lipstick, sle, survey, systemic lupus erythematosus
K Masters. Lupus And Lipstick: The Industry Responds. The Internet Journal of Dermatology. 2008 Volume 7 Number 1.
Since 1969 , there has been a suggested link between the use of lipstick and the onset of systemic lupus erythematosus (SLE). More recently, Wang
Studies consistently report that 80% to 90% of all SLE patients are women, half of whom first present symptoms between the age of 15 and 30 [3,4,5,6,7].
It is difficult to know the percentage of women who wear lipstick, but, in Western Countries, the figure appears to be at least 50% [2,8,9] with some estimates of 98% of women in the USA between the ages of 18 and 34 , and popular press estimates ranging from 70% to 90% [11,12].
Given this information, there is surely a need for a response to the work of Burry and Wang
Of the 30 largest cosmetics and toiletries companies (by market share, as determined by Euromonitor International ), 19 companies either manufacture lipstick, or are holding companies of lipstick manufacturers.
From June through August 2008, a survey was conducted of these 19 companies. The survey consisted of a brief introduction, including a link to Wang
1. Is your company aware of these studies that suggest this link between lipstick and SLE?
2. Has your company (or somebody on behalf of your company) ever researched the link between lipstick and SLE?
3.1 If Yes, what were the results, and how can the public access them?
3.2 If No, what are the reasons?
4. Given the research, especially this most recent article, what is your company's overall comment on this link between lipstick and SLE?
Of the 19 companies, 16 could be surveyed electronically, either via email, or their “contact us” form on their web page. The three remaining companies were contacted via normal postage.
After two weeks, follow up emails and letters were sent to non-responders. After a further two weeks, a second follow up, in the form of normal postage, was sent.
The responses were themed using NVivvo Version 7.
Of the 16 companies contacted electronically, 100% sent computer-generated confirmations that the survey questions had been received.
Of the 19 companies, a total of 10 (53%) companies responded to the survey. (For the purposes of this study, although the number of machine-generate response is noted, only these 10 human-generated responses are considered survey responses).
The responses were classified into the following themes:
Refusal to participate
Two companies [C, I] refused to participate in the survey, only one of which gave a reason:
Refusal to participate electronically
Three companies (D, E, H) refused to participate via email; one [D] cited the complexity of the question, and gave further contact details. The contact details drew no further response.
Three companies [B, F, J] gave standard disclaimer-type responses, referring in general to laws and safety, with little or no reference to the questions.
's response appeared to be a copy-and-paste from a “Frequently Asked Questions” (FAQ) question on the company's web page, regarding the amount of lead in lipstick. (The response cannot be reproduced in this article, as a search on the Internet for the quotation would identify the company).
One Company [J] dismissed the validity of Wang
Further, that the relationship between lipstick and SLE is not known and not confirmed by the named study. [J]
Answering the questions
Only two companies [A, G] addressed the questions. [A] was aware of the link between lipstick and lupus, while [G] was not. Neither company had conducted research into the link, although [A] had been following the research. [G] had not come across “any specific reports linking lipstick use with the onset of Lupus or any other similar medical conditions.” [A] could not express an overall opinion because of the limited number of reports, and [G] said that it would “carry out an analysis of this any other related medical reports to establish if any further investigation or action is necessary.”
The high female/male ratio of SLE patients and the fact that most women wear lipstick does not argue a causal relationship, as there is a range of factors that contribute to the onset of SLE [3,7,14,15]. It appears, however, that the lipstick manufacturers' target consumer group is the highest at-risk group for SLE. When one considers this fact in the light of the research by Wang
A lack of lipstick industry concern
From the results of this survey, however, the concern does not appear to be shared by the lipstick industry.
There is the possibility that the industry's researchers are unaware of SLE, and the impact that it has on women. This, however, is certainly not across the board: representatives from lipstick manufacturing companies openly support lupus research programs , the companies have funded research into lupus , and their products are recommended as topical protection for lupus [19,20,21]. In addition, the survey conducted in this study directed the companies to Wang
Parallels with another industry
It might be unfair to draw parallels, but the responses and broad assurances in the face of the evidence are reminiscent of the responses and assurances from the tobacco industry to the connections between tobacco usage and lung and heart disease [22,23].
Perhaps, however, there are lessons to be taken from this parallel. Firstly, as was realised by the tobacco industry, it may be time that the lipstick industry “come forward with evidence to show that its products, present and prospective, are not harmful” . This need is heightened by the ingestion of lipstick , and is surely heightened by long-lasting lipstick.
Secondly, this parallel indicates a route for medical professionals. A legitimate defence of the lipstick manufacturers is that they adhere to international laws and practices. The medical profession, just as it did with tobacco, may, therefore, have a role to play in adjusting those international laws and practices.
Apart from further research on the direct link between SLE and lipstick usage, we should be concerned about third parties. Just as the dangers of passive smoking were not initially recognized , so there is not yet evidence on the impact of lipstick transfer, an area chiefly the domain of forensic scientists or lipstick companies concerned with aesthetics. Further research into lipstick transfer, particularly in respect of transfer to children and infants, is required.
Where do the consumers stand?
The consumers in this case are potential SLE patients. The lack of meaningful response from the cosmetics companies means that these potential patients are left to decide for themselves. Their reaction may move between two extremes: one in which they ignore the lupus research, and the other in which they refer to lipstick as ‘lupustick.’
For four decades there has been a small but growing body of evidence to suggest a link between lipstick and SLE. This paper has attempted to obtain the industry's position to this link. The current industry response is not appropriate, and it is necessary to pursue this further.
The author thanks the companies that participated in this survey.