Expert Perspectives
Tırnaklardaki Çizgiler Hangi Sağlık Sorunlarının İşaretçisi Olabilir?
Tırnak Çizgileri Neden Oluşur? Yatay ve Dikey Çizgilerin Anlamları Tırnaklarda görülebilen yatay ve dikey çizgiler birçok rahatsızlığın göstergesi olarak ortaya çıkabilmektedir. Yatay tırnak çizgileri akut hastalıklar, enfeksiyonlar, travmalar sonucu görülürken; dikey tırnak çizgilerinin ise yaşlanma, vitamin ve mineral eksiklikleri, kronik rahatsızlıklar sonucu görülebilmektedir [1]. El ve ayak tırnaklarının dikkatli bir şekilde incelenmesi, tırnak çizgilerinin neyin belirtisi olduğunu ve altta yatan sistemik hastalıklara dair bulgular sunabilmektedir. Özellikle, tırnaklardaki değişiklikler, vücudun genel sağlık durumu hakkında önemli ipuçları sunar ve erken dönemdeki belirtiler sayesinde doğru tedaviye yönlendirilmesine yardımcı olabilir. Tırnaklar, kalp hastalıklarından böbrek sorunlarına, tiroid bozukluklarından anemiye kadar pek çok sağlık sorununun belirtisi olabilmektedir. Beau Çizgileri (Yatay Çizgiler): Akut Hastalıklar ve Travma İlişkisi Beau çizgileri (yatay çizgiler), tırnak plağının yüzeyinde ve proksimal tırnak kıvrımının altından çıkan enine doğrusal çöküntülerdir. Bu çizgiler tırnak matrisindeki keratinositlerin mitotik aktivitelerinde meydana gelen geçici azalmadan kaynaklanmaktadır ve tırnak plağında enine olukların oluşmasına neden olmaktadır [2], [3]. Beau çizgilerinin hastalık ilişkisi, sistemik ve lokal travmalar, sitotoksik ajanlar veya metabolik olaylarla bağlantılı olarak gelişebilmektedir. Beau çizgileri, belirgin klinik bulgulara sahip tırnak distrofisi olup, genellikle başlatıcı faktör olarak travma ile ilişkilendirilmiştir. Bunun yanı sıra enfeksiyonlar, ciddi tıbbi rahatsızlıklar, ilaç yan etkileri ve otoimmün hastalıklar Beau çizgilerine neden olabilmektedir [4]. Beau çizgileri, koroner tromboz, kızamık, kabakulak, Kawasaki hastalığı, zatürre, pulmoner emboli ve böbrek yetmezliği gibi sistemik bozukluklarda tanımlanmıştır [5]. Bu çizgiler, tırnak büyümesinin geçici olarak durması sonucu oluşur ve genellikle hastalıkların şiddeti ile ilişkilidir. Akut hastalıklar sırasında, vücutta yaşanan stres ve metabolik değişiklikler, tırnak matriksinde bir duraklamaya neden olabilir. Ayrıca, kemoterapi gibi sitotoksik tedavi süreçleri, tırnakları etkileyerek Beau çizgilerinin oluşumunu tetikleyebilir. Bununla birlikte, tırnaklara uygulanan lokal travmalar veya ciddi enfeksiyonlar da bu çizgilerin gelişmesine neden olabilir [6]. Yapılan bir çalışmada, Beau çizgilerinin en yaygın nedenlerinin sırasıyla ilaçlar (%36,3) ve enfeksiyonlar (%36,9) olduğu kanıtlanmıştır. Diğer nedenler ise otoimmün olmayan sistemik hastalıklar, otoimmün sistemik hastalıklar, travma, kalıtsal hastalıklar, nörolojik veya nöromüsküler hastalıklar, onikomikoz olarak tespit edilmiştir [7]. Dikey Çizgiler: Yaşlanma, Beslenme Eksiklikleri veya Kronik Sorunlar Tırnağın proksimalinden serbest ucuna doğru uzanan çizgiler doğal yaşlanma sürecinin bir parçasıdır [8]. Lineer tırnak uzamasının yavaşlaması yaş ilerledikçe tırnağın kimyasal yapısının değişmesine bağlıdır. Bu değişikliğe bağlı olarak da dikey çizgilenmede artış görülebilmektedir [9]. Tırnaklar incelir ve matlaşırsa bu durum trakiyonişi olarak bilinmektedir. Bu durum, alopesi areata, sedef hastalığı, atopik dermatit ve liken planus gibi ilişkili durumlarla ilgili olabilmektedir [10]. B vitamini, folat ve protein açısından yetersiz beslenme sonucu da tırnaklarda dikey çizgiler görülebilmektedir. Bu dikey çizgiler tırnak yüzeyinde ince, uzun çizgiler şeklinde görülür ve tırnak sağlığını olumsuz yönde etkileyen bu çizgiler beslenme eksikliklerinin ve kronik hastalıkların belirtisi olabilmektedir. [11]. Vitamin ve Mineral Eksikliklerinin Tırnak Üzerindeki Etkileri Normal tırnak plağı belirli oranlarda çeşitli besinlerden oluşmaktadır. Bundan dolayı vitamin ve mineral eksiklikleri tırnak plağında önemli değişikliklere sebep olabilmektedir. Vücut ve kandaki besin seviyeleri ile tırnak plağındaki konsantrasyonları arasında korelasyon olduğu bilinmektedir. Vitamin ve mineral eksikliği durumunda tırnaklardaki besin konsantrasyonları düşerken aşırı alım veya toksisite durumunda tırnak konsantrasyonları yükselmektedir. Özellikle demir, kalsiyum, çinko, magnezyum gibi minerallerin, A, D, B ve C vitaminlerinin eksiklikleri tırnaklarda belirgin değişikliklere neden olabilmektedir [12]. Demir Eksikliği Anemisi ve Soluk Tırnak Yatağı Tırnak yatağının soluk görünümlü olması anemi belirtisi olarak bilinmektedir [13]. Demir eksikliği anemisinde vücuttaki oksijen taşıma kapasitesinin düşmekte ve tırnağa giden kan akışı azalmaktadır. Normal durumda pembe renkte olan tırnak yatağı demir eksikliği anemisi görüldüğünde soluk bir hale gelmektedir [13]. Ayrıca demir eksikliği anemisi sonucu oldukça kırılgan hale gelen tırnaklar, katman biçiminde ayrılabilmekte ve kabarık uzunlamasına çizgiler görülebilmektedir. Demir eksikliğinde görülen tırnak belirtileri arasında koilonişi de bulunmaktadır [15], [16]. Koilonişi aynı zamanda kaşık tırnak olarak da bilinmektedir. Tırnak plağının orta kısmının düz olup distal tırnak plağının ve lateral kenarların yukarı doğru eğrilmesini ile karakterize bir durumdur ve demir eksikliği anemisinde sıkça gözlenen bir belirtidir [17]. Biotin (B7 Vitamini) Eksikliğinde Kırılganlık ve Çizgilenme Biotin süt, yumurta, tahıl gibi gıdalarda bulunan suda çözünen bir vitamindir. Vücutta keratinin biyosentezinde görev almaktadır. Keratinositlerin bir arada durmasını sağlar. Ayrıca tırnak plağının dayanıklılığını artırır, hücre yenilenmesini uyararak tırnağın büyümesini iyileştirir ve nem kaybını azaltarak tırnak sağlığını desteklemektedir [18], [19]. Biotin eksikliğinde tırnaklarda kırılma ve çizgilenme gibi sorunlar meydana gelmektedir. Tırnaklar normalden daha kırılgan hale gelmesi, tırnak büyümesi yavaşlaması ve uzunlamasına çizgiler görülmesi vücudun biyotine ihtiyacı olduğunu göstermektedir. Bu durumda biyotin takviyesi alınması ve biyotinden zengin gıdaların tüketilmesi tırnakların güçlenmesi ve sağlıklı büyümesi açısından faydalı olacaktır [19]. Sistemik Hastalıkların Tırnaklarda Yansıması Tırnakların şeklinde, renginde ve büyüme hızında meydana gelen değişiklikler sistemik hastalıkların belirtisi olabilmektedir. Dolaşım, solunum, endokrin, renal, kas-iskelet, beslenme ve metabolik sistemlerdeki hastalıklar ile ilgili ipuçları vermektedir. Örneğin sedef hastalığı, tiroid hastalıkları ve diyabet tırnaklarda karakteristik özelliklerde değişikliklere neden olabilmektedir. Sedef hastalığında (Psorasis) tırnak yüzeyinde çukurlaşma (Pitting) görülmektedir. Tiroid hastalarında hassas hale gelen tırnakların kırılması, büyümesinin yavaşlaması gibi belirtiler görülürken diyabet hastalarında ise tırnaklarda sararma ve kalınlaşma gözlenmektedir. Tırnaklarda görülen bu değişiklikler sistemik hastalıkların teşhisinde önem kazanmakta ve hastalıklara erken aşamada tanı konmasını sağlamaktadır [20], [21]. Sedef Hastalığı (Psoriasis) ve Tırnak Pitting Belirtisi Tırnaklarda görülen sedef hastalığı hastalarda işlevsel problemlere sebep olan sosyal ve psikolojik bir sorun olarak bilinmektedir. Sistemik bir hastalık olan sedef hastalığı kozmetik bir kusur olmanın yanı sıra günlük yaşamı da etkilemektedir [22]. Yapılan bir çalışmada tırnak rahatsızlıkları arasında onikomikozdan (tırnak mantarı) sonra en sık görülen hastalık sedef hastalığı (%20) olarak belirlenmiştir [23]. Sedef hastalığının yaygın belirtileri arasında çukurlaşma (pitting), tırnak altı kalınlaşma (subungual hiperkeratoz) ve tırnak plağında gevşemeler bulunmaktadır [22]. En sık görülen belirti pitting olup hastaların %68’inin etkilemektedir. Tırnak plağındaki bu yüzeysel çöküntüler tırnak matrisinin iltihaplanması ile ilgili bir durumdur [24]. Pitting liken planus, egzama, alopesi areata gibi hastalıklarda da görülebilmektedir fakat sedef hastalığında meydana gelen çukurlar daha derindir [1]. Daha nadir ise tırnaklarda renk değişikliği ve kanamalar gibi belirtiler görülebilmektedir. Bu semptomlar başka hastalıklarda da görülebileceğinden doğru tanının konulması önem taşımaktadır. Tiroid Bozuklukları ile İlişkili Tırnak Değişimleri Hipertiroidi hastalarının %5’inde tırnak problemleri görülmektedir. Onikoliz (tırnak plağının yatağından ayrılması), tırnakların kırılgan hale gelmesi, tırnakta kahverengi lekeler gibi belirtiler gözlenmektedir [25]. Hipotiroidi hastalarında ise tırnaklarda kırılma, düzleşme, yavaş büyüme, kuruluk ve onikoreksis (uzunlamasına çıkıntılar) gözlenmektedir [26]. Hipotiroidizm sekonder gelişen vazokonstriksiyon ve metabolik hızın düşmesi sebebiyle hipotermiye neden olmaktadır. Vazokonstriksiyon oksijen ve besinin deriye geçişini azaltır ve kırılgan, yavaş büyüyen tırnaklar ortaya çıkmaktadır. Hipertiroidizmde ise vazodilatasyon görüldüğü için tırnakların hızlı büyümesi söz konusu olabilmektedir [27]. Tirotoksikoz hastalarında ise onikoliz, yumuşak ve içbükey tırnaklar gözlenmektedir [28]. Meydana gelen tırnak değişiklikleri tiroid bozukluklarının erken klinik belirtileri olabilmektedir. Dermatolojik ve Kozmetik Faktörler Tırnaklarda estetik görünüm sağlamak için yapılan işlemler, tırnak yüzeyine ve çevresine zarar verebilmektedir [29]. Tırnak bakımında yanlış kesim yapılması tırnaklarda batmalara ve enfeksiyonlara yol açabilmektedir. Kütiküllerin çıkarılması ile tırnak çevresindeki koruyucu bariyer uzaklaştırılmakta ve enfeksiyonlara açık hale gelmektedir. Tırnak kozmetik bakımında dikey çizgilerin düzeltilmesi amacıyla yapılan törpüleme işlemi tırnakların kırılmasına neden olmaktadır. Manikür gibi işlemler sonrası da tırnaklar zayıflamakta ve uzun süreli oje kullanımı sonucu da tırnağın oksijenle temasının kesilmesine, renk değişimlerine yol açabilmektedir [30], [31]. Aseton gibi çözücüler ve ojeler tırnağın yapısına zarar verdiğinden kırılmalar ve incelmeler görülebilmektedir. Uzun süreli aseton kullanımı keratin granülasyonuna sebep olabilmektedir [32]. Yanlış Oje Temizleyici Kullanımı ve Tırnak Yüzey Hasarı Oje temizleyiciler genellikle koku ve renk eklenerek elde edilen organik bir çözücülerdir [33]. Oje temizleyiciler tırnak yüzeyinde biriken reçine tabakasının çözülmesini sağlamaktadır [34]. Yaygın kullanılan ve en bilinen oje temizleyici ise asetondur. Güçlü bir çözücü olduğu için ojeyi hızla çıkarabilir ancak yanlış kullanım sonucu düşük konsantrasyonlarda dahi tahriş edebilir ve tırnakların kuru ve mat görünmesine neden olabilmektedir. Ayrıca, çok sık aralıklarla aseton kullanımı sonucu tırnak plağında keratin degranülasyonu görülebilmektedir. Bu da tırnak yüzeyinde beyaz çizgilenmelere neden olmaktadır [32]. Tırnak bakımında doğru oje temizleyici seçimi tırnak sağlığı açısından önem taşımaktadır. Olumsuz etkileri en aza indirmek için az miktarda ürün tercih edilmeli ve ürünlerin aşırı kullanımından kaçınılmalıdır. Nem Kaybı ve Lipid Bariyer Bozukluğunun Rolü Tırnakların su içeriği keratinize dokunun yapısının korunmasında önemlidir. Tırnaklarda kullanılan kozmetik ürünler keratin yapıya zarar vererek su içeriğinin azalmasıyla nem kaybına neden olmaktadır. Nem dengesinin sağlanması tırnakların sağlıklı büyümesi açısından önemlidir. Oje temizleyiciler tırnağın doğal nem dengesini bozarak tırnakların incelmesine ve kırılmasına yol açmaktadır [35]. Ayrıca kullanılan kozmetik ürünler lipit bariyer bozukluğuna da sebep olmaktadır. Aseton kullanımı lipid bariyerine zarar vermektedir. Tırnaklarda yumuşama, kırılma ve tırnakların katmanlı yapısında boşluklar gözlenmektedir. Tırnak sağlığı için nemlendirici ve besleyici ürünlerin kullanımı ile meydana gelecek olumsuz durumların önüne geçilebilir [36]. Tırnak Sağlığını Korumak İçin Öneriler Tırnakların sağlıklı görünmesi ve kırılmaların önüne geçebilmek adına bazı önlemler almak gerekmektedir. İşte tırnak sağlığını korumak için öneriler: Tırnakları kısa tutun: Düzenli bir şekilde tırnakların kesilmesi kırılmaların ve travmaların önüne geçecektir. Tırnakları temiz ve kuru tutmaya özen gösterin: Temiz tırnaklar bakterilerin ve mantarların tırnaklarda üremesini engeller. Cilt-tırnak bütünlüğünü koruyacak SLS içermeyen tırnak temizleyici ürünler tercih edilmelidir. Uzun süre suya maruziyet sonucu tırnaklar çatlayabilir. Maruziyeti azaltmak için eldiven tercih edebilirsiniz. Nemlendirici ve besleyici ürünleri bakım rutininize ekleyin: Tırnakların nemli olması hasara ve çatlamalara karşı tırnağı koruyacaktır. Kimyasal ürünlerden kaçının: Kimyasal içerikli temizlik malzemeleri, tırnakların yapısına zarar verir. Aseton içeren oje temizleyiciler, tırnakların nem dengesini bozarak zayıflamalarına neden olabilir. Kimyasal içeriği daha az ürünler seçerek tırnakların doğal yapısını koruyabilirsiniz [37], [38]. Tırnak sağlığını korumak sadece bakım rutiniyle sınırlı değildir; aynı zamanda tırnak mantarı gibi enfeksiyonlara karşı da önlem almak gerekir. Bu nedenle erken teşhis ve doğru tırnak mantarı tedavisi uygulamaları büyük önem taşır. Cilt-Tırnak Bütünlüğüne Uygun Temizleyici Seçimi (SLS İçermeyen Ürünler) Tırnak sağlığı sadece tırnak bakımından ibaret değildir. Ciltle uyumlu bir temizleyici seçimi yapmak önemlidir. Tırnak etleri tırnağı destekleyen bir bariyer görevi görmektedir. Bu sebeple, uygun temizleyici ürünlerin seçilmesi, cilt-tırnak bütünlüğünün korunmasında kritik rol oynamaktadır. SLS (Sodyum Lauril Sülfat) cilt bakım ürünlerinde yaygın temizleme maddesi olarak kullanılan yüzey aktif maddedir [39]. SLS cilt lipitlerinin bileşimini bozarak stratum korneum yüzeyinden lipitleri uzaklaştırabilir ve böylece cilt bariyer fonksiyonunu bozabilir [40]. Tırnak çevresindeki ciltte daha hassas olduğundan bu etki daha belirgin olabilmektedir. Özellikle ellerin suyla sık temas ettiği durumlarda, SLS içeren temizleyici ürünler tırnak etlerinin kurumasına, çatlamasına yol açabilmektedir. Ayrıca, tırnakları besleyen ve güçlendiren doğal yağların kaybolmasına sebep olabilmektedir. Cilt-tırnak bütünlüğünü korumak için uygun bakım yapılmalı ve cilt dostu, SLS içermeyen ürünler tercih edilmelidir. [41]. Nemlendirici İçerikler (Seramid, Panthenol) ile Tırnak Çevresi Bakımı Nemlendirici içerikli ürünler tırnakların nem dengesinin korunması, kırılma ve çatlama riskini önemli ölçüde azaltmaktadır. Seramid ciltte doğal olarak bulunan ve cilt bariyerinin güçlenmesine yardımcı olan lipitlerdendir. Cildin nemli kalmasını sağlar, kuruma ve tahrişi engellemektedir [42]. Panthenol, tırnak çevresi bakımında önemli bir bileşendir. Panthenol suda çözünen ve higroskopik bir madde olduğu için cilt nemlendirme etkisi vardır. Cildi nemlendirmenin yanı sıra pürüzlü görünümü iyileştirmektedir. Aynı zamanda bu özelliği sayesinde cilt tahrişine ve SLS gibi maddelerden kaynaklanan hasarlara karşı koruyucu etkiler de göstermektedir [43].Nemlendirici ürünlerin düzenli kullanımı, tırnak plağı ve etlerinin sağlıklı ve güçlü kalmasına yardımcı olmaktadır. Biyoteknolojik Aktiflerle Desteklenen Onarıcı Formüller Tırnak sağlığını desteklemek amacıyla biyoaktif içerikli tırnak ürünlerinin kullanımı, son yıllarda büyük bir önem kazanmıştır. Biyoaktif içerikli tırnak ürünleri, tırnak sağlığını destekleyen ve onaran çeşitli biyoteknolojik ve doğal bileşenler içermektedir. Keratin, biotin, hyalüronik asit, panthenol, seramid ve çeşitli yağlar gibi içerikler, tırnakların güçlü ve sağlıklı olmasına katkı sağlamaktadır. Bu bileşenler, tırnak yapısının güçlenmesini sağlarken, nem dengesinin korunmasına ve tırnak çevresindeki cilt bariyerinin iyileştirilmesine de yardımcı olmaktadır [44].Onarıcı, besleyici ve nemlendirici formülü ile tırnak bakım kalemi, tırnakların sağlıklı bir görünüm kazanmasını sağlamaktadır. Kaynakça1. Fawcett, R. S., Linford, S., & Stulberg, D. L. (2004). Nail abnormalities: clues to systemic disease. American family physician, 69(6), 1417-1424.2. Kim, B. R., Da-Ae, Y. U., Lee, S. R., Lim, S. S., & Je-Ho, M. U. N. (2023). Beau’s Lines and Onychomadesis: a systematic review of characteristics and aetiology. Acta Dermato-Venereologica, 103, 18251.3. Robert, C., Sibaud, V., Mateus, C., Verschoore, M., Charles, C., Lanoy, E., & Baran, R. (2015). Nail toxicities induced by systemic anticancer treatments. The Lancet Oncology, 16(4), e181-e189.4. Braswell, M. A., Daniel III, C. R., & Brodell, R. T. (2015). Beau lines, onychomadesis, and retronychia: a unifying hypothesis. Journal of the American Academy of Dermatology, 73(5), 849-855.5. Metin, A., Güzeloğlu, M., Delice, İ., & Subaşı, Ş. " Beau Çizgileri" Tırnak Deformitesi.6. Saraswat, N., Sood, A., Verma, R., Kumar, D., & Kumar, S. (2020). Nail changes induced by chemotherapeutic agents. Indian Journal of Dermatology, 65(3), 193-198.7. Kim, B. R., Da-Ae, Y. U., Lee, S. R., Lim, S. S., & Je-Ho, M. U. N. (2023). Beau’s Lines and Onychomadesis: a systematic review of characteristics and aetiology. Acta Dermato-Venereologica, 103, 18251.8. Kaptanoğlu, A. F., & Egemen, A. (2001). Sağlıklı çocuk izleminde tırnak muayenesi. Sürekli Tıp Eğitimi Dergisi, 10(5), 168-173.9. KARTAL, S. P. Cemile Tuğba ALTUNELa.10. Piraccini, B. M., Iorizzo, M., Antonucci, A., & Tosti, A. (2004). Treatment of nail disorders. Clinical Practice, 1(1), 159.11. Noppakun, N., & Swasdikul, D. (1986). Reversible hyperpigmentation of skin and nails with white hair due to vitamin B12 deficiency. Archives of dermatology, 122(8), 896-899.12. Seshadri, D., & De, D. (2012). Nails in nutritional deficiencies. Indian Journal of Dermatology, Venereology and Leprology, 78, 237.13. Cashman, M. W., & Sloan, S. B. (2010). Nutrition and nail disease. Clinics in dermatology, 28(4), 420-425.14. Yamaguchi, T., & Shimizu, K. (2022). Koilonychia in a Patient with Heart Failure and Iron Deficiency Anemia. The American Journal of Medicine, 135(10), e393-e394.15. GÜNDÜZ, M. (2017). Demir Eksikliği Semptom ve Klinik Bulguları. Turkiye Klinikleri Hematology-Special Topics, 10(3), 171-175.16. Bolaman, Z. (2004). Demir Eksikliği Anemisi. 6. Ulusal İç Hastalıkları Kongresi Kongre Program ve Bildiri Özetleri Kitabı, 50-57.17. Walker, J., Baran, R., Vélez, N., & Jellinek, N. (2016). Koilonychia: an update on pathophysiology, differential diagnosis and clinical relevance. Journal of the European Academy of Dermatology and Venereology, 30(11), 1985-1991.18. Kannan, S., Balakrishnan, J., & Nagarajan, P. (2024). Vitamin B7 (Biotin) and Its Role in Hair, Skin and Nail Health. In Hydrophilic Vitamins in Health and Disease (pp. 233-252). Cham: Springer International Publishing.19. Iorizzo, M., Pazzaglia, M., M Piraccini, B., Tullo, S., & Tosti, A. (2004). Brittle nails. Journal of cosmetic dermatology, 3(3), 138-144.20. Holzberg, M. (2012). The nail in systemic disease. Baran & Dawber's Diseases of the Nails and their Management, 315-412.21. Satasia, M., & Sutaria, A. H. (2023). Nail Whispers Revealing Dermatological and Systemic Secrets: An Analysis of Nail Disorders Associated With Diverse Dermatological and Systemic Conditions. Cureus, 15(9).22. Sobolewski, P., Walecka, I., & Dopytalska, K. (2017). Nail involvement in psoriatic arthritis. Reumatologia/Rheumatology, 55(3), 131-135.23. Satasia, M., & Sutaria, A. H. (2023). Nail Whispers Revealing Dermatological and Systemic Secrets: An Analysis of Nail Disorders Associated With Diverse Dermatological and Systemic Conditions. Cureus, 15(9).24. Jiaravuthisan, M. M., Sasseville, D., Vender, R. B., Murphy, F., & Muhn, C. Y. (2007). Psoriasis of the nail: anatomy, pathology, clinical presentation, and a review of the literature on therapy. Journal of the American Academy of Dermatology, 57(1), 1-27.25. Mullin, G. E., & Eastern, J. S. (1986). Cutaneous consequences of accelerated thyroid function. Cutis, 37(2), 109-114.26. Rosenberg, A., & Lipner, S. R. (2022). Nail changes associated with thyroid disease. Cutis, 110(2), E8-E12.27. Heymann, W. R. (1992). Cutaneous manifestations of thyroid disease. Journal of the American Academy of Dermatology, 26(6), 885-902. 28. Safer, J. D. (2011). Thyroid hormone action on skin. Dermato-endocrinology, 3(3), 211-215. 29. Dinani, N., & George, S. (2019). Nail cosmetics: a dermatological perspective. Clinical and Experimental Dermatology, 44(6), 599-605.30. Iorizzo, M., Piraccini, B. M., & Tosti, A. (2007). Nail cosmetics in nail disorders. Journal of cosmetic dermatology, 6(1), 53-58.31. Chen, A. F., Chimento, S. M., Hu, S., Sanchez, M., Zaiac, M., & Tosti, A. (2012). Nail damage from gel polish manicure. Journal of cosmetic dermatology, 11(1), 27-29.32. Rieder, E. A., & Tosti, A. (2016). Cosmetically induced disorders of the nail with update on contemporary nail manicures. The Journal of clinical and aesthetic dermatology, 9(4), 39.33. Arora, H., & Tosti, A. (2017). Safety and efficacy of nail products. Cosmetics, 4(3), 24.34. Bansal, S., & Grover, C. (2024). Adverse effects of nail cosmetics and how to prevent them. Cosmoderma, 4.35. Barba, C., Méndez, S., Martí, M., Parra, J. L., & Coderch, L. (2009). Water content of hair and nails. Thermochimica Acta, 494(1-2), 136-140.36. Maeda, K., & Iwashita, N. (2022). Experimental Study of the Reduction in Ceramide Content in Fingernails Due to Nail Polish Remover Use. Cosmetics, 9(6), 125.37. Chessa, M. A., Iorizzo, M., Richert, B., López-Estebaranz, J. L., Rigopoulos, D., Tosti, A., ... & Piraccini, B. M. (2020). Pathogenesis, clinical signs and treatment recommendations in brittle nails: a review. Dermatology and therapy, 10, 15-27.38. Menge, J. Tips for Nail Health.39. Fiume, M., Bergfeld, W. F., Belsito, D. V., Klaassen, C. D., Marks, J. G., Shank, R. C., ... & Andersen, F. A. (2010). Final report on the safety assessment of sodium cetearyl sulfate and related alkyl sulfates as used in cosmetics. International journal of toxicology, 29(3_suppl), 115S-132S.40. Wilhelm, K. P., Freitag, G., & Wolff, H. H. (1994). Surfactant-induced skin irritation and skin repair: evaluation of a cumulative human irritation model by noninvasive techniques. Journal of the American Academy of Dermatology, 31(6), 981-987.41. Leoty-Okombi, S., Gillaizeau, F., Leuillet, S., Douillard, B., Le Fresne-Languille, S., Carton, T., ... & André, V. (2021). Effect of sodium lauryl sulfate (SLS) applied as a patch on human skin physiology and its microbiota. Cosmetics, 8(1), 6.42. Baran, R., & Maibach, H. I. (Eds.). (2017). Textbook of Cosmetic Dermatology. CRC Press.43. Ebner, F., Heller, A., Rippke, F., & Tausch, I. (2002). Topical use of dexpanthenol in skin disorders. American journal of clinical dermatology, 3, 427-433.44. Gomes, C., Silva, A. C., Marques, A. C., Sousa Lobo, J., & Amaral, M. H. (2020). Biotechnology applied to cosmetics and aesthetic medicines. Cosmetics, 7(2), 33.
Learn more
Güvenli Güneş Koruması: Oksibenzon ve Hormon Dengesi İlişkisi
Oksibenzon (Benzofenon-3) Nedir? Oksibenzon ((Benzofenon-3), güneş kremlerinde kullanılan cildi hem UV-B hem de UV-A radyasyonuna karşı koruyan bir filtredir. Oksibenzonun Endokrin Sistem Üzerindeki Etkileri Endokrin sistem, hormonları üreten ve kana salgılayan organlar ve bezlerden oluşan sistem için kullanılan bir terimdir. (14) Endokrin sistem; hipotalamus, epifiz bezi, hipofiz bezi, tiroit bezi, paratiroit bezi, timüs bezi, adrenal bezler ve pankreas, erkeklerde testisler, kadınlarda yumurtalıklar ve hamilelik döneminde plasentadan oluşmaktadır.(14) Yapılan bilimsel çalışmalara göre en endişe verici güneş kremi aktif maddesi oksibenzondur. Cilt tarafından kolayca emilir. Hormon dengesini bozucu etkileri vardır. (1) Östrojen Benzeri Aktivite Endokrin bozucu kimyasallar ile ilgili artan kanıtlar, östrojenik veya antiandrojenik etkileri nedeniyle üreme sistemi ve prostat dahil olmak üzere endokrin sistem üzerinde olumsuz etkilerini göstermektedir. (2) Yapılan in vivo ve in vitro çalışmalara göre oksibenzon östrojen reseptörüne bağlanabilir ve vücutta doğal östrojen gibi davranabilir. Bu durum özellikle meme kanseri hücrelerinde hücre çoğalmasını (proliferasyon) artırabilir ve üreme sağlığını olumsuz etkileyebilir. (3) Tiroid Fonksiyonlarına Etkisi Oksibenzonun (benzofenon-3) tiroid fonksiyonları üzerinde potansiyel bozucu etkileri olduğu çeşitli çalışmalarla ortaya koyulmuştur. Bu etkiler, oksibenzonun tiroid hormonlarının (özellikle T3 ve T4) sentezi, salgılanmaları ve reseptör etkileşimlerini değiştirici özelliği ile ilişkilidir. Fareler üzerinde yapılan çalışmalarda oksibenzonun tiroid hormonları olan T3 (triiyodotironin) ve T4 (tiroksin) seviyelerini azaltabileceği gösterilmiştir. Hipotiroidizme benzer sonuçlara yol açabilir. Tiroid hormon düzeylerindeki azalma feedback mekanizması ile tiroid stimülan hormon (TSH) düzeylerinde artışa neden olabilir. Bu durum uzun vadede tiroit fonksiyon bozukluklarına yol açabilir. (4) Bazı epidemiyolojik çalışmalar oksibenzon gibi hormon sistemi bozucu maddelerin otoimmün tiroid hastalıklarının gelişimiyle ilişkili olabileceğini öne sürmektedir. (3) Tiroit hormonları beyin gelişimi ve metabolizma üzerinde kritik rol oynar. Oksibenzon hamilelerde kullanımı sonucu fetüste nörogelişimsel bozukluklara sebep olması ile dikkatleri üzerine çekmektedir. (4) Üreme Sağlığı Üzerindeki Etkileri Oksibenzonun üreme sağlığı üzerindeki etkileri, hem erkek hem de kadın üreme sistemine yönelik olumsuz sonuçlar doğurabilme potansiyeli çeşitli bilimsel çalışmalarda incelenmiştir. Oksibenzona maruz kalmanın, sperm kalitesinde azalma ve sperm motilitesinde düşüş ile ilişkili olduğu gösterilmiştir. Yapılan hayvan deneylerinde oksibenzonun testis ağırlığını azaltabileceği ve testosteron seviyelerini düşürebileceği rapor edilmiştir. (4) Buck Louis ve arkadaşları tarafından yapılan epidemiyolojik bir çalışmaya göre de oksibenzonun insanlarda sperm sayısında azalmaya neden olabilceği ve DNA hasarına yol açabileceği belirtilmektedir. (5) Oksibenzonun östrojen benzeri etkileri nedeniyle hormonal döngüleri bozabileceği ve erken menopoz gibi sorunlara yol açabileceği düşünülmektedir. (3) Gebelikte oksibenzona maruz kalan kadınlarda düşük doğum ağırlığı ve erken doğum riskinin arttığı görülmektedir. (6) Oksibenzonun Vücuda Geçiş Yolları Oksibenzonun vücuda geçiş yolları çevresel ve kişisel bakım ürünleri yoluyla maruziyetle ilişkilidir. İnsan vücuduna genellikle bu iki temel yolla girdiği görülmektedir. Dermal Absorbsiyon Oksibenzonun en yaygın geçiş yolu hormon bozucu güneş kremleri gibi kişisel bakım ürünleri ile deri yoluyla emilimdir. (7) Oksibenzon lipofilik (yağda çözünen) bir bileşik olduğu için epidermal lipit tabakasından kolayca geçebilir. (8) Emilim oranı, cilt bariyerinin bütünlüğüne, uygulama sıklığına, oksibenzon konsantrasyonuna ve uygulanan cilt yüzeyinin genişliğine bağlı olarak değişir. (8) UV ışınlarına maruz kalma, oksibenzon emilimini artırabilir. Bu durum cilt bariyerinin zayıflaması ve daha derin tabakalara ulaşma olasılığının artmasından kaynaklanır. (9) Sistemik Dolaşıma Katılması Deri yoluyla emilen (transdermal geçiş) oksibenzon epidermal bariyeri geçerek dermis tabakasına ulaşır ve kan dolaşımına katılır. Matta ve arkadaşlarının 2019 yılında JAMA dergisinde yayımladıkları bir çalışmada oksibenzon içeren güneş koruyucularının cilde uygulanmasından sonra plazma konsantrasyonları ölçülmüştür. (7) 24 katılımcı ile dört gün boyunca günde dört kez oksibenzon içeren güneş koruyucu uygulanmış ve her uygulamadan sonra düzenli aralıklarla plazma örnekleri toplanmıştır.(7) İlk uygulama sonrası oksibenzon plazma konsantrasyonu 0.5 ng/ml gibi düşük bir seviyeden başlamış, uygulama sayısı arttıkça hızlı bir şekilde yükselmiştir.(7) Dördüncü gün sonunda plazma oksibenzon seviyeleri 210.1 ng/ml seviyesine kadar çıkmıştır.(7) Uygulama sonlandırıldıktan sonra oksibenzonun plazmada kalma süresi yaklaşık 24-48 saat olarak hesaplanmıştır. (7) Ancak bazı katılımcılarda uygulama sona erdikten 4 gün sonrasına kadar plazmada tespit edilmiştir. (7) Bu bulgular oksibenzonun cilt bariyerini aşıp kan dolaşımına girdiğini, tekrarlanan uygulamalar ile birikim yaptığını, vücutta metabolize edilip yavaş yavaş atıldığını ve bireysel farklılıklara bağlı olarak plazmada kalma süresinde değişiklik gösterdiğini ortaya koymaktadır. Sistemik dolaşıma katılan oksibenzon, plazma proteinlerine bağlanır ve vücutta çeşitli dokulara taşınır. Biyotransformasyonu ise karaciğerde gerçekleşir ve glukuronidasyon yoluyla daha polar metabolitlere dönüştürülerek atılır. (10) Risk Grupları Oksibenzon zararları ile gündeme geldiğinden beri, etkilenecek popülasyon önem kazanmaya başladı. Oksibenzonun zararlarından en çok etkilenebilecek risk grupları hamile kadınlar, fetüsler, bebekler, küçük çocuklar, hormon dengesizliği olan kişiler, alerjik reaksiyonlara eğimli bireyler, kanser geçmişi olan bireyler, yüksek kanser riski taşıyan bireyler olarak sıralanmaktadır. Hamileler ve Emziren Anneler Oksibenzonun plasenta bariyerini aşarak fetüse geçebildiği birçok çalışmada kanıtlanmıştır. Bu geçiş fetal gelişim üzerinde olumsuz etkiler yaratabilir. Çin’de gebe kadınlarda yapılan bir çalışmada fenol türevlerine (özellikle oksibenzon, bisfenol A gibi kimyasallar) prenatal maruziyetin doğum ağırlığı, gebelik süresi ve yenidoğan sağlığı üzerindeki etkileri değerlendirilmeye çalışılmıştır. 450 kadının gebelik dönemlerinde idrar örnekleri alınarak fenol ve oksibenzon metabolit düzeyleri ölçülmüştür. Yenidoğanların doğum ağırlığı, doğum zamanları, baş çevresi ve sağlık durumları gibi parametreler kaydedilmiştir. İdrar örneklerinde benzofenon-3 (BP-3) metabolitleri analiz edilmiş, elde edilen veriler hamilelik dönemindeki kimyasal maruziyet seviyelerini değerlendirmek için kullanılmıştır. Ölçülen seviyeler, fenol maruziyeti olmayan gebe kadınlarla karşılaştırılmıştır. Gebelik boyunca oksibenzona yüksek seviyede maruz kalan annelerin bebeklerinin doğum ağırlığı, düşük maruziyet seviyesine sahip kadınların bebeklerine göre ortalama 120-150 gram daha düşük bulunmuştur. Oksibenzon seviyelerinin en yüksek çeyreğinde yer alan annelerin bebeklerinde düşük doğum ağırlığı görülme olasılığı %22 artmıştır. Oksibenzon metabolitleri seviyeleri yüksek olan kadınlarda erken doğum (37. Gebelik haftasından önce doğum) riski belirgin şekilde artmıştır. Erken doğum oranı oksibenzon seviyeleri yüksek olan grupta %18, düşük seviyede olan grupta ise %8 olarak tespit edilmiştir. (11) Yüksek oksibenzon maruziyeti bebeklerin baş çevresi ortalama 0,5 cm daha küçük ölçülmüştür. Prenatal oksibenzon maruziyeti fetal büyüme kısıtlaması (FGR) riskini artırmıştır. FGR vakaları maruziyetin yüksek olduğu grupta daha sık görülmüştür. (11) Emziren anneler üzerindeki etkileri konusunda spesifik ve kapsamlı bilimsel çalışmalar sınırlıdır. Birçok çalışma, güneş kremi kullanıcılarının anne sütünde değişen miktarlarda oksibenzon ve oktinoksat bulunduğunu bulmuştur. Bu kimyasalların emzirilen bebeklerde olumsuz etkilere neden olacak kadar yüksek miktarlarda aktarılıp aktarılmadığı henüz bilinmemektedir. (12,13) Anne ve bebek sağlığını korumak için oksibenzon içermeyen güneş kremleri tercih edilmeli ve gerekirse bir sağlık profesyoneline danışılması önemlidir. Nanopartikül olmayan çinko oksit içeren güneş koruyucular emziren anneler için iyi bir alternatiftir. (17) Çocuklar ve Ergenler Çocukluk ve ergenlik dönemlerinde hormonal değişiklikler çok daha hassas olduğu için oksibenzon maruziyeti bu yaş grubunda daha ciddi sonuçlara yol açabilir. Ayrıca çocukların ciltleri daha hassas ve geçirgen olduğundan birikim riski daha yüksektir. Birçok endokrin bozucu kimyasalın erken ergenliğe sebep olduğu gözlenmiştir. Erken ergenlik, ikincil cinsiyet özelliklerinin normalden erken belirginleşmesiyle ilgili patolojik bir durumu ifade etmektedir. Çocukların hormon salgısında artışa sebep olduğundan hem fiziksel hem psikolojik sağlıklarını tehdit edecek sonuçları olur. Kız çocuklarında genelde bir sebep belirlenemez iken erkek çocuklarında belirli bir sebep bulunabilmesi ihtimali daha yüksektir. (14) Erken ergenlik, epifiz bezlerinin erken birleşmesine, bunun sonucunda da gelişimin erken tamamlanmasına sebep olur. Hipotalamusta hematom oluşması, hipofiz bezinde adenom oluşumu, sinir sisteminde tümörler, yetişkinlikte kısa boy, meme veya üreme sistemi kanserleri, erken ergenlikle ilişkilendirilmiştir. (14) Güvenli Alternatifler Cilt bakımı ürünleri ve güneş kremi seçimi yapılması gerektiği durumlarda güneş kremlerinin içeriklerine dikkatlice bakılması gerekmektedir. Amerika Birleşik Devletleri Gıda ve İlaç Dairesi (FDA)’nın son açıklamalarına göre 16 bileşen incelenmiş ve yalnızca ikisinin, çinko oksit ve titanyum dioksitin, mevcut bilgilere göre "genel olarak güvenli ve etkili olarak kabul edildiğini" veya GRASE olduğunu bildirilmiştir. (15,16) Güvenlik sorunlarını gösteren verilere göre nadiren kullanılan iki güneş kremi bileşeni olan aminobenzoik asit ve trolamin salisilatın GRASE olmadığını ileri sürülmüştür. (15,16) FDA, yetersiz veri nedeniyle 12 diğer bileşenin GRASE olmadığını belirtmektedir: Oksibenzon avobenzon, sinoksat, dioksibenzon, ensülizol, homosalat, meradimat, oktinoksat, oktisalat, oktokrilen, padimat O ve sulizobenzon.(15,16) Mineral Bazlı Güneş Koruyucular FDA tarafından onaylanan güneş kremi bileşeni olan çinko oksit gibi mineral güneş kremleri hem UVA hem de UVB ışınlarını engellemek ve yansıtmak için fiziksel bir bariyer oluşturur. Titanyum dioksit genellikle kozmetiklerde güneş kremi olarak bulunur, ancak bazı UVA ışınlarını engellemede o kadar etkili değildir ve bu nedenle güneş koruması için (tek başına) tercih edilmez. (17) Daha güvenli güneş kremleri kullanmak istenildiğinde nanopartikül olmayan çinko oksit içeren güneş koruyucular tercih edilebilir. Bu form cilt üzerinde kalır (ciltten emilip kan dolaşımına katılmaz) ve UV ışınlarını dağıtarak, emerek ve yansıtarak koruma sağlar. (17) Dezavantajları ise cilt yüzeyinde beyaz bir kalıntı şeklinde durabilmeleridir. (17) Sistemik dolaşıma geçmediği için anne sütüne geçiş yapmaz ve emziren anneler için iyi bir alternatiftir. (17) Nanopartikül çinko oksit formülasyonları da bulunmaktadır ve beyaz kalıntı görünümü azaltmak için yapılmıştır. (17) Ancak, küçük nanopartiküllerin cilde nüfuz etme ve sistemik olarak küçük bir dereceye kadar emilme yeteneği bulunur. (17) Yine de, nanopartikül çinko oksidin kimyasal güneş kremlerine göre daha düşük emilime ve dolayısıyla daha düşük potansiyel yan etki riskine sahip olduğu görülmektedir. (17) Buna karşın anne sütüyle beslenen bebeklerde ishale neden olacak kadar nanopartikül çinko oksit kullanmasının mümkün olduğunu öne süren bir rapor bulunmaktadır. (18) Doğal UV Filtreleri Sistematik veritabanı taraması yapılan bir araştırmaya göre in vitro insan keratinosit hücreleri (HaCaT) üzerinde UV ışınlarının etkileri ve in vivo fare modellerinde UVB ışınlarına maruziyet incelenmiştir. Doğal UV fitreler için örnek bazı bitkisel kaynaklar Hibiscus roseus, Moringa oleifera, Coffea arabica ve Vinis vinifera olarak gösterilmiştir. (19) Doğal UV filtreler genellikle flavonidler, polifenoller, fenolik asitler ve karotenoidler gibi bitkisel bileşiklerden oluşur. Flavonoidler ve fenolik bileşikler moleküler yapılarındaki çift bağlar sayesinde 200-400 nm dalga boyundaki UV ışınlarını absorbe eder. Bitkisel polifenoller serbest radikal üretimini engelleyerek oksidatif stresi azaltır bu şekilde cilt hücrelerini UV ışınlarının neden olduğıu DNA hasarından korur. (19) Ayrıca bazı içerikler matris metalloproteinazların (MMP) inhibisyonunu artırarak ciltte kolajen yıkımını azaltarak kırışıklık oluşumunu azaltır. (19) Yasal Düzenlemeler ve Sınırlamalar Oksibenzon hem insan sağlığı hem de çevresel etkileri nedeniyle çeşitli yasal düzenlemelere ve sınırlamalara tabidir. AB Kozmetik Yönetmeliği’ne ve ABD Gıda ve İlaç Dairesi (FDA)’ya göre güneş koruyucularda oksibenzonun maksimum %6 oranında kullanımı onaylanmıştır. Ancak Avrupa Komisyonu’nun bir raporunda mevcut insan maruziyeti seviyelerinin güvenli olmadığı belirtilmiş ve bu nedenle oksibenzon konsantrasyonunun %2.2 ile sınırlandırılması önerilmiştir. (16) 2021 yılında FDA oksibenzonun güvenliği ile ilgili yeterli veri bulunmadığını belirtmiş ve güvenlik testlerinin tamamlanmasını talep etmiştir. (16) ABD, Hawaii’de 1 Ocak 2021’den itibaren oksibenzon içeren güneş koruyucuların satışı yasaklanmıştır. (20) Ek olarak oksibenzonun mercan resiflerine zarar verdiği ve deniz yaşamını olumsuz etkilediği bilimsel çalışmalarla gösterilmiştir. (21) Bilinçli Tüketici Rehberi Oksibenzonun insan vücudunda birikimi ve nesiller arası aktarımı üzerinde yapılan çalışmalar ışığında güvenli alternatif ürünlerin kullanımı potansiyel risklerden kaçınmak ve çevre sağlığının korunmasının anahtarıdır. (22) Güneş kremi seçiminde içerik listesi dikkatli bir şekilde incelenmeli ve oksibenzon gibi kimyasalların olmadığı güneş kremleri ya da mineral bazlı doğal güneş koruyucular veya doğal ve bitkisel UV koruyucular tercih edilmelidir. Ya da sizler için HelioVita güneşten koruyucu serisini tüm bu ayrıntılara dikkat ederek, güvenle kullanmanız için oluşturdu. Hamile kadınlar, fetüsler, bebekler, küçük çocuklar, hormon dengesizliği olan kişiler, alerjik reaksiyonlara eğimli bireyler, kanser geçmişi olan bireyler, yüksek kanser riski taşıyan bireylerde güneş kremi seçiminde çok daha titiz olunmalıdır. Güneş kremi kullanmak istenmiyorsa güneşten korunmak için şapka, güneş gözlüğü, uzun kollu giysiler gibi fiziksel koruma önlemleri alınmalıdır. Güneş maruziyeti, kum ve sıcak hava, rüzgar gibi maruziyetler sonrası cildinizin kaybettiği nemi Remedium Vücut Losyonu yerine koyacaktır. Referanslar 1) Ghazipura M, McGowan R, Arslan A, Hossain T. Exposure to benzophenone-3 and reproductive toxicity: A systematic review of human and animal studies. Reprod Toxicol. 2017 Oct;73:175-183. doi: 10.1016/j.reprotox.2017.08.015. Epub 2017 Aug 24. PMID: 28844799. 2) Vitku J, Skodova T, Varausova A, Gadus L, Michnova L, Horackova L, Kolatorova L, Simkova M, Heracek J. Endocrine Disruptors and Estrogens in Human Prostatic Tissue. Physiol Res. 2023 Dec 17;72(S4):S411-S422. doi: 10.33549/physiolres.935246. PMID: 38116777. 3) Krause, M., Klit, A., Blomberg Jensen, M., Søeborg, T., Frederiksen, H., Schlumpf, M., Lichtensteiger, W., Skakkebaek, N.E. and Drzewiecki, K.T. (2012), Sunscreens: are they beneficial for health? An overview of endocrine disrupting properties of UV-filters. International Journal of Andrology, 35: 424-436. https://doi.org/10.1111/j.1365-2605.2012.01280.x 4) Amira M. Aker, Lauren Johns, Thomas F. McElrath, David E. Cantonwine, Bhramar Mukherjee, John D. Meeker, Associations between maternal phenol and paraben urinary biomarkers and maternal hormones during pregnancy: A repeated measures study,Environment International,Volume 113,2018,Pages 341-349, ISSN 0160-4120, https://doi.org/10.1016/j.envint.2018.01.006. 5) Buck Louis GM, Sundaram R, Schisterman EF, Sweeney AM, Lynch CD, Gore-Langton RE, Maisog J, Kim S, Chen Z, Barr DB. Persistent environmental pollutants and couple fecundity: the LIFE study. Environ Health Perspect. 2013 Feb;121(2):231-6. doi: 10.1289/ehp.1205301. Epub 2012 Nov 14. PMID: 23151773; PMCID: PMC3569685. 6) Wolff MS, Engel SM, Berkowitz GS, Ye X, Silva MJ, Zhu C, Wetmur J, Calafat AM. Prenatal phenol and phthalate exposures and birth outcomes. Environ Health Perspect. 2008 Aug;116(8):1092-7. doi: 10.1289/ehp.11007. PMID: 18709157; PMCID: PMC2516577. 7) Matta MK, Florian J, Zusterzeel R, Pilli NR, Patel V, Volpe DA, Yang Y, Oh L, Bashaw E, Zineh I, Sanabria C, Kemp S, Godfrey A, Adah S, Coelho S, Wang J, Furlong LA, Ganley C, Michele T, Strauss DG. Effect of Sunscreen Application on Plasma Concentration of Sunscreen Active Ingredients: A Randomized Clinical Trial. JAMA. 2020 Jan 21;323(3):256-267. doi: 10.1001/jama.2019.20747. Erratum in: JAMA. 2020 Mar 17;323(11):1098. doi: 10.1001/jama.2020.1950. PMID: 31961417; PMCID: PMC6990686. 8) Nadeem Rezaq Janjua, Brian Mogensen, Anna-Maria Andersson, Jørgen Holm Petersen, Mette Henriksen, Niels E. Skakkebæk, Hans Christian Wulf,Systemic Absorption of the Sunscreens Benzophenone-3, Octyl-Methoxycinnamate, and 3-(4-Methyl-Benzylidene) Camphor After Whole-Body Topical Application and Reproductive Hormone Levels in Humans,Journal of Investigative Dermatology,Volume 123, Issue 1,2004,Pages 57-61,ISSN 0022-202X,https://doi.org/10.1111/j.0022-202X.2004.22725.x. 9) Gonzalez H, Farbrot A, Larkö O, Wennberg AM. Percutaneous absorption of the sunscreen benzophenone-3 after repeated whole-body applications, with and without ultraviolet irradiation. Br J Dermatol. 2006 Feb;154(2):337-40. doi: 10.1111/j.1365-2133.2005.07007.x. PMID: 16433806. 10) Janjua NR, Mogensen B, Andersson AM, Petersen JH, Henriksen M, Skakkebaek NE, Wulf HC. Systemic absorption of the sunscreens benzophenone-3, octyl-methoxycinnamate, and 3-(4-methyl-benzylidene) camphor after whole-body topical application and reproductive hormone levels in humans. J Invest Dermatol. 2004 Jul;123(1):57-61. doi: 10.1111/j.0022-202X.2004.22725.x. PMID: 15191542. 11) Tang R, Chen MJ, Ding GD, Chen XJ, Han XM, Zhou K, Chen LM, Xia YK, Tian Y, Wang XR. Associations of prenatal exposure to phenols with birth outcomes. Environ Pollut. 2013 Jul;178:115-20. doi: 10.1016/j.envpol.2013.03.023. Epub 2013 Apr 3. PMID: 23562958. 12) Anderson PO. Summer Topics on Breastfeeding. Breastfeed Med. 2020 Jun;15(6):354-356. doi: 10.1089/bfm.2020.0053. Epub 2020 Mar 20. PMID: 32196354. 13) Lin H. Chen, Caroline Zeind, Sheila Mackell, Trisha LaPointe, Margot Mutsch, Mary E. Wilson, Breastfeeding Travelers: Precautions and Recommendations, Journal of Travel Medicine, Volume 17, Issue 1, 1 January 2010, Pages 32–47, https://doi.org/10.1111/j.1708-8305.2009.00362.x 14) https://yadacosmetics.com/blogs/uzman-gozuyle/endokrin-hormon-sistemi-bozucu-kimyasal-maddeler-ve-erken-ergenlik-i%CC%87liskisi 15) https://www.fda.gov/drugs/cder-conversations/update-sunscreen-requirements-deemed-final-order-and-proposed-order 16) https://www.ewg.org/sunscreen/report/the-trouble-with-sunscreen-chemicals/ 17) https://www.infantrisk.com/content/sunscreen-smarts-breastfeeding-families 18) Ceballos-Rasgado M, Lowe NM, Mallard S, Clegg A, Moran VH, Harris C, Montez J, Xipsiti M. Adverse Effects of Excessive Zinc Intake in Infants and Children Aged 0-3 Years: A Systematic Review and Meta-Analysis. Adv Nutr. 2022 Dec 22;13(6):2488-2518. doi: 10.1093/advances/nmac088. PMID: 36055780; PMCID: PMC9776731. 19) Li L, Chong L, Huang T, Ma Y, Li Y, Ding H. Natural products and extracts from plants as natural UV filters for sunscreens: A review. Animal Model Exp Med. 2023 Jun;6(3):183-195. doi: 10.1002/ame2.12295. Epub 2022 Dec 19. PMID: 36536536; PMCID: PMC10272908. 20) https://www.personalcarecouncil.org/sunscreen/ 21) https://www.surfrider.org/news/your-guide-to-reef-friendly-sunscreens 22) Çetinkaya S. Endokrin çevre bozucular ve ergenlik üzerine etkileri. diclemedj. Mart 2009;36(1):59-66.
Learn more
Impacts of Climate Change on Sustainable Production and Consumption
Climate change has become one of the biggest global problems of our day due to the rapidly increasing consumption of fossil fuels since the industrial revolution, excessive use of natural resources and environmentally insensitive production models. The concept of sustainable production and consumption is an approach that aims to use existing resources without harming future generations and plays a critical role in combating climate change. In this context, sectors that consume large amounts of raw materials, especially the cosmetics industry, need to take steps to minimize their environmental impacts. Renewable energy, sustainable agriculture, protection of biodiversity and biotechnological solutions stand out among climate-friendly production models. Establishing the correct link between global warming and resource management will both protect nature and support economic and social sustainability in the long term. Climate Change and Sustainability Relationship: Basic Concepts Climate change is a global problem that results in increased greenhouse gas emissions as a result of fossil fuel-based energy production, resulting in rising global temperatures, intensifying extreme weather events, decreasing water resources, and disrupting ecosystem balance. Sustainability is an approach that aims to achieve economic and social development without consuming natural resources or harming the environment. While sustainability policy aims to achieve balanced development in terms of environmental, economic, and social dimensions, climate change disrupts this balance. Climate change, as one of the biggest factors threatening sustainability, necessitates long-term planning in natural resource management. Sustainable practices such as the use of renewable energy sources, reducing carbon footprint, and water and energy efficiency can help mitigate the effects of climate change. In addition, reducing waste production with a circular economy approach, turning to nature-friendly production processes, and supporting biodiversity by protecting ecosystems are critical for sustainable development. In order to be successful in combating climate change on a global scale, sustainability principles must be adopted in every sector and at an individual level. The Link Between Global Warming and Resource Management Global warming is accelerating with fossil fuel consumption, deforestation and industrial activities, making natural resource management increasingly critical. Rising temperatures trigger water scarcity, melting glaciers raise sea levels, threatening coastal areas and extreme weather events destroy ecosystems. It is not possible to stop these effects without efficient resource management strategies. Energy efficiency practices, the expansion of renewable energy sources and the adoption of circular economy models are necessary to both reduce the carbon footprint and use resources sustainably. Especially in production-oriented sectors such as the cosmetics industry, practices such as water saving, the use of biodegradable packaging and waste management play a critical role in reducing the negative effects of global warming. In the fight against global warming, resource management necessitates change not only in industrial and production processes but also in individual consumption habits; making the implementation of sustainability policies inevitable. Ecological Footprint of the Cosmetics Industry The cosmetics industry has a large ecological footprint, from raw material production to packaging waste. Petroleum-derived chemicals used in production processes, water consumption and greenhouse gas emissions are the main factors that threaten environmental sustainability. While microplastics and synthetic chemicals mix with water resources and negatively affect marine ecosystems, single-use plastic packaging increases the waste problem. Biodegradable content, water-saving production techniques and recyclable packaging should be encouraged for the transition to sustainable production in the sector. In addition, renewable energy use and processes aimed at reducing carbon footprints are critical for cosmetics manufacturers to minimize their environmental impacts. Consumer awareness and preference for sustainable products is an important step that will accelerate the green transformation in the sector. Climate Crisis and Sustainable Production in the Cosmetics Industry The climate crisis is forcing the cosmetics industry to reduce its environmental impact and adopt a sustainable cosmetics production approach. One of the most important components of this transformation is the widespread use of renewable energy in the cosmetics industry. Production facilities operating on clean energy sources such as solar and wind energy contribute to environmental sustainability in the sector by significantly reducing carbon emissions. In addition, regulations that limit the use of microplastics and harmful chemicals ensure the spread of sustainable cosmetics production processes with environmentally friendly formulas. These developments allow both brands to fulfill their environmental responsibilities and consumers to turn to eco-conscious products. Carbon Footprint Reduction Strategies (Energy Efficiency, Renewable Energy) Carbon footprint refers to the total amount of greenhouse gases released into the atmosphere as a result of human activities and is one of the biggest drivers of climate change. Two basic strategies stand out for reducing carbon footprint: energy efficiency and renewable energy use. Energy efficiency covers applications that aim to achieve the same output by consuming less energy and can be applied in a wide range of areas from industry to transportation. Thermal insulation in buildings, LED lighting systems, electric vehicle use and efficient production technologies are among the solutions that reduce carbon emissions by increasing energy efficiency. Renewable energy is the use of energy sources that do not harm nature, such as solar, wind, hydroelectric and biomass, instead of fossil fuels and supports sustainable development by significantly reducing carbon emissions. These strategies are also of great importance in terms of reducing the carbon footprint in the cosmetics industry. Cosmetics production is a sector that generally requires energy-intensive processes and traditional production methods are based on fossil fuels. Therefore, the transition of factories to renewable energy and the spread of production facilities operating with solar and wind energy are steps that support environmental sustainability in the sector. In addition, waste heat recovery, low-temperature machines and water-saving systems can be used in production processes within the scope of energy efficiency. In addition, preferring sustainable content will reduce the carbon footprint not only at the production stage but also throughout the supply chain. We see that reducing and tracking the carbon footprint is becoming the new management approach of the manufacturers. Consumers' preference for products with low carbon footprints will accelerate the green transformation of the sector and encourage a more environmentally friendly approach to the climate crisis. Protection of Water Resources and Waste Management The protection of water resources is a critical issue in maintaining ecosystem balance and combating climate change. The effects of increasing population, industrialization and global warming are leading to the decrease of freshwater resources and water scarcity. This situation has made it necessary to develop sustainable solutions that save water. Rainwater harvesting, water recycling systems, efficient irrigation techniques such as drip irrigation and the reuse of water in industrial processes are effective methods to reduce water consumption. In addition, waste management is also of great importance in terms of preventing water pollution. Industrial waste, agricultural chemicals and plastic pollution are the main factors that threaten water resources. Expanding recycling systems, reducing single-use plastics, switching to refillable packaging and encouraging biodegradable packaging are critical steps in protecting aquatic ecosystems. In this context, the cosmetics industry must also take responsibility for the protection of water resources and waste management. Traditional cosmetics production processes consume large amounts of water, while production waste also causes water pollution. The development of water-based formulas, the use of sustainable raw materials and the improvement of wastewater treatment systems can help the industry reduce water consumption. Banning microplastics in cosmetics and promoting natural ingredients can also reduce negative impacts on the ecosystem. Climate-Friendly Impact of Biotechnological Raw Materials Biotechnological raw materials offer climate-friendly alternatives that leave a lower carbon footprint compared to traditional agricultural and chemical production processes. Traditional raw material production leads to environmental problems such as high water and energy consumption, excessive use of agricultural lands, and carbon emissions. While plant and animal ingredients obtained through traditional methods cause deforestation with high water and energy consumption, biotechnological production processes minimize environmental impacts by using renewable resources. Biomimetic ingredients, especially those produced through fermentation and cell culture technologies, both reduce natural resource consumption and create a sustainable raw material source. The cosmetics sector can both reduce the pressure on the ecosystem and develop environmentally friendly formulations by providing water and energy efficiency by using these innovative ingredients. Biotechnological raw materials, which replace traditional ingredients, are an important step in the sector's fight against climate change and accelerate the transition to sustainable production models. Assets Obtained through Sustainable Agriculture Sustainable agriculture is a production model that protects soil health, uses water resources efficiently, and minimizes the use of synthetic chemicals. The herbal active ingredients obtained through this method support biodiversity while also reducing the carbon footprint in production. For example, herbal oils, extracts, and antioxidant components produced through organic farming have a lower environmental impact compared to synthetic alternatives. Sustainable agricultural practices are also of great importance for the cosmetics sector because the active ingredients used in herbal cosmetic products are produced without harming nature, contributing to the reduction of the ecological footprint of brands. Laboratory-Produced Innovative Ingredients (Fermented Substances) With the development of biotechnology, fermented ingredients and biomimetic raw materials produced in laboratory environments offer a much more sustainable alternative compared to traditional methods. Fermentation technology allows the production of vitamins, antioxidants and skin-renewing ingredients using microorganisms. This method minimizes the use of agricultural resources while also greatly reducing water consumption. The cosmetics industry is increasingly adopting ingredients such as probiotics, enzymes and amino acids produced from fermented ingredients. This both increases the bioavailability of products and prevents the depletion of traditional raw material resources, creating a sustainable production process. Biodiversity Loss and Cosmetic Formulations Biodiversity and cosmetics can be considered two concepts that are difficult to bring together. Biodiversity is one of the most important elements that maintain the health and balance of ecosystems. However, due to global warming, habitat destruction, excessive agricultural production and industrial activities, many plant and animal species are in danger of extinction. The cosmetics industry is directly affected by biodiversity loss due to production processes based on herbal extracts, natural oils and biologically active ingredients and can be one of the factors that accelerate this loss. The sector's shift towards formulations that are less harmful to nature by using sustainable ingredients and local resources can contribute to the protection of biodiversity. Endangered Plant Species and Alternative Contents Some plant raw materials commonly used in the cosmetic industry have become endangered species due to over-consumption and habitat loss. For example, sandalwood (Santalum album) is in high demand for its essential oil, leading to the extinction of its natural populations. Similarly, ginseng (Panax ginseng), known for its antioxidant and anti-aging properties, threatens ecosystem balance due to over-harvesting. Unsustainable collection of these species accelerates biodiversity loss and damages ecological systems. As a solution to this problem, there is an increasing tendency towards biotechnological and synthetic alternative ingredients. For example, biomimetic essential oils produced by fermentation in a laboratory environment can be used instead of sandalwood oil. Instead of ginseng, fermented green tea extract with similar antioxidant properties or seaweed-based active ingredients are added to the formulations to develop solutions that are less harmful to nature. In addition, hyaluronic acid and microalgae-based biotechnological ingredients provide a sustainable alternative in the cosmetics sector by providing high levels of nourishment and skin rejuvenation effects without depleting natural resources. The conscious steps taken by the industry in this direction will both support ecological sustainability by ensuring the protection of endangered plants and offer consumers environmentally friendly product options. The Importance of Local Sourcing Local sourcing is an approach that encourages sustainable production, reduces carbon footprint and supports regional economies. While dependence on the global supply chain causes high carbon emissions in logistics processes, the use of local resources minimizes this impact and increases environmental sustainability. Turkey has significant potential in terms of sustainable cosmetic raw materials with its rich flora and natural resources. For example, Isparta rose (Rosa damascena) is a world-famous ingredient and is used in the production of rose oil and rose water, increasing the income of local farmers while providing an ecosystem-friendly alternative. Similarly, olive oil and bay leaf extract grown in the Aegean and Mediterranean regions are among the sustainable ingredients used in natural cosmetics and soap production. Ethical and sustainable processing of such local raw materials both reduces environmental impact and helps protect Türkiye's biodiversity. In addition, propolis, lavender oil and black cumin oil, traditionally used in Anatolia, offer environmentally friendly alternatives to imported chemical ingredients and encourage sustainable production in the cosmetics sector. Conscious use of local resources will both protect the ecological balance and increase Türkiye's competitiveness in the global market by increasing its sustainable production capacity. Adopting sustainable production and consumption habits has become an inevitable necessity in the fight against climate change. Strategies such as energy efficiency, use of renewable energy, protection of water resources and support of biodiversity are the basic elements of ensuring environmental sustainability. In particular, the cosmetics sector should adopt sustainable solutions such as biotechnological raw materials, fermented ingredients and production based on local resources in order to reduce its ecological footprint. In addition, consumers' orientation towards environmentally friendly products will accelerate the sustainable transformation process. Implementing sustainability principles on a global scale will not only provide economic and environmental benefits, but will also be an effective solution in minimizing the negative effects of climate change. As ya da multicosmetics; Our greatest sensitivity is to leave a livable world for future generations. We aim to make sustainability an indispensable part of the cosmetics industry by developing innovative and environmentally friendly solutions in the production of our products. The basic principles of our sustainability policy are shaped around protecting nature. We pay attention to the protection of natural resources when choosing the raw materials of our products. Within the framework of our philosophy , we attach importance to the respectful use of natural and herbal extracts. We consider environmental compatibility both in raw material production and in post-use waste. We observe the sensitivity of nature with recyclable and sustainable packaging and carbon-free production. In this way, you can gift yourself climate-friendly skin care with 'ya da' skin care products without harming nature. Our world is more fragile than we think. Making nature the basis of production and consumption is no longer a choice, it is a necessity. We can remain silent and turn a blind eye to climate change OR we can adopt the principle of sustainability and leave a hopeful future. The choice is ours! SOURCE IPCC (2022) - Climate Change 2022: Impacts, Adaptation, and Vulnerability. Cambridge University Press. NASA (2023) - Global Climate Change: Vital Signs of the Planet. NASA Earth Observatory. IEA (2023) - Energy Efficiency 2023 Report. International Energy Agency. UNEP (2023) - Sustainable Consumption and Production in the Beauty Industry. United Nations Environment Programme. UNEP (2023) - Plastic Pollution and Waste Management in the Cosmetics Industry. OECD (2023) - Bio-Based Economy and Sustainable Resource Management. Organization for Economic Co-operation and Development. OECD (2023) - Sustainable Water Use and Circular Economy Strategies. OECD (2023) - Sustainable Resource Management and Local Sourcing Strategies. FAO (2023) - Sustainable Agriculture and Biodiversity in the Mediterranean Region. European Environment Agency (2022) - Environmental Impact of the Beauty and Personal Care Industry in Europe. PBES (2023) - Global Assessment Report on Biodiversity and Ecosystem Services. IUCN (2023) - The Red List of Threatened Species and Plant Conservation Strategies. WMO (2023) - State of the Global Climate 2023. World Meteorological Organization.
Learn more
Effects of UVB Filters on the Endocrine System: What Should We Know?
UVB filters, which are widely used to protect against the harmful effects of sunlight, are one of the main ingredients of sunscreens. However, in recent years, scientific research has increased on the potential effects of these chemicals on the endocrine system. The effects of UVB filters on hormonal balance, thyroid function and reproductive health are being investigated. In this article, we will discuss scientific information about the effects of UVB filters on the body, their relationship with the endocrine system and safe alternatives. What Are UVB Filters? UVB filters are chemical or physical compounds that protect the skin by absorbing or reflecting the sun's harmful ultraviolet B (UVB) rays. Chemical UVB filters are usually composed of compounds such as oxybenzone, octinoxate, and homosalate, while physical filters contain mineral-based ingredients such as titanium dioxide and zinc oxide. Chemical Structures and Areas of Use Chemical UVB filters are organic compounds that absorb sunlight and convert it into heat after being applied to the skin. These filters are found in many cosmetic products, such as sunscreens, makeup, and moisturizers. Physical filters protect by physically reflecting sunlight and are often recommended for sensitive skin or children. Effects of UVB Filters on the Body These filters, also known as physical filters, are particles that scatter and reflect UV rays back through the skin into the environment. They act as a physical barrier to trap ultraviolet and UV light. The most commonly used particulate mineral filters are titanium dioxide and zinc oxide. They are considered broad spectrum because they cover the entire ultraviolet spectrum. Inorganic sunscreens are also called sunscreens, a term derived from their light protection mechanism. The ONLY UV filters approved by the FDA are Zinc Oxide and Titanium di Oxide. Green algae slow down photosynthesis and growth), causing a decrease in biomass. Dolphins accumulate in tissues such as the liver and can pass to children through the placenta and breast milk. Coral accumulates in reef tissues and causes coral bleaching, damages DNA and deforms children; destroys zooxanthellae, leading to death. Mussels accumulate in lipids and other tissues, causing defects in children. Sea Urchins damage the reproductive and immune systems. They cause deformation in children. Fish reduce fertility and reproduction, impair brain and liver functions, stimulate vitellogenin protein production, exhibit estrogenic activity, alter gene transcripts, cause cardiorespiratory stress, lead to neurotoxicity, cause immune system disorders and oxidative stress. Humans, estrogenic activity, antiandrogenic activity, uterotrophic activity, potential developmental and reproductive toxicity, induction of apoptosis, inflammatory response. Dermal Absorption Mechanism Chemical UVB filters can be absorbed by the skin and enter the bloodstream. Research shows that some UVB filters can bioaccumulate in the body and that their levels in the blood increase with long-term sunscreen use. Chemical (Organic) Filters: Reduces the harmful effects of UV energy by converting it into heat energy and absorbing it, reducing the depth at which it can penetrate the skin. Organic sunscreens work primarily through this mechanism by mixing into the blood. Mineral (Inorganic) Filters: Scattering and reflection of UV energy from the skin surface. Mineral based (Inorganic sunscreens mainly work with this mechanism.) They provide a coating that prevents the sun's rays from passing through the skin. Relationship between SPF value and protection: People often assume that applying SPF 50 sunscreen provides almost twice the protection as applying SPF 15. This is not true, because the extra protection provided by a higher SPF value is negligible after SPF 15. SPF 50 sunscreen blocks 98 percent of UVB rays, while SPF 30 sunscreen blocks 97 percent of sunburn rays - the difference is one percentage point. The internationally accepted thickness of SPF application to the SKIN is 2 mg/cm2 (USA) or 1.5 g/cm2 (EU). Importance of Bioaccumulation Bioaccumulation refers to the accumulation of chemicals in the body over time. The detection of substances such as oxybenzone in breast milk and urine in particular raises concerns about the potential health effects of long-term exposure. It shows the main human systems and marine organisms that suffer from the adverse effects of UV filter toxicity. Regarding organic UV filters, some reports have proven their presence in biological samples such as urine and blood samples, especially benzophenone and cinnamate derivatives. Additionally, many organic UV filters have been reported in collected marine samples, namely: homosalate (algae and brine shrimp); benzophenone-1 (algae) and benzophenone-3 (corals and algae); avobenzone (algae, crustaceans and brine shrimp); EHMC (fish and mussels); octocrylene (brine shrimp, crustaceans and mussels); PABA (mussels) and camphor derivatives (fish). Growth inhibition was one of the adverse effects affecting algal organisms, namely Tetraselmis sp. ZnO nanoparticles are widely used in sunscreens and UV protectors. Unlike larger particles, nanoparticles can easily pass through the skin and biological membranes, thus penetrating various cells, tissues and organs. When mixed with the blood, they can circulate throughout the body and reach vital organs and tissues. According to the hypothesis, high amounts of nanoparticles entering the body trigger stress reactions by creating an overload in the phagocyte cells of the immune system. This can lead to inflammation and weaken the body's defense mechanisms. In addition, the chemical reactivity of nanoparticles can increase the formation of free radicals, causing damage to proteins, cell membranes and DNA. DNA damage can lead to mutations and trigger cancer development. However, the toxicity of nanomaterials and their long-term effects on the organism have not yet been fully determined and the current information is at a hypothetical level. In order to understand the possible effects of nanomaterials on the ecosystem, extensive research needs to be conducted on wastewater, drinking and utility water, surface water, soil, air and plants. Relationship Between the Endocrine System and UVB Filters Some UVB filters are classified as endocrine disrupting chemicals (EDCs). Endocrine disruptors can alter the body's natural hormone balance by interfering with the hormonal system. Benzophenone-3 (oxybenzone) is a broad-spectrum UV filter that absorbs UVB (290-320 nm) and UVA (320-340 nm) rays. It is widely used in sunscreens, hair sprays, and colored cosmetics. There are many studies that it can cause allergic reactions, endocrine disrupting effects, and environmental damage. Initially, it was permitted to be used up to 10% in sunscreens in Turkey and the EU, but this limit was reduced to 6% in 2017. The FDA also determined this rate as 6%, and its use was banned in Hawaii. In a study conducted in the US between 2003-2012, benzophenone-3 was detected in the urine of 96.8% of volunteers. Higher concentrations were found in women and high-income individuals. While 0.4% of benzophenone-3 was detected in urine 48 hours after the application of sunscreens, another study showed that the dermal absorption rate was 2%. Benzophenone-3 is rapidly absorbed from the skin and reaches maximum plasma levels within 4 hours. Since its molecular weight is 228.26 Da, it can easily cross the skin barrier. Similarly, benzophenone-8 is rapidly absorbed from the skin. However, it has been found that by synthesizing dioxybenzone in polymer form, skin penetration decreases and the same level of UV protection is provided. The Organisation for Economic Co-operation and Development (OECD) has published a document containing standardised tests to assess potential endocrine disrupting chemicals. Accordingly, potential endocrine disruption by UV filters has already been reported in biological samples, namely placenta and human sperm. Witorsch et al. (2010) mentioned the adverse effect of some classes of compounds, including UV filters that penetrate skin layers; however, this study highlighted that serum and reproductive hormone levels were not affected by this exposure. Recently in 2016, Rehfeld et al. studied the in vitro effect of UV filters on male fertility, assuming the possibility that UV filters mimic progesterone, considering that both the hormone and the UV filter can interfere with Ca2+ channel signaling and consequently activate certain biological processes. Various research groups have reported other adverse effects of UV filters using in vivo models such as rats, insects, fish, among others. Estrogenic, androgenic, and thyroid activities are included in the endocrine disrupting effects of UV filters. Effects on Hormone Balance UVB filters such as oxybenzone and octinoxate have been shown to interact with the hormones estrogen and androgen. This can disrupt hormonal balance and pose potential health risks. Various organic UV filters are absorbed systemically and therefore may affect endocrine processes, therefore they are classified as endocrine active chemicals (EACs) [ 49 ]. Some of the more relevant UV filters are benzophenones or those derived from cinnamates or camphor. Changes in Thyroid Functions Some studies suggest that UVB filters may have thyroid hormone-disrupting effects. Specifically, they may interfere with the mechanisms that regulate the production and metabolism of thyroid hormones, increasing the risk of hypothyroidism or hyperthyroidism. Animal Studies: UV filters such as BP-3, OMC and 4-MBC have been found to have effects on thyroid hormones in various animal models. BP-3 and OMC demonstrated thyroid receptor-mediated transcriptional activation in vitro. 4-MBC increased TSH and decreased thyroxine (T4) levels by reducing iodine uptake in rats. OMC decreased T3 levels and TSH receptor expression. 4-MBC was observed to increase thyroid weight in both parent and offspring mice. Although some studies have shown changes in thyroid hormone levels in animals exposed to UV filters, the functional effects of these changes are not always clear. Human Studies: The study by Janjua et al suggested that UV filters do not disrupt the homeostasis of human thyroid hormones. Other studies (case-control, cohort, and cross-sectional) have not found a significant or consistent association between BP-3 and thyroid hormone levels. Overall Result: UV filters can be taken into the body through environmental exposure or topical use. It has been shown to affect hormonal pathways in animal studies, but human data are inconclusive. The effects of UV filters on the human endocrine system are still unclear and further research is needed. Effects on Reproductive Health It is thought that some UVB filters may have negative effects on reproductive health due to their endocrine disrupting effects. It is suggested that they may reduce sperm quality, especially in men, and affect fertility by causing hormonal imbalances in women. Effects on Pregnancy and Development: Santamaria et al. (2020): BP-3 taken via dermal absorption during pregnancy caused intrauterine growth retardation, change in sex ratio and deterioration in the growth chart of the offspring. Downs et al. (2015): BP-3 exposure decreased body weight, increased prostate weight by 30%, and led to a significant increase in uterine weight in childhood in mice. Overall Result: BP-3 can disrupt hormone balance by exhibiting estrogenic and anti-androgenic effects. Mouse and fish studies suggest that BP-3 may have adverse effects on the reproductive system and development. Long-term effects on humans are unclear, but should be evaluated carefully due to its endocrine disrupting potential. Groups at Risk Pregnant Women and Developing Fetuses: UVB filters (e.g. benzophenone-3, octinoxate, 4-MBC) can cross the placenta and reach the fetus. Intrauterine growth retardation, changes in sex ratio, and hormonal imbalances have been observed. Babies and Children: Because their hormonal systems are still developing, they may be more affected by estrogenic and anti-androgenic effects. There are risks of early puberty, developmental disorders and weakened immune systems. Women and Men of Reproductive Age: It can disrupt the balance of estrogen and androgen, which can lead to negative effects on fertility. It can lower testosterone levels in men and cause an increase in prostate weight. In women, menstrual irregularities and effects on the reproductive system may occur. People with Hormonal Imbalance or Endocrine Disease: Those with thyroid diseases, polycystic ovary syndrome (PCOS), diabetes and other endocrine diseases may be more sensitive to the hormonal effects of UVB filters. Individuals Who Use Heavy Sunscreen (Especially Daily Users and Athletes): Frequent use of sunscreens and skin care products containing UVB filters can cause high levels of absorption through the skin. Those who spend long periods of time in the sea or pool may be exposed to the environmental effects of UV filters and thus pose an additional risk. Things to Consider During Pregnancy The content of the sunscreen is of great importance when using sunscreen during pregnancy. It has been shown that endocrine disrupting chemicals such as oxybenzone can cross the placental barrier and have an effect on the fetus. Therefore, it is recommended that pregnant women prefer mineral-based sunscreens. Use in Children Children should be careful about sunscreen use because their skin barrier is more permeable than adults, and they may be more exposed to chemical UVB filters. Therefore, it is a safer option to choose mineral-based sunscreens for children. Safe Alternatives Safe alternatives can be preferred to chemical UVB filters, which are thought to have negative effects on the endocrine system. Mineral-based filters: zinc oxide, titanium dioxide should be preferred as safer sunscreens. Mineral Based Preservatives Sunscreens containing zinc oxide and titanium dioxide reflect sunlight by creating a protective barrier on the skin's surface. It is known that these minerals are not absorbed by the skin and do not affect the endocrine system. Natural UV Filters Some plant oils, multicosmetic solutions , and extracts may have natural sunscreen properties. For example, carrot seed oil and raspberry seed oil may naturally provide low SPF values. However, since they do not offer as strong protection as traditional sunscreens, extra precautions should be taken. Conscious Use Suggestions Avoid prolonged and excessive use of sunscreens containing chemical filters. Choose mineral-based sunscreens for children and pregnant women. When using daily sunscreen, check for ingredients that may have a negative effect on the endocrine system. Look for safe, natural sunscreens that do not contain UVB filters. Instead of relying solely on sunscreen to protect yourself from the sun, use physical protection methods such as hats and long-sleeved clothing. Conclusion Although UVB filters play an important role in protecting against harmful sun rays, the possible effects of some chemical filters on the endocrine system should be considered. Safer sunscreens should be preferred, especially for children and pregnant women. Mineral-based sunscreens and natural filters are more reliable options in terms of protecting skin health and not affecting hormonal balance. SOURCE: Jesus, Ana et al. “UV Filters: Challenges and Prospects.” Pharmaceuticals (Basel, Switzerland) vol. 15.3 263. 22 Feb. 2022, doi:10.3390/ph15030263 Yang, Changwon et al. “Avobenzone suppresses proliferative activity of human trophoblast cells and induces apoptosis mediated by mitochondrial disruption.” Reproductive toxicology (Elmsford, NY) vol. 81 (2018): 50-57. doi:10.1016/j.reprotox.2018.07.003 Schlumpf, Margret et al. “Developmental toxicity of UV filters and environmental exposure: a review.” International journal of andrology vol. 31.2 (2008): 144-51. doi:10.1111/j.1365-2605.2007.00856.x Guan, Linna L et al. “Sunscreens and Photoaging: A Review of Current Literature.” American journal of clinical dermatology vol. 22.6 (2021): 819-828. doi:10.1007/s40257-021-00632-5 Krause, M et al. “Sunscreens: are they beneficial for health? An overview of endocrine disrupting properties of UV-filters.” International journal of andrology vol. 35.3 (2012): 424-36. doi:10.1111/j.1365-2605.2012.01280.x Breakell, Thomas et al. “Ultraviolet Filters: Dissecting Current Facts and Myths.” Journal of clinical medicine vol. 13,10 2986. 19 May. 2024, doi:10.3390/jcm13102986 ÜNER, DR MELİKE, and İMRAN ALTIOKKA. "RELIABILITY AND COSMETOVIGILANCE IN COSMETICS." Berardesca, E et al. “Review of the safety of octocrylene used as an ultraviolet filter in cosmetics.” Journal of the European Academy of Dermatology and Venereology: JEADV vol. 33 Suppl 7 (2019): 25-33. doi:10.1111/jdv.15945 PEKCAN, AHMET NEZİHİ. "DESIGN OF VARIOUS DERMAL FORMULATIONS FOR MELASMA TREATMENT." GÜLER, Ülker Aslı, Eliza Tuncel, and MEhtap ERŞAN. "Toxicology of Nanomaterials." ÜNAL, İdil, and Ayda ACAR. "Sun Protection." Turkish Clinics Cosmetic Dermatology Special Journal 11.2 (2018). SARAY, Yasemin, and Deniz DUMAN. "Current Information and Developments on Sunscreens." Turkish Clinics Cosmetic Dermatology Special Journal 8.4 (2015). Ertekin, KADR İ. YE "Cosmetic chemicals and their interactions with the endocrine system." CHAIRMAN, Emel BÜLBÜL. "Reliability, Undesirable Effects and Side Effects of Sunscreens." Turkiye Klinikleri Cosmetic Dermatology-Special Topics 3.2 (2010): 62-69. Sarı, Canan. "The Relationship Between Personal Care and Cosmetic Product Use During Pregnancy and Fetal Health." Turkish Journal of Family Medicine and Primary Care 15.3 (2021): 633-638.
Learn more
Nail Problems: Causes and Professional Solutions
Nail problems can be listed as nail peeling, nail cracks, dry nail and nail breakage. They are usually caused by dryness and moisture loss, improper nail cutting, chemicals, vitamin deficiency, fungal and bacterial infections. Solution suggestions for such problems include moisturizing, nail care products, correct manicure techniques, protection from chemicals, vitamin supplements and medical treatment. Nail Anatomy The cuticle anatomy includes a tissue structure that protects the nail and surrounding tissues. Parts of the nail anatomy: 1. Nail Plate: It is the visible, hard part of the nail. It is made up of a protein called keratin. Underneath is the nail bed. 2. Nail Matrix: It is the area where the cells that enable the nail to grow are produced. It is located just above the finger bone. The light-colored half-moon-shaped lunula or half-moon at the base of the nail is the only visible part of the matrix. The nail grows from here and damage can cause permanent deformities. 3. Nail Bed: It is the sensitive vascular area just under the nail plate. It gives the nail its pink color. The nail plate is firmly attached here. 4. Eponychium (Cuticle): It is the thin layer of skin at the base of the nail. It protects the nail and matrix from bacteria and external factors. Excessive cutting can cause infections. 5. Hyponychium: It is a thin layer of skin located just below the free edge of the nail plate. It forms a barrier against infection by covering the underside of the nail. 6. Paronychium: The soft tissue on the sides of the nail. This area is prone to inflammation and infections called "paronychia" are often seen here. Characteristics of Healthy Cuticles It should be pink or pale pink in color: The cuticles should be a natural pink color, and there should be no color changes such as paleness or bruising. It should be moist and flexible: Dry, hard or peeling cuticles are unhealthy. Healthy cuticles have a soft and flexible texture. Must be neat and intact: There should be no peeling, cracking or excessive retraction. If the cuticles are constantly cracking or breaking, this may be a sign of vitamin deficiency or irritation from external factors. There should be no inflammation, redness or swelling: If there is any swelling, tenderness or redness around the nail edge, this could be a sign of infection. It should be painless and tender: There should be no pain or ache when you touch the cuticles. The cuticle structure must be smooth: Cuticles should be slightly adherent and thin to protect the nail bed. Excessively hardened or retracted cuticles can negatively affect nail health. Main Causes of Nail Problems Environmental Factors Moisture and Dryness Imbalance Excessive exposure to water: When hands are frequently exposed to water, the cuticles become soft and easily irritated. Detergents and chemicals: Cleaning products, soaps and disinfectants can dry out the cuticles and cause them to crack. Weather Conditions Cold weather: Low temperatures and wind dry out the skin and cuticles, causing cracking. Hot and dry weather: Causes moisture loss, which can cause the cuticles to harden and peel. Nutritional Deficiencies Nutritional deficiencies that lead to nail problems are often caused by vitamin and mineral deficiencies. Here are the most common deficiencies and their effects on the nails: 1. Biotin (Vitamin B7) Deficiency: Causes the nails to weaken, dry and crack. 2. Vitamin A Deficiency: Causes the skin and nails to dry, become sensitive and crack. 3. Vitamin C Deficiency: As it reduces collagen production, it leads to weakening of the cuticles, bleeding and slowing down of the healing process. 4. Vitamin E Deficiency: It dries out the cuticles, causing cracking and irritation. 5. Iron Deficiency: Causes the cuticles to become pale, dry and sensitive. Nails may also become thin and break. 6. Zinc Deficiency: Causes the cuticles to peel, heal slowly and become irritated. 7. Omega-3 Deficiency: It dries the skin and cuticles, causing cracks. 8. Protein Deficiency: Causes the cuticles to become weak and prone to irritation. 9. Dehydration: It causes the body's moisture balance to be lost, which causes the cuticles to dry out, harden and crack. Wrong Care Habits Instilling the habit of protecting your cuticles from an early age can put aside issues that will cause problems throughout your life. Picking or Biting Cuticles: Picking or biting your cuticles increases the risk of infection and inflammation. It can create open wounds, which can lead to bacterial or fungal infections. Overcutting Cuticles: Cuticles are a natural barrier that protects nails from infection. Cutting too much can cause irritation and infection. Deep cuts can cause bleeding and pain. Using Unhygienic Tools: Using unsterilized nail clippers or meat tweezers increases the risk of infection. Shared manicure tools can cause fungal or bacterial infection. Excessive and Harsh Manicure Practices: Pushing the cuticles too hard or filing them hard can cause irritation. Chemical-based nail polish removers and harsh manicure products can dry out the cuticles. Chemical Exposure: Nail polish removers that contain strong solvents like acetone dry out the cuticles and cause irritation. Handling detergents and cleaning materials without gloves can cause the cuticles to wear down. Not Moisturizing Enough: Unmoisturized cuticles dry out, crack, and become sensitive. Especially people who wash their hands frequently or are exposed to cold weather should moisturize regularly. Continuous use of gel or acrylic nails: UV lamps and artificial nail applications can dry out and weaken the cuticles. Improper removal procedures can damage the cuticles. Nail Biting Habits Nail biting (onychophagia) is the unconscious biting and tearing of one's nails and sometimes cuticles, usually due to stress, anxiety, distress or habit. It usually begins in childhood and continues into adulthood in some people. The main harms of nail biting are: Nail and Cuticle Damage Nails become deformed: Constant biting causes nails to look irregular and ugly. Cuticles become irritated: When cuticles are torn, open wounds can form, increasing the risk of infection. Nail growth disorders: When the nail root is damaged, the nail may grow unhealthily and irregularly. Risk of Infection Bacterial and fungal infections: Bacteria found in the mouth can infect the nail and cause inflammation (such as a nail infection called paronychia). Wart and fungal formation: Nail biting can lead to the transmission of viruses (such as HPV) to the nail area. Risk Factors That May Cause Nail Problems Seasonal Effects In the winter months, the cold weather causes dryness, cracking, and peeling of the cuticles. In the summer months, the increase in temperature can cause discomfort such as sweating, fungus, and infection in the cuticles. Finally, in the spring months, the most important factor is allergic reactions. Such reactions can cause itching, dryness, and peeling of the cuticles. Occupational Exposure In occupational groups that are exposed to chemicals a lot (hairdressers, beauticians, cleaning workers), constantly exposing the hands to these conditions can cause dryness and irritation in the cuticles. Another risk factor is that the cuticles of people who do physical and mechanical work can be exposed to violence or irritation. Hand Hygiene Products The substances we use while paying attention to hygiene can damage our hands, nails and cuticles due to their content. These can be alcohol-based disinfectants, antibacterial soaps, use of latex gloves and creams and lotions containing harsh chemicals. Using such products can cause problems such as serious dryness, cracking and wound formation in the cuticles. Nail Treatment Some of the most important steps in preventing cuticle problems are practicing proper hand care, creating a moisturizing routine, and using appropriate protective products. Proper Cuticle Care Hand care usually starts with a manicure. The biggest mistake made here is cutting the cuticles. Instead, they should be pushed back. The tools used should be personalized and sterile. Otherwise, it can cause fungus and infection. Another thing is that instead of chemicals such as nail polish removers, hand care can be completed with products that are purer in content and will not irritate the skin. Using a cuticle moisturizer should be considered the safest of all possible care. Moisturizing Routine Creating a moisturizing routine is very important in eliminating dryness in the cuticles. This routine can be created with moisturizers suitable for the skin every day. Especially in the winter months, since there may be extra cracking and dryness in cold weather, the routine can be supported with intensive moisturizers. Use of Protective Products To prevent dryness of the cuticles, appropriate moisturizers, cuticle oils, and cuticle softening products can be used. In daily life, gloves containing nitrile or cotton products can be used instead of latex to protect hands at work. Gentle hand soaps and alcohol-free products should be used to prevent the cuticles from losing moisture. Natural nail care Nail problems can be treated with natural methods. Some of these include regularly using nutritious oils and vitamin supplements. Nourishing Oils Applying a few drops of valuable fixed oils such as almond oil, coconut oil, olive oil or jojoba oil to the nails and cuticles at night helps to treat nail breakage , nail breakage, nail crack treatment and nail dryness. Nail care pen, a very valuable solution from an expert in this regard, is with you. Thanks to its fixed oils, rich minerals and easy use, it prevents problems such as dryness, breakage and peeling of the cuticles. It is very important to check if the nail care products contain hormone disruptors, harmful chemicals and carcinogenic substances and to get into the habit of reading labels. These products, which are used from a young age, can cause various blockages especially in acupuncture points, as they are areas with intense blood flow. Vitamin Supplements Water should be consumed at least 2 liters a day as the most important vitamin. It is very important in addition to moisturizers used to maintain the body's moisture balance. Apart from this, Biotin (vitamin B7), vitamin E, vitamin C, vitamin A, vitamin D, zinc and iron are vitamins that can be used. Consuming foods that contain these vitamins in abundance in our daily nutrition habits will also help the treatment. Consuming rich foods such as eggs, almonds, olive oil and lemon is very important. SOURCE Jangra RS, Gupta S, Singal A, Kaushik A. Hangnail: A simple solution to a common problem. J Am Acad Dermatol. 2019;81(5):e123-e125. Relhan, Vineet et al. “Management of chronic paronychia.” Indian journal of dermatology vol. 59.1 (2014): 15-20. doi:10.4103/0019-5154.123482 Leggit JC. Acute and chronic paronychia. Am Fam Physician. 2017;96(1):44-51. PMID: 28671378 pubmed.ncbi.nlm.nih.gov/28671378/.
Learn more
Fighting Nail Fungus: Comprehensive Treatment and Prevention Methods
What is Nail Fungus? Nail fungus is an infection that occurs as a result of the proliferation of fungi under the nails. Medically known as onychomycosis, it is a health problem caused by fungi that usually settle in the bed under the nail. This infection manifests itself with various symptoms such as color change, thickening, and breakage in the nails. Nail fungus occurs when fungal infections in the skin spread to the nails, and this can negatively affect the person in terms of both aesthetics and health. It is evaluated differently from foot fungus. Although nail fungus is usually seen in the nails on the fingertips, it is more commonly observed in the toenails. Fungal infections can develop rapidly in areas of the body where there are moist and warm environments, which puts the toenails at greater risk. Feet are often moist due to sweating and closed shoes, which creates the perfect environment for the fungus to grow. It is very important to pay attention to nail fungus prevention methods and to support the nail fungus solution process with the right care practices. Nail Fungus Formation Mechanism The development of nail fungus begins with the proliferation of fungi that settle in the bed under the nail. Fungi multiply rapidly in warm and humid environments. These environments can be provided by factors such as sweaty shoes, damp socks, shared surfaces and closed areas. The surface of the nails and the skin around them provide a suitable ground for the fungus to enter. After entering the nail, the fungus affects the upper layer of the nail, causing it to turn yellow, thicken and break. Over time, the infection progresses, the nail tissue weakens and inflammation occurs. Nail fungus is most commonly seen in toenails, but it can also be seen in fingernails. Fungus that infects toenails tends to spread in moist areas, such as the heel and between the toes. Fungal infection gradually spreads to larger areas of the nail and can sometimes progress to complete nail loss. Risk Factors The risk of getting nail fungus increases with several factors. These factors are closely related to the person's general health, environmental conditions and individual habits. Here are some risk factors that can lead to nail fungus: Individuals with a Weak Immune System: Individuals with a weak immune system are more susceptible to fungal infections. Especially the elderly, diabetics, and people undergoing cancer treatment, as well as individuals with suppressed immune systems, can more easily contract nail fungus. Closed Shoes and Sweaty Feet: When feet sweat in closed shoes for a long time, it creates a suitable environment for fungi to grow. Sweaty shoes prevent feet from getting air, paving the way for the rapid spread of fungus. Walking in Common Areas: Damp areas such as gyms, swimming pools, and communal showers are places where fungi can spread quickly. Walking barefoot in such places increases the risk of infection. Nail Injuries: Small wounds, cracks or breaks on the nails provide an opportunity for the fungus to enter the nail. Such physical damage makes the nails more susceptible to fungal infection. Poor Hygiene Habits: Poor hygiene habits, such as not washing feet regularly, wearing damp shoes for long periods of time, or not taking care of nails, pave the way for the development of fungal infections. Nail Fungus Symptoms The symptoms of nail fungus may vary depending on the stage of the infection. While milder symptoms are seen in the early stages, the severity of the infection may increase in the later stages. Symptoms of nail fungus include: Early Symptoms Yellowing or white spots on the nail color Irregularities, small cracks or roughness on the nail surface Slight thickening or cracking Advanced Stage Symptoms Intense yellowing and noticeable thickening of the nail Deformity, peeling and splitting of the nail Inflammation, pain and tenderness around the nail Formation of bad odor Complete separation or falling of the nail If nail fungus is left untreated, these symptoms can worsen and make daily life difficult for the person. Early treatment is very important to prevent complications. Factors That Trigger Nail Fungus There are a number of factors that play a role in the development of nail fungus. These factors range from personal habits to environmental factors: Shoe Selection Closed and moisture-holding shoes cause feet to sweat. This creates a favorable environment for fungi to grow. In addition, shoes in the wrong size can put pressure on nails and increase the risk of infection. Immune System In people with a weak immune system, the body becomes less resistant to fungi, which leads to infections spreading more easily. Injuries and Traumas Physical trauma to the nails can trigger fungal infections. Small cuts, cracks, or wounds present an opportunity for infection to enter. Excessive Sweating Constantly moist feet provide the most suitable environment for the development of fungus. Sweat helps the fungus to reproduce and accelerates the spread of infection. Nail Fungus Treatment Methods There are many ways for those looking for a solution to nail fungus. These approaches may vary depending on the severity of the infection and personal preferences. Here are nail fungus remedies: Topical Treatment Methods Topical treatments can be effective in the early stages of nail fungus and in milder cases. In these treatments, antifungal medications are applied directly to the infected nail. Antifungal Creams and Gels: In cases of early stages of fungal infection, doctors usually recommend antifungal creams or gels. These products affect the part of the fungus that is on the surface of the nail. They usually need to be used regularly for 2-3 weeks. The active ingredients of these drugs can be substances such as clotrimazole, terbinafine and miconazole. Antifungal Sprays: Antifungal medications are also available in spray form against nail fungus. Sprays are especially suitable for use on toenails and can be applied frequently at different times of the day. Topical Antifungal Varnishes: Special antifungal varnishes can also be used to treat nail fungus. This treatment is less common but can be recommended as an effective option for treating nail fungus. This treatment requires long-term use (up to 6 months) for the varnish to dry on the nail and prevent the fungus from entering the nail. Advantages: Local treatment results in fewer side effects. The treatment process is usually shorter and less invasive. Disadvantages: It is only effective in early and limited infections. It may have limited effectiveness in penetrating deep into the nail. Oral (Systemic) Antifungal Drugs Oral antifungal medications are used in more advanced stages of nail fungus or in cases that do not respond to topical treatment. These medications treat the fungus internally in the body and are usually more powerful. Terbinafine (Lamisil): Terbinafine is one of the most commonly used oral antifungal medications for treating nail fungus. Terbinafine targets the cell membrane of the fungus, preventing the infection from spreading. The duration of treatment usually ranges from 6 to 12 weeks. Itraconazole (Sporanox): Itraconazole is another effective antifungal medication used for systemic treatment. In most cases, it requires regular use for 3 months. Itraconazole stops the spread of infection by inhibiting the growth of fungus. Fluconazole (Diflucan): Fluconazole is another oral antifungal medication used to treat nail fungus. This medication is usually taken once a week and may be treated for a shorter period of time (about 6 to 12 weeks). Advantages: It gives more effective results in deep infections. It is effective against more types of fungi thanks to its broad spectrum effects. Disadvantages: Potential side effects may occur (such as changes in liver function tests, stomach upset). It requires long-term use and the treatment process may be longer. Surgical intervention In advanced stages of nail fungus and in cases that do not respond to other treatment methods, surgical intervention may be required. In this procedure, the infected nail part is surgically removed or treated and cleaned. Complete Nail Removal: If the nail is severely damaged, doctors may sometimes recommend removing the nail entirely. This can help clear the infection and provide space for the nail to grow back healthy. However, this procedure is usually a last resort. Removing Nails with Chemical Treatment: Apart from surgical intervention, the nail can also be removed from the infected area with chemical treatments. Chemical substances can be applied to the nail surface and cause the nail to peel or fall off. Advantages: It offers an effective solution for advanced infections. Quick results can be obtained. Disadvantages: It can be a painful procedure. When the nail regrows, it can be time-consuming and sometimes problematic. Nail Fungus Natural Treatment Natural nail fungus treatment is one of the most researched topics lately. Especially herbal nail fungus treatment methods attract the attention of those looking for solutions with natural ingredients. Tea Tree Oil: Tea tree oil is known for its antifungal properties and is widely used as a natural fungal treatment. Apple Cider Vinegar: Apple cider vinegar has antiseptic properties and can be effective in treating nail fungus. Added to warm water, it makes a foot bath and provides foot care. Garlic: Garlic offers a natural treatment option against nail fungus as it has antibacterial and antifungal properties. For those looking for reliable and multicosmetic products in this regard, the Ya Da brand offers a nail care pen called LU'NAIL, enriched with walnut shell extract, fixed oils and minerals. This product is designed to provide both nail care and protection and has a special brush mechanism for ease of use. Nail Fungus Preventive Care Strategies Preventing nail fungus is possible with proper care habits. Here are the recommended strategies to prevent nail fungus: Pay Attention to Nail Hygiene: Washing the feet regularly, drying the areas between the toes thoroughly, and using antifungal soaps provide protection against nail fungus. Choosing the Right Socks: Choosing cotton socks allows your feet to breathe and helps absorb sweat. Nylon and synthetic socks should be avoided. Protection from Moisture: It is important to wear breathable shoes, avoid sweaty shoes, and use antifungal sprays to protect feet from moisture. Nail Care: Cutting nails short and neatly, keeping nails clean, and not sharing personal care tools with others reduces the risk of infection. Strengthening the Immune System: A healthy diet and regular exercise help strengthen the immune system and protect against fungal infections. Be Careful in Common Areas: Wearing slippers or sandals in humid areas such as gyms and pools and not sharing nail care tools with others reduces the risk of fungal infection. Source American Academy of Dermatology – Onychomycosis (Nail Fungus) “Onychomycosis: Diagnosis and Management” – Dermatologic Clinics (2018) Mayo Clinic – Onychomycosis Treatment “Nail Fungus” – Turkish Dermatology Association
Learn more
Homosalate and the Process of Banning Cosmetic Products: What You Need to Know
Sunlight is a source of energy for living things, necessary for the continuation of life, a major source of vitamin D, stimulating melanin production in the skin, having an antibacterial effect and an immune-boosting effect, as well as being an energy source that can cause acute and chronic harmful effects when exposed to the ultraviolet (UV) rays it emits for long periods of time and without protection (1,2). Sunscreens are one of the most effective ways to protect our skin from harmful UV rays. Sunscreens contain main components such as UV filters (chemical and physical filters) that protect against UV-A and UV-B Ye rays coming from the sun, preservatives and stabilizers such as PABA, antioxidants such as vitamin C or green tea extract, moisturizers and skin care ingredients, and fragrances (3). However, the effects of some chemicals contained in sunscreens on health are still being debated. In recent years, some UV filters have been banned or their use has been restricted in the European Union. One of these filters is homosalate, which is our topic. So, what is homosalate and why is it banned? Chemical Structure of Homosalate and Its Role in Sunscreens Homosalate (HMS) is a salicylate molecule commonly included in commercial sunscreen formulations to protect against the adverse effects of ultraviolet (UV) radiation exposure (4). It is listed on product labels as “Homosalate, Homomentyl salicylate, HMS, 3,3,5-trimethyl-cyclohexyl-salicylate, Salicylic acid M-homomentyl ester” (5). Chemical Properties and Function in Formulation Homosalate is a chemical filter known for its ability to absorb UVB rays. It is produced by the Fischer-Speier esterification of salicylic acid and 3,3,5-trimethylcyclohexanol (5). The salicylic acid part of the molecule protects the skin from sun damage by absorbing ultraviolet rays with wavelengths between 295 nm and 315 nm. The hydrophobic trimethylcyclohexyl group provides oiliness that prevents it from dissolving in water. For this reason, it is often used in water-resistant sunscreens. It has low photostability, meaning it can degrade and lose its protective power over time when exposed to the sun. For this reason, it is stabilized by combining it with other UV filters such as Octocrylene or Avobenzone. Since it does not provide sufficient sun protection on its own, it is usually found in broad-spectrum sunscreens (covering both UVA and UVB) with other filters (6). Homosalate also has emollient properties, which is why it is found in moisturizers, body lotions and after-sun care products, as well as sunscreens. It provides a smoother texture in sunscreens and makes them easier to apply. Mechanism of Action as a UV Filter Studies have shown that HMS undergoes a rapid chemical process called "ultrafast excited state proton transfer (ESIPT)" when exposed to light. During this process, HMS undergoes a structural transformation by absorbing energy and then dissipates this energy largely as heat, rendering it harmless. In addition, laser studies have determined that HMS has two different forms (conformers). One of these performs the ESIPT process, while the other does not. Overall, these studies show that HMS works effectively as a sunscreen and has favorable photophysical properties (4). Adverse Effects on the Endocrine System and Health Risks The endocrine system regulates the balance of hormones in our body, and even the smallest changes can have major effects on our health. Studies suggest that Homosalate can bind to estrogen, progesterone and androgen receptors in the body and that these interactions can find hormone levels. This can have negative effects, especially on reproductive health and thyroid function. It can also increase the risk of cancer and cause skin irritation and redness. Changes in Hormonal Balance In a study conducted on human cells, it was observed in in vitro experiments that 6 UV filters, including Homosalate, exhibited estrogenic activity by binding to estrogen receptors. Homosalate is a lipophilic (fat-soluble) compound, so it tended to accumulate in the environment and organisms. It has been found in fish and aquatic ecosystems and has been reported to carry potential long-term ecological risks. However, in in vivo tests conducted on a transgenic zebrafish model, it was determined that Homosalate exhibited significant estrogenic activity. The general conclusion of the study is that UV filters tend to accumulate in the environment and could potentially have long-term effects. Therefore, it was emphasized that Homosalate and other UV filters should be further investigated in terms of their hormone disrupting effects (7). In addition, it was determined that human breast cancer cells, which grow and proliferate under the influence of estrogen, showed 3.5 times more growth and proliferation as a result of exposure to Homosalate (8). Effects on Reproductive Health and Clinical Findings Studies have shown that Homosalate suppresses androgen receptors, which can affect the reproductive system. In particular, another study has indicated that this chemical may be linked to female infertility, endometriosis, and polycystic ovary syndrome (PCOS) (9). Homosalate can cross the placenta during pregnancy and have negative effects on trophoblast cells. Normal proliferation and invasion of trophoblast cells are critical for placental development; however, homosalate can suppress the proliferation of these cells and cause placental vascular restructuring. This can lead to pregnancy complications such as spontaneous abortion and intrauterine growth retardation. In addition, homosalate has estrogenic activity, affecting the endocrine system, and has been detected in breast milk and placental tissues. Although homosalate, which mixes with the blood through products such as sunscreens, has the potential to be transmitted to the fetus, it has been stated that more research is needed to understand the exact effects of this substance on pregnancy (9). International Cosmetic Regulations and Reasons for Bans The main reason for the ban on homosalate is that it should not be considered a safe cosmetic ingredient. The European Union has determined that this substance poses a health risk and harms the environment when used above a certain dose and has restricted it. Its negative effects on the marine ecosystem in particular have been proven by scientific studies. While research on homosalate continues in countries such as the USA, experts advise consumers to turn to safer alternatives. EU Cosmetics Regulation Changes With the recent changes to the European Union (EU) Cosmetics Regulation, the use of homosalate in cosmetic products has been re-regulated. The Scientific Committee (SCCS) has determined that homosalate is not safe to use as a UV filter at concentrations up to 10%, considering its potential endocrine disrupting properties, and this substance is only considered safe to use in facial products (non-spray and pump spray products) up to a maximum concentration of 7.34%. This regulation aims to limit the use of homosalate in other cosmetic products and to increase consumer safety. These changes were announced on November 11, 2022 and entered into force on January 1, 2025 (10,11). Legal Regulations and Adaptation Process in the Global Market With the entry into force of these changes, a transition period of 24 months has been determined for new products to be launched on the market and 30 months for existing products to comply. In this context, the Turkish Medicines and Medical Devices Agency (TİTCK) has also started to update national cosmetic legislation to be compatible with the EU Cosmetics Regulation. In October 2022, the European Commission reduced the maximum permitted concentration of homosalate in body sunscreens from 10% to 0.5%. The Canadian Ministry of Health accepts homosalate as safe but is following developments in the EU. The Australian Therapeutic Goods Administration (TGA) accepts homosalate and allows its use up to 10%. The FDA has not evaluated homosalate on the GREASE (Generally Recognized As Safe and Effective) list and is requesting more safety data and is currently allowed to use up to a maximum of 15% (12, 13). Some alternatives that are considered safer to replace homosalate have become more popular. These are; mineral-based sunscreens such as zinc oxide and titanium dioxide. They provide physical protection instead of chemical filters and offer a safer alternative. Mexoryl SX and Tinosorb S are shown as safer options with fewer endocrine disrupting properties (12,14). In conclusion, considering the potential risks of homosalate, it would be a safer choice, especially for pregnant women, children and individuals with sensitive skin, to prefer sunscreens that do not contain homosalate, are mineral-based or contain low-risk chemical filters, both to protect skin health and to avoid long-term health risks. While sun protection is vital, the content of the products used should be evaluated as carefully as the protection factor. Therefore, it is of great importance to make a conscious choice when choosing sunscreens, which are one of the skin care products . References: Gül, Ü. (2012). Environmental Factors Affecting Skin Aging. Turkey Clinics Dermatology-Special Topics, 5(4), 1-6. Slevin, T. (Ed.). (2014). Sun, skin and health. Csiro Publishing. Cancer Council. Western Australia. TEKBAŞ, Ö. F., Didem, EVC İ., & ÖZCAN, UDU AN INCREASING DANGER WITH THE APPROACHING SUMMER SEASON: ULTRAVIOLET RAYS FROM THE SUN. Holt, EL, Krokidi, K.M., Turner, MA, Mishra, P., Zwier, TS, Rodrigues, NDN, & Stavros, V.G. (2020). Insights into the photoprotection mechanism of the UV filter homosalate. Physical Chemistry Chemical Physics, 22(27), 15509-15519. Homosalate, ChemIDplus. Wong, NG, Rankine, CD, Anstöter, CS, & Dessent, CE (2022). Photostability of the deprotonated forms of the UV filters homosalate and octyl salicylate: molecular dissociation versus electron detachment following UV excitation. Physical Chemistry Chemical Physics, 24(28), 17068-17076. Schreurs, R., Lanser, P., Seinen, W., & van der Burg, B. (2002). Estrogenic activity of UV filters determined by an in vitro reporter gene assay and an in vivo transgenic zebrafish assay. Archives of toxicology, 76, 257-261. Jiménez-Díaz, I., Molina-Molina, J.M., Zafra-Gómez, A., Ballesteros, O., Navalón, A., Real, M., ... & Olea, N. (2013). Simultaneous determination of the UV-filters benzyl salicylate, phenyl salicylate, octyl salicylate, homosalate, 3-(4-methylbenzylidene) camphor and 3-benzylidene camphor in human placental tissue by LC–MS/MS. Assessment of their in vitro endocrine activity. Journal of Chromatography B, 936, 80-87. Yang, C., Lim, W., Bazer, F.W., & Song, G. (2018). Homosalate aggravates the invasion of human trophoblast cells as well as regulates intracellular signaling pathways including PI3K/AKT and MAPK pathways. Environmental Pollution, 243, 1263-1273. Scientific Committee on Consumer Safety (SCCS). "Opinion on Homosalate." European Union, 2021. US Food and Drug Administration (FDA). "Sunscreen: How to Help Protect Your Skin from the Sun." FDA, FDA. US Food and Drug Administration. (n.d.). CFR - Code of Federal Regulations Title 21. Retrieved from https://www.fda.gov/drugs/understanding-over-counter-medicines/questions-and-answers-fda-posts-deemed-final-order-and-proposed-order-over-counter-sunscreen Health Canada. (2022). Draft: Guidance document - sunscreen monograph. Retrieved from https://www.canada.ca/content/dam/eccc/documents/pdf/pded/salicylates/Risk-management-scope-salicylates-group.pdf Benson, H. A. (2007). Sunscreens: efficacy, skin penetration, and toxicological aspects. In Dermatologic, Cosmeceutic, and Cosmetic Development (pp. 433-450). CRC Press.
Learn more
The Right Care Routine for Your Skin Type: A Comprehensive Care and Product Guide
The Right Care Routine for Your Skin Type: A Comprehensive Care and Product Guide Basic Criteria and Importance of Determining Your Skin Type Correctly Choosing the right product: Each skin type has different needs. By knowing the answer to the question of how to understand your skin type, you can choose the right products for your skin and minimize the risk of adverse reactions. Effective facial care: Using products suitable for your skin type helps prevent skin problems and eliminate existing ones. Healthy and radiant skin: A care routine suitable for your skin type preserves the natural balance of your skin and makes it look healthy and radiant. Symptoms of Dry Skin: Feeling of tension Flaking Itching Matte appearance Proneness to wrinkles and fine lines Symptoms of Oily Skin: Shiny and oily appearance Enlarged pores Tendency to blackheads, whiteheads and acne formation Makeup runs easily Symptoms of Combination Skin: Oiliness in the T-zone • Dryness on the cheeks Enlarged pores in the T-zone Tendency to blackheads and acne formation in the T-zone Symptoms of Sensitive Skin: Redness Burning and stinging sensation Itching Dryness and flaking Predisposition to allergic reactions How to Perform Skin Analysis and Changing Needs Simple Skin Tests You Can Do at Home If you are wondering how to understand your skin type, there are a few simple tests you can easily apply at home. Determining Skin Type with Napkin Test Cleanse your face: Wash your face with a gentle cleanser to remove any makeup or dirt, and pat dry. Wait: Wait 30 minutes for your skin to regain its natural oil balance. Tissue test: Press a clean tissue against your face and check for oiliness, especially in your T-zone (forehead, nose, and chin). Results: If the tissue is dry: You may have dry skin. If the tissue has too much oil: You may have oily skin. If the tissue has oil only in the T-zone: You probably have combination skin. Understanding Skin Type with Mirror Test Cleanse your face: Wash your face with a gentle cleanser to remove any makeup or dirt, and pat dry. Look in the mirror: After 15-20 minutes, look in the mirror and examine the overall appearance of your skin. Results: If your skin looks tight and flaky: Dry skin If your skin is shiny and oily: Oily skin If your T-zone is shiny and your cheeks are normal: Combination skin If you have redness or irritation on your skin: Sensitive skin Skin Type Analysis Through Observation The simplest answer to the question of how to understand your skin type is to observe your skin regularly. Pay attention to how your skin behaves in daily life. If your skin is often stretched and flaky during the day: Dry skin If your skin starts to shine and your makeup runs during the day: Oily skin If you feel oily in your T-zone and dry on your cheeks: Combination skin If your skin gets red, itchy or irritated easily: Sensitive skin Professional Methods to Determine Skin Type In order to get the most accurate results on how to understand your skin type, it is recommended that you consult a dermatologist. Dermatologists can determine your skin type by examining your skin in detail and can make special care recommendations for you. Skin Analysis by Dermatologists Dermatologists use various methods to find answers to the question of how to understand skin type: Visual Inspection: They examine the overall appearance, texture, and tone of your skin. Medical History: They will ask about your skin problems, allergies, and medications you are taking. Skin Tests: When necessary, they can perform tests such as allergy tests and sebum production tests. Determining Skin Type with Wood's Light Wood's light is a type of ultraviolet (UV) light that makes different pigments and bacteria in the skin visible. Dermatologists can find a more detailed answer to the question of how to understand skin type by using Wood's light. Effect of Seasonal Changes on Skin Type During seasonal transitions, skin care is at least as important as your immunity. During seasonal transitions, the skin can lose its healthy appearance due to sudden changes in weather conditions. The changes in humidity and temperature levels during transitions disrupt the skin's moisture balance. As a result, problems such as oiliness, dryness and sensitivity occur depending on the skin type. Applying appropriate care to the skin's needs during seasonal transitions is of great importance to maintain skin health. It would be good for us to review seasonal skin care practices. Some of the Skin Symptoms of Weather Change: Dryness and Flaking: Changes in temperature and humidity disrupt the skin's moisture balance and cause dryness. Redness and Irritation: External factors such as cold weather and wind can cause redness and irritation. Skin Tension: With weather changes, the skin may lose its elasticity and a feeling of tension may occur. Acne and Oiliness: Increased humidity can cause the oil glands to work too much and cause acne. More Sensitive Skin: During seasonal transitions, the skin becomes more sensitive and more reactive to external factors. Common skin problems during seasonal transitions are as follows: Dryness and flaking: Especially in cold weather, the skin dries faster and flaking occurs. Pore enlargement: When the temperature increases, pores enlarge, which can lead to oil accumulation on the skin. Skin spots: As a result of exposure to sunlight, spots increase during seasonal changes. Skin sensitivity: Wind and sudden temperature changes can cause skin sensitization and irritation. How Should Skin Care Be Done During Seasonal Transitions? During seasonal transitions, skin care should be organized to help the skin adapt to changing weather conditions. Here are the basic steps to consider: Moisturizing: With the change in weather, the skin's need for moisture may increase. Therefore, it is important to prevent the skin from drying out by using more concentrated moisturizers. Use of Sunscreen: UV rays continue to affect the skin during the winter months. Gentle Cleansers: Instead of harsh products for skin cleansing, gentle cleansers that preserve the skin's natural oil balance should be preferred. Peeling: Peeling should be applied once or twice a week to cleanse the skin of dead cells. Regular Care: Creating a care routine appropriate for your skin type and following the routine helps keep the skin healthy. Customized Care Program and Product Selection for Dry Skin Dry skin requires more care and attention than other skin types. There are several reasons for this: Fewer Oil Glands: Dry skin has fewer oil glands than other skin types, so the skin retains less moisture. Moisture Loss: Dry skin is less resistant to moisture and loses moisture faster. Tension and Itching: Dry skin often feels tense and is prone to itching. Easy Sensitization: Dry skin is more sensitive to external factors and can be easily irritated. → When choosing the right cleaning products, paying attention to the following points will be beneficial for dry skin: Sensitive Formulas: It is important to choose cleansing products that are formulated for dry skin, taking into account the pH balance. These products cleanse the skin without drying it and maintain its moisture balance. Moisturizing Properties: Choosing those with moisturizing properties among cleaning products will help meet the moisture needs of dry skin. Fragrance-free products: Perfume or scented cleaning products can irritate dry skin. Therefore, it would be more appropriate to choose unscented or lightly scented products. → One of the most important steps for dry skin care is choosing the right moisturizer. Dry skin needs extra moisturizing and therefore choosing the right product is important. Moisturizers Containing Hyaluronic Acid: Ideal for dry skin, these moisturizers penetrate deeply into the skin and provide long-term moisturization. They also increase the skin's elasticity. Creams Containing Shea Butter or Cocoa Butter: These oils nourish and soften dry skin. They also prevent water loss by strengthening the skin barrier. Moisturizers Containing Glycolic Acid: For dry skin, it renews the skin by removing dead cells and provides moisture balance. It can also help reduce fine lines and wrinkles. → Points to consider when creating a daily routine for dry skin care: Gentle Cleansing: Mild cleansers that do not dry out dry skin should be preferred. Oil-based cleansers can be used to remove makeup. Water-based cleansers can dry out the skin, so they should be chosen carefully. Moisturizer Usage: Moisturizing is very important for dry skin. Light-textured, specially formulated moisturizers for dry skin should be preferred. It is necessary to apply moisturizer at least twice a day, morning and evening. Sun Protection: Sunscreen products should be used to protect against the harmful effects of the sun. Sunscreens suitable for dry skin with at least 30 SPF should be preferred. Oily Skin Care-Balancing Care Routine and Special Applications Oily skin type is one of the most common types. If a person cannot correctly identify their skin type, they may use the wrong care product and this will cause more harm than good. Therefore, this skin type should be well known for oily skin cleansing and care. If the sebum produced by the skin is more than necessary, this means that you have oily skin. It is quite easy to identify oily skin type. If the skin thickens, gains an uncomfortable shine, there is acne and pimple formation, lines and flaking occur on the skin, pores are enlarged, and the makeup you apply does not last long, you can easily understand that you have oily skin type. In addition, it is necessary to be careful with sunscreens used in oily skin care; how homosalate containing products are absorbed by the skin and their possible effects should be taken into consideration. The care routine required by oily skin can be summarized in four steps: cleansing the skin, balancing oil production, moisturizing the skin and preventing the appearance of shine. How to Clean Oily Skin? Cleansing the skin regularly and effectively makes oily skin look more refreshed and clean. Therefore, choosing a cleansing gel and foam for oily skin is very important. Toners play a big role in combating pore appearance, which is one of the biggest problems of oily skin. Toner selection for oily skin should be made in favor of products that soothe and tighten the skin. Toners are antiseptic lotions prepared using different formulas and ingredients. People with oily skin can use toners containing alcohol continuously or periodically. However, since using products with a high alcohol content continuously can dry out the skin, the moisturizing stage of the skin should never be neglected. How to Moisturize Oily Skin? Moisturizers that oily skin should use should be lightweight and low in oil. The skin tissue around your eyes is extremely sensitive and thin. Therefore, it is necessary to be more careful and careful when applying moisture to this area. Because the eye area reveals oiliness, shine, fatigue and signs of aging much more clearly than other areas of the face. If you wish, you can choose products that are suitable for use on all areas of the face or you can add moisturizers prepared only for the eye area to your skin care routine. Using Masks and Peelings for Oily Skin For oily skin, using peeling is very important. Your skin renews itself approximately every 24 hours. This renewal process causes dead cells to accumulate on the upper layer of your skin. When dead cells are not removed from the skin, the appearance of pores and the possibility of skin problems increase. Peeling products allow you to remove dead cells from your skin with the particles they contain. The vast majority of face masks prepared for oily skin are aimed at preventing blackhead formation, tightening the skin and purifying pores. You can accelerate the renewal process of your skin and perform a more effective skin cleansing with face masks that you can use 1-3 times a week. Sebum Control and Pore Care: Hormones can cause increased sebum production and oily skin. This situation can cause pores to form. Pores can become clogged with sebum buildup. Clogged pores can cause skin blemishes. This can lead to skin imperfections such as blackheads. Individuals who are at risk of having open and visible skin pores can eliminate the possibility of skin pore enlargement by making a few small changes in their lives. Excess oil, dirt and makeup residue should be removed by cleansing the skin regularly. Using oil-free, water-based sunscreen can help reduce collagen loss in the skin and prevent enlarged pores. In cases where the number of pores increases too much, professional skin care help should be sought. Comedogenic (pore-clogging) products that can clog pores and cause them to expand should be avoided. Before going out in the sun, you should definitely use a sunscreen suitable for your skin type. A diet rich in omega-3 fatty acids and antioxidants can help keep skin healthy. Creating a regular skin care routine that suits your skin type can prevent pores from becoming enlarged. Using products and treatment methods that are suitable for your skin and approved by experts will be the most effective way to manage your pores. People who have pore enlargement problems on their skin should first discuss these ailments with a dermatologist who is an expert in the field. After the causes of pore enlargement are determined after a detailed examination, products suitable for the skin can be determined and medical treatment can be arranged if necessary. If medical treatments do not yield results, pore enlargements can be reduced or completely eliminated with the following procedures; Chemical Peeling: It can help to achieve smoother and firmer skin by peeling off the top layer of the skin. Carbon peeling: After applying a black solution containing carbon particles, laser is applied. With regular applications, a significant reduction in pores is observed. The biggest advantage of the procedure is that it can be done in the summer months. Laser Treatments: Tightens skin and reduces the visibility of pores by encouraging collagen production. Precautions for Acne-Prone Skin Most acne-prone skin is caused by hormonal changes. These changes start during puberty, but can also occur during women's menstrual periods or pregnancy. It can also be caused by stress, fatigue, inappropriate skin care products, and some medical care. Acne-prone skin is also genetic. Acne care is one of the top priorities for skin health. Topical Care Techniques and Product Combinations for Combination Skin Combination skin type is a combination of two main skin types: oily and dry. There is a mix of oily and dry areas in different areas of the face. It is characterized by skin with an oily area, typically on the nose, chin, and forehead. A gentle cleanser is used morning and evening to remove excess oil and dirt from the skin's surface. After cleansing, a nourishing toner should be used to balance and refresh the skin. People with combination skin should not touch their faces too often. All skin types need moisture. Therefore, combination skin should also be moisturized frequently. Using non-comedogenic products creates a good effect in combination skin care. Facial Cleansing For Combination Skin You can start by choosing a gentle, water-soluble cleanser. Gel-based and slightly foaming cleansers work well for combination skin. Face washing should not be skipped during the day to prevent oil buildup. Faces with combination skin should be washed twice a day, morning and evening. The skin should be exfoliated at regular intervals with the right products. Moisturizer for Combination Skin Combination skin needs a non-oily, yet rich moisturizer. Oil-free and fragrance-free moisturizers do not trigger oil production. Products with hyaluronic acid and minerals that are rich in hydration are suitable for daily use. Some moisturizers help prevent acne. If the T-zone is not too oily and there is little dryness, the same moisturizer can be used on the entire face. It is important to avoid heavy creams that contain oil, as they will make the skin oily and clog pores. Choosing an oil-free, water-based lotion or gel will help maintain the skin’s health by creating adequate moisture balance. Different Approaches for T-Zone and Cheek Area Combination skin type is usually a skin type where the forehead, nose and chin area is oily while the cheeks are dry. If the oil glands on the face produce more sebum than normal, a shiny and oily appearance can occur. If combination skin care is not done correctly, pores can become clogged and unwanted results such as acne or blackheads can be seen. The most well-known feature of combination skin is that there are both oily and dry areas on the skin. While flaky skin can occur on the cheeks due to dryness, blackhead tendency, shiny appearance and enlarged pores are common conditions in oily areas. It can be difficult to find skin care products suitable for the entire face because the forehead, nose and chin are oily and the other parts are dry. Using only products developed for oily or dry skin in combination skin care will not provide satisfactory results. For your daily care routine, you should first choose a cleansing gel for combination skin. After the cleansing gel, you can use a toner for combination skin for freshness. After toner in your care routine, you can provide the moisture your skin needs with a moisturizer for combination skin. In addition, you can prevent the formation of blackheads by cleansing pores from accumulated dirt with a mask for combination skin that you can use 1-2 times a week. Using products specifically formulated for combination skin: Treat the T-zone like oily skin. The aim is to reduce the shiny and oily appearance and effectively combat excess sebum by providing a mattifying effect. Moisturize and relax areas where you feel tense. You should never use "peeling" treatments, which are too aggressive for the dry parts of the face and stimulate sebum production in the oily parts. Proper Use of Balancing Care Products When applying care products, first apply water-based products, then oil-based products; that is, first apply products such as tonic, mist, lotion, serum; then creams and oils. Before moving on to routine examples, let's briefly explain what all skin care products are used for and how they are used: Step 1: Cleansing: The first step of morning and evening skin care is cleansing. It is known that there is no need for cleansers in the morning. However, a well-cleansed skin increases the absorption of other products you will use. And the skin produces sebum at night, the pores close. You can clean your skin with a gentle cleanser in the morning. There is no need for a double-step cleansing in the morning. You can preferably use a face wash gel or oil cleanser. You can do a two-stage cleansing in the evening. First, you can use facial cleansing oil and then facial cleansing gel. Oil-based cleanser: Cleanses the skin of oil, oily products, make-up and sunscreen. Applied to dry skin by massaging with dry hands. Water-based cleanser; Cleans water-based products, dead skin and dirt from the skin. 2. Tonic; Tonics have more than one function depending on their content. They have properties such as moisturizing, purifying, soothing, sebum balancing, skin pH balancing. If there is dirt or residue left from cleansers on the skin, it cleans the pores deeply. They also increase the absorption of products such as serums and moisturizers. Thus, it prepares the skin for skin care products after cleansing. They are suitable for morning and evening use. It is recommended to use acidic tonics in the evening. Acidic toners are specifically designed to purify the skin. The purpose of non-acidic toners, which have moisturizing properties, is to refresh, soothe and moisturize the skin while preparing it for care. 3. Serum; Serums that contain active ingredients in high concentrations reach deeper layers of the skin than other care products thanks to their fine molecules and offer intensive care for different skin concerns from spots to wrinkles. You can use serums containing arbutin, vitamin C, hyaluronic acid during the day. You can use serums containing retinol, AHA, BHA in your evening care. If you are going to use more than one serum on top of each other, you can order them from less concentrated to more concentrated. Do not use ingredients such as AHA and retinol on the same day. 4. Cream products Products applied before creams allow the cream to be absorbed better. Creams create a protective barrier on the skin. Moisturizers are included in this group. Skin that is not moisturized well is left defenseless, wrinkles more quickly, becomes more prone to blemishes and acne. 5. Oil-Based Products (Serum/Cream): Since oils have a covering structure, they prevent absorption when another product is applied on top. Thanks to their fixing feature, they increase the effectiveness of your care routine by ensuring that your serum or cream is better absorbed. 6. Eye Contour Cream: You can apply it at the last stage of skin care. It is a completely oil-based balm.
Learn more
The Link Between Endocrine-Disrupting Chemicals and Early Puberty
What is the Endocrine System (Hormone System)? The endocrine system is the name given to the system consisting of organs and glands that produce hormones and secrete them into the blood. What is the Endocrine (Hormone System) and What Does It Do? The endocrine glands (endocrine glands) are responsible for producing, storing and secreting hormones, each of which has different functions. These glands and the hormones they secrete mix with the blood and stimulate various organs. In this way, they perform many vital functions such as growth and development, metabolism, reproduction, and homeostasis, that is, the internal balance of the body. The main function of this system is to regulate body functions. What are the Parts of the Endocrine System (Hormone System)? The endocrine system consists of the hypothalamus, pineal gland, pituitary gland, thyroid gland, parathyroid gland, thymus gland, adrenal glands and pancreas, testicles in males, ovaries in females and placenta during pregnancy. What is an Endocrine (Hormone System) Disorder? Endocrine diseases occur when there is a deficiency or excess of hormones secreted by the endocrine glands, when the endocrine glands are too small or too large, or when the hormones do not work properly. In this case, the hormones disrupt the regulatory functions they are supposed to perform. Diabetes, thyroid deficiency, Cushing's syndrome are examples of diseases caused by disruptions in the hormonal system. What Causes Endocrine (Hormone System) Disorder? Disorders in the hormonal system can cause secondary attention deficit, immune system problems, metabolic disorders, premature birth, early puberty or gynecomastia, and epigenetic differences in the urogenital system. In addition, developmental disorders, polycystic ovary, hair growth, erection problems, beardlessness, small testicles and penis, inability to gain weight, inability to lose weight, obesity, hair loss and many similar problems are also caused by disruptions in the endocrine system. Endocrine (Hormone System) Disrupting Chemicals Endocrine disrupting chemicals are foreign substances that are suspected to cause hormonal system disorders, both naturally occurring and synthetic.[1] These chemicals interact with nuclear receptors in undesirable ways, disrupting the synthesis, transport, mechanisms, and metabolism of hormones. Although not limited to these, it has been observed that α and β estrogen receptors, androgen receptor, pregnane X receptor, peroxisome proliferative activating receptor α and γ, and α and β thyroid receptors are particularly affected by endocrine disrupting chemicals. Chemicals that affect different mechanisms are associated with developmental defects, immune, reproductive, and nervous system dysfunction, and increased risk of cancer. Type 1 diabetes, obesity, and nonalcoholic fatty liver disease are also among the diseases caused by endocrine disruptors. The idea that some chemicals could cause diseases and disorders in the endocrine system was first put forward in 1997 in the book Our Stolen Future, which claimed that DDT, dioxin, DES, and many other industrial chemicals damaged the endocrine system and caused disorders in the reproductive system.[1] At the time, the general consensus was that these chemicals showed their effects in high doses and were rare. Now, although more than 1,000 chemicals are identified as endocrine disruptors, this number is not even close to the truth. Even today, the methods used to identify and discover these chemicals are not systematic and fail to report the potential dangers of endocrine disrupting chemicals. Endocrine Disruptor Products Endocrine disrupting chemicals have become intertwined with our daily lives after industrialization, especially in cosmetic products, food packaging, pesticides and textile products. Although there are restrictions on some endocrine disruptors, especially those that emerge as by-products or mix with soil, water and air still pose a completely unpredictable danger. Endocrine disrupting chemicals that mix with nature threaten not only human health but also the ecosystem. These chemicals, which have found a place in the formulas of cosmetic preparations, are frequently used as preservatives, antibacterials and UV filters within the framework of restrictions. Some were completely banned after the Stockholm Congress, but they are still in use worldwide. Endocrine Disrupting Chemicals Bisphenol A is one of the most common endocrine disruptors in cosmetic products. Although there are many studies proving that it affects the endocrine system and is associated with cancer, it is frequently used in plastic production and, as a result, in packaging. It easily penetrates the food or cosmetic product inside the packaging material and enters the human body. BPA, a synthetic estrogen, has a receptor affinity of 1000 to 10,000 times that of natural estrogens. It negatively affects primarily the female reproductive system, as well as the pancreas, immune system and central nervous system.[31] Dichlorodiphenyldichloroethylene (DDE) is a derivative of DDT. It causes developmental disorders and male reproductive system disorders. It is very difficult to remove from the body because it accumulates in fat tissue. DDT and DDE are substances used in insecticides. It is also one of the first substances to have endocrine disrupting properties discovered.[1], [10] Triclosan is an endocrine disruptor often added to cosmetics as a preservative. It is found in shampoos and soaps. Dioxins are endocrine disruptors that are produced as a by-product of industrial production. They are released into the air due to the burning of waste. [10] Phthalates are added to many personal care products to increase fluidity. During pregnancy, they can inhibit or damage fetal development and cause premature birth. [9], [29] The endocrine disruptors in our daily lives are not limited to these; many endocrine disrupting chemicals are added to product formulations for different purposes. What is Early Puberty? Early puberty is a pathological condition characterized by the early manifestation of secondary sex characteristics. This condition is observed in one in every 5,000 to 10,000 children. This condition, which is up to ten times more common in girls than in boys, manifests itself in girls with early breast development before the age of 8 or menstruation before the age of 10, and in boys with secondary sex characteristics appearing before the age of 9. Early puberty causes an increase in hormone secretion in children, which can have consequences that threaten both their physical and psychological health. While a cause cannot generally be determined in girls, a specific cause is more likely to be found in boys. Precocious puberty is divided into two according to its dependence on the gonadotropin hormone; the one related to the gonadotropin hormone is called central precocious puberty, and the one unrelated is called peripheral (pseudo-precocious) puberty. The most common central precocious puberty is the idiopathic form. What are the symptoms of early puberty? In girls, breast growth, underarm and groin hair, acne, sweat odor, penis or testicular growth are signs of early puberty. In other words, the early changes that a child should experience during puberty are signs of early puberty. What Causes Early Puberty? Early puberty causes the pineal glands to fuse early and, as a result, development to be completed early. Tumors in the nervous system, hematoma formation in the hypothalamus, adenoma formation in the pituitary gland, short stature in adulthood, breast or reproductive system cancers have been associated with early puberty. Again, it can have consequences such as hypertension, diabetes and obesity in adulthood. Does Endocrine Disorder Cause Early Puberty? Adolescence is a period initiated and regulated by sex hormones. Therefore, disorders in sex hormones will also affect the puberty process. Although puberty is a condition that begins and develops depending on many genetic factors, the effect of environmental factors on development cannot be denied. Especially central precocious puberty, since it is dependent on the gonadotropin hormone, can be triggered by endocrine disrupting chemicals. Kisspeptin neurons, which are responsible for activating GnRH neurons in the neuroendocrine regulation of puberty, are sensitive to endocrine disrupting chemicals.[7], [8] It has been observed in mice that these neurons are damaged as a result of exposure to Bisphenol A, an endocrine disruptor. Again, in studies conducted on mice, it was observed that the ovaries of mice exposed to Bisphenol A and Diethylhexyl Phthalate during the fetal period were smaller than normal.[35] When rodents were exposed to endocrine disrupting chemicals during puberty, early puberty or delayed puberty occurred. It was determined that exposure to dibutyl phthalate during puberty accelerated puberty and disrupted estrogen balance in mice.[30] Bisphenol A has been observed to accelerate the onset of puberty by directly affecting neural pathways and reducing the activity of GnRH neurons.[18] Many endocrine disrupting chemicals have also been observed to cause early puberty in humans. For example, phthalates accumulate in breast tissue and cause changes in this tissue. Perfluorooctanoic Acid changes the structure of the mammary gland, again causing the tissue to grow. Dichlorodiphenyltrichloroethane, known as DDT, and its metabolites are linked to early puberty due to their estrogenic and anti-androgenic activities. In light of this information, it can be concluded that endocrine disrupting chemicals - regardless of the time and route of exposure before puberty - are effective in the pathophysiology of early puberty. Ways to Prevent Early Puberty Studies show that early puberty is closely related to genetic factors. In addition, exercise, diet, consumption of foods containing preservatives and dyes, and pollution of the living environment are among the risk factors.[5], [9], [12], [15], [34] While it has been observed that the risk of early puberty decreases as vegetable and protein consumption increases, it has been observed that excessive animal food intake increases this risk.[12], [15] It is possible to reduce the risk of early puberty with proper nutrition, sufficient exercise, healthy sleep, and extra care in the consumption of cosmetics , personal care products, and food. Source [1] Agostini, L.P., et al. “Glyphosate and the Key Characteristics of an Endocrine Disruptor: A Review.” Chemosphere, Pergamon, 19 Oct. 2020, www.sciencedirect.com/science/article/pii/S0045653520328149?casa_token=-18JKt5ALhoAAAAA%3APHOPPxv6VNUHOIj_CdL3hNGZ_QM0RcS94miYaBjzAM9mO5zbkIx7bTtq8pMVSPzHahSgd49Mmw. Accessed 26 Nov. 2024. [2] Amato, Angelica Amorim, et al. “Obesity and Endocrine-Disrupting Chemicals.” EC, Bioscientifica Ltd, 1 Feb. 2021, ec.bioscientifica.com/view/journals/ec/10/2/EC-20-0578.xml. Accessed 26 Nov. 2024. [3] Banerjee, Sayan, and Anurag Bajpai. “Precocious Puberty - Indian Journal of Pediatrics.” SpringerLink, Springer India, 19 Apr. 2023, link.springer.com/article/10.1007/s12098-023-04554-4. Accessed 26 Nov. 2024. [4] Bigambo, Francis Manyori, et al. “The Effect of Environmental Factors on Precocious Puberty in Children: A Case–Control Study - BMC Pediatrics.” SpringerLink, BioMed Central, 1 May 2023, link.springer.com/article/10.1186/s12887-023-04013-1. Accessed 29 Nov. 2024. [5] Brito, Vinicius N, et al. “The Congenital and Acquired Mechanisms Implicated in the Etiology of Central Precocious Puberty.” OUP Academic, Oxford University Press, 5 Aug. 2022, academic.oup.com/edrv/article/44/2/193/6656412. Accessed 26 Nov. 2024. [6] Cano, Raquel, et al. “Role of Endocrine-Disrupting Chemicals in the Pathogenesis of Non-Alcoholic Fatty Liver Disease: A Comprehensive Review.” MDPI, Multidisciplinary Digital Publishing Institute, 1 May 2021, www.mdpi.com/1422-0067/22/9/4807. Accessed 26 Nov. 2024. [7] Chen, Chung-Yu, et al. “Phthalates May Promote Female Puberty by Increasing Kisspeptin Activity.” Human Reproduction (Oxford, England), US National Library of Medicine, pubmed.ncbi.nlm.nih.gov/23945596/. Accessed 26 Nov. 2024. [8] MM Abdel, et al. “Short-Term Neonatal/Prepubertal Exposure of Dibutyl Phthalate (DBP) Advanced Pubertal Timing and Affected Hypothalamic Kisspeptin/GPR54 Expression Differently in Female Rats.” Toxicology, Elsevier, 20 Sept. 2013, www.sciencedirect.com/science/article/pii/S0300483X13002448?casa_token=W0ANRGH3J7QAAAAA%3AYypgbOoPY07Lc-wvsM-vyYNNM8lsZZRAnYAbPbSr5gQ3dDSbGQrFUfRlQarHWFxUEw8iqd4cBg. Accessed 26 Nov. 2024. [9] Dong, Yan, et al. “Analysis of Risk Factors of Precocious Puberty in Children.” SpringerLink, BioMed Central, 22 Sept. 2023, link.springer.com/article/10.1186/s12887-023-04265-x. Accessed 26 Nov. 2024. [10] “Endocrine Disruptors.” National Institute of Environmental Health Sciences, US Department of Health and Human Services, www.niehs.nih.gov/health/topics/agents/endocrine. Accessed 26 Nov. 2024. [11] EPA, Environmental Protection Agency, www.epa.gov/endocrine-disruption/overview-endocrine-disruption#:~:text=Disruption%20of%20the%20endocrine%20system,when%20it%20is%20not%20needed) . Accessed 26 Nov. 2024. [12] Fu, Dongxia, et al. “Analysis of the Incidence and Risk Factors of Precocious Puberty in Girls during the COVID-19 Pandemic.” Wiley Online Library, 28 Sept. 2022, Accessed 26 Nov. 2024. [13] Gea, Marta, et al. “Oestrogenic Activity in Girls with Signs of Precocious Puberty as Exposure Biomarker to Endocrine Disrupting Chemicals: A Pilot Study.” MDPI, Multidisciplinary Digital Publishing Institute, 20 Dec. 2022, www.mdpi.com/1660-4601/20/1/14. Accessed 26 Nov. 2024. [14] Gore, Andrea C., and Barbara Cohn. “Endocrine-Disrupting Chemicals in Cosmetics.” JAMA Dermatology, JAMA Network, 1 May 2020, jamanetwork.com/journals/jamadermatology/article-abstract/2762872. Accessed 26 Nov. 2024. [15] Gu, Qiuyun, et al. “Dietary Pattern and Precocious Puberty Risk in Chinese Girls: A Case-Control Study - Nutrition Journal.” SpringerLink, BioMed Central, 31 Jan. 2024, link.springer.com/article/10.1186/s12937-024-00916-6. Accessed 29 Nov. 2024. [16] “History of EDSP.” EPA, United States Environmental Protection Agency, www.epa.gov/endocrine-disruption/history-edsp. Accessed 26 Nov. 2024. [17] Jaël, Ngoie Mutunda, and Kasamba Ilunga Eric. “Endocrine Disruptors and Additives in Cosmetic Makeup Products: Alert to User.” Oarjbp.Com, 25 Dec. 2023, Accessed 26 Nov. 2024. [18] Klenke, Ulrike, et al. “BPA Directly Decreases Gnrh Neuronal Activity via Noncanonical Pathway.” OUP Academic, Oxford University Press, 1 May 2016, academic.oup.com/endo/article/157/5/1980/2422725#52077307. Accessed 26 Nov. 2024. [19] La Merrill, Michele A, et al. “Consensus on the Key Characteristics of Endocrine-Disrupting Chemicals as a Basis for Hazard Identification.” Nature Reviews. Endocrinology, US National Library of Medicine, Jan. 2020, pmc.ncbi.nlm.nih.gov/articles/PMC6902641/#Sec4. Accessed 26 Nov. 2024. [20] Lawson, Crystal, et al. “Gene Expression in the Fetal Mouse Ovary Is Altered by Exposure to Low Doses of Bisphenol A1.” OUP Academic, Oxford University Press, 1 Jan. 2011, academic.oup.com/biolreprod/article-abstract/84/1/79/2530282. Accessed 26 Nov. 2024. [21] Lee, Jeong Eun, et al. “Early-Life Exposure to Endocrine-Disrupting Chemicals and Pubertal Development in Girls.” Annals of Pediatric Endocrinology & Metabolism, US National Library of Medicine, June 2019, pmc.ncbi.nlm.nih.gov/articles/PMC6603611/. Accessed 26 Nov. 2024. [22] Lucaccioni, Laura, et al. “Endocrine-Disrupting Chemicals and Their Effects during Female Puberty: A Review of Current Evidence.” MDPI, Multidisciplinary Digital Publishing Institute, 18 Mar. 2020, www.mdpi.com/1422-0067/21/6/2078. Accessed 26 Nov. 2024. [23] Martin-Pozo, Laura, et al. Analytical Methods for the Determination of Endocrine Disrupting Chemicals in Cosmetics and Personal Care Products: A Review, Elsevier, Accessed 26 Nov. 2024. [24] Moise-Silverman, Joshua, and Lawrence A. Silverman. “A Review of the Genetics and Epigenetics of Central Precocious Puberty.” Frontiers, 8 Nov. 2022, www.frontiersin.org/journals/endocrinology/articles/10.3389/fendo.2022.1029137/full. Accessed 26 Nov. 2024. [25] Mucci, Andrea, and Ethel Clemente. “The Role of Genetics in Central Precocious Puberty: Confirmed and Potential Neuroendocrine Genetic and Epigenetic Contributors and Their Interactions with Endocrine Disrupting Chemicals (Edcs).” MDPI, Multidisciplinary Digital Publishing Institute, 25 July 2022, www.mdpi.com/2673-396X/3/3/35. Accessed 26 Nov. 2024. [26] “Overview of Endocrine Disruption.” EPA, Environmental Protection Agency, www.epa.gov/endocrine-disruption/overview-endocrine-disruption#:~:text=Disruption%20of%20the%20endocrine%20system,when%20it%20is%20not%20needed). Accessed 26 Nov. 2024. [27] National Center for Biotechnology Information. PubChem Compound Database, US National Library of Medicine, pubchem.ncbi.nlm.nih.gov/compound/p_p_-DDE#section=Metabolism-Metabolites. Accessed 26 Nov. 2024. [28] Papadimitriou, Anastasios, and Dimitrios T Papadimitriou. “Endocrine-Disrupting Chemicals and Early Puberty in Girls.” MDPI, Multidisciplinary Digital Publishing Institute, 10 June 2021, www.mdpi.com/2227-9067/8/6/492. Accessed 26 Nov. 2024. [29] Predieri, Barbara, et al. “Endocrine Disrupting Chemicals and Type 1 Diabetes.” MDPI, Multidisciplinary Digital Publishing Institute, 22 Apr. 2020, www.mdpi.com/1422-0067/21/8/2937. Accessed 26 Nov. 2024. [30] Qian, Yiyu, et al. “The Endocrine Disruption of Prenatal Phthalate Exposure in Mother and Offspring.” Frontiers, 26 June 2020, www.frontiersin.org/journals/public-health/articles/10.3389/fpubh.2020.00366/full?ref=assuma-o-controle-de-sua-saude.com. Accessed 26 Nov. 2024. [31] Terasawa, E., et al. “Endocrine-Disrupting Chemicals and Their Effects on Puberty.” Best Practice & Research Clinical Endocrinology & Metabolism, Baillière Tindall, 17 Sept. 2021, www.sciencedirect.com/science/article/pii/S1521690X21000968?fr=RR-2&ref=pdf_download&rr=8ea2cf8af9e77236. Accessed 26 Nov. 2024. [32] Xue, J., et al. “Endocrine Disrupting Chemical and Its Potential Effects on Female Health.” Diabetes & Metabolic Syndrome: Clinical Research & Reviews, Elsevier, 31 Mar. 2021, www.sciencedirect.com/science/article/abs/pii/S1871402121001077. Accessed 26 Nov. 2024. [33] Yin Wan, Murphy Lam, et al. Full Article: Endocrine Disrupting Chemicals and Breast Cancer: A Systematic Review of Epidemiological Studies, Taylor and Francis Online, www.tandfonline.com/doi/full/10.1080/10408398.2021.1903382. Accessed 30 Nov. 2024. [34] You, Jingyu, et al. “Clinical Risk Score for Central Precocious Puberty among Girls with Precocious Pubertal Development: A Cross Sectional Study - BMC Endocrine Disorders.” SpringerLink, BioMed Central, 20 Apr. 2021, link.springer.com/article/10.1186/s12902-021-00740-7. Accessed 29 Nov. 2024. [35] Zhang, Xi-Feng, et al. “Transgenerational Inheritance of Ovarian Development Deficiency Induced by Maternal Diethylhexyl Phthalate Exposure.” CSIRO PUBLISHING, 12 June 2014, www.publish.csiro.au/RD/RD14113. Accessed 26 Nov. 2024. [36] Zhou, Fang, et al. “A Preliminary Study on the Relationship between Environmental Endocrine Disruptors and Precocious Puberty in Girls.” De Gruyter, 1 Aug. 2022, www.degruyter.com/document/doi/10.1515/jpem-2021-0691/html. Accessed 26 Nov. 2024.
Learn more