreasing agents. The atopic skin is an irritable one, intolerant alike of degreasing agents and excessive grease and easily provoked by physical, chemical or stress irritation.

6 JOURNAL OF THE SOCIETY OF COSMETIC CHEMISTS The greasy skin is intolerant of additional grease and susceptible to infection. The complexion is muddy or sallow and the pores large. Ache abounds in adolescence and ache rosacea later. Boils or fo!liculitis may appear at any time. The teenager with ache may try to disguise her dis- figuring spots with pan-cake make-up or unsuitable foundation creams which aggravate the ache by blocking the pilosebaceous orifices. They may also add infection to the usually sterile ache pustules by picking or squeezing with their finger nails. Sepsis is followed by scarring. The very selenium so commonly prescribed for greasy scalps has been shown to make matters worse by increasing the flow of sebum in some people. The flaming red face of the rosacea sufferer liberally spotted with pustules or grog blossoms, flushing more deeply under stress, the influence of hot drinks, alcohol, spring sunshine and the menopause demands our sympathy. How many cosmetics have been blamed by the. indignant sufferers for provoking this constitutional and highly irritant disorder. The red patches seem to be irritated by any cleansing routine, the application of any cosmetic disguise, and indeed reacting in a quite capricious manner to any change in the environment. Then there is the wet skin of excessive sweating, with cold fishlike hands, the wet armpit which stains the fabrics of dresses, the offensively damp feet, and the body folds running with moisture. These unfortunates are particu- larly liable to contact dermatitis, as the sweat leaches dyes from clothing or dissolves nickel or chrome from suspenders, zips, etc. if they wear dress shields they may get rubber dermatitis. Excessive sweating makes them equally liable to detergent or soap dermatitis, and intolerant of rubber gloves and nylon. Sweating lowers the pH in the affected areas particularly when it cannot escape, as in folds, under impermeable clothing, etc., bacterial or fungus infection may supervene. Attempts to block the sweat ducts by antiperspirant lotions or powders may produce blister formation. Removal of axillary hair to prevent re- tention, and decomposition of the sweat, may provoke mechardcal or chemical irritation and infection. Here we might pause to consider the difficult skin which may become impossible, and the place of the imagination in such a change. At its worst, the difficult skin will react to all manner of things one day, and yet seem to be soothed by these very things the next. Here is no true allergy but merely a personal, temporary intolerance which may easily lead to unworthy suspicions of a harmless cosmetic. I recently saw one such lady who could neither wear rubber g!oves nor use soap and detergents. She could not tolerate wool or nylon clothing or any form of cosmetics, and when I had reached the stage of being sorry