<h4>Background</h4>The use of perfumes and cosmetic products is widespread, serving personal hygiene, aesthetic, and olfactory functions. However, concerns have been raised regarding the potential health impacts associated with long-term exposure to various ingredients used in these products.<h4>Objectives</h4>This narrative review aims to synthesize evidence on the health risks associated with perfumes and cosmetics, focusing on specific health concerns, including fertility, respiratory health, cancer risk, allergies, skin disorders, endocrine disruption, and neurological effects. It also discusses the presence of heavy metals in cosmetics, regulatory challenges, and the need for transparency in ingredient disclosure.<h4>Methods</h4>A comprehensive review of the literature that was published between 2005 and 2024 was conducted, examining findings from interdisciplinary studies relevant to the health impacts of cosmetic and fragrance products. The review highlights health concerns linked to specific chemical components, including synthetic chemicals such as phthalates, parabens, and volatile organic compounds (VOCs).<h4>Results</h4>The findings indicate that many synthetic chemicals in perfumes and cosmetics are associated with adverse health outcomes. These include allergies, respiratory issues, endocrine disruption, reproductive problems, and potentially cancer. Heavy metals in cosmetics also pose significant health risks. Despite regulatory guidelines, the cumulative and long-term effects of combined exposure to multiple cosmetic ingredients remain poorly understood and inadequately addressed.<h4>Conclusion</h4>There is a pressing need for stricter regulatory oversight and improved transparency in ingredient disclosure to safeguard consumer health. Further research is required to clarify the long-term health risks associated with the daily use of cosmetic products and to develop safer alternatives. Despite regulatory guidelines, the cumulative and long-term effects of combined exposure to multiple cosmetic ingredients remain poorly understood and inadequately addressed. Conclusion There is a pressing need for stricter regulatory oversight and improved transparency in ingredient disclosure to safeguard consumer health. Further research is required to clarify the long-term health risks associated with the daily use of cosmetic products and to develop safer alternatives. EDCs can interfere with hormones such as estrogen, testosterone, thyroid hormones, and insulin, provoking physiological disturbances across multiple systems. See Table 1 for health risks associated with common cosmetic ingredients and contaminants across multiple bodily systems and functions. TABLE 1 Common cosmetic contaminants: uses, exposure, health risks, regulations, and vulnerable populations. Reformulating products to use low- or zero-VOC ingredients, transitioning to solid or water-based cosmetic formats, and increasing the availability of unscented or naturally derived fragrance options can significantly lower exposure levels ( Anagnosti et al., 2021 ). For Skin disorders Cosmetic-induced skin disorders are widespread, particularly among individuals with sensitive skin or pre-existing conditions such as eczema, rosacea, and psoriasis. These individuals often have compromised skin barriers, making them more susceptible to irritation and allergic reactions from various cosmetic ingredients. Contact dermatitis, one of the most frequent adverse reactions, results from direct exposure to irritants or allergens ( Clouston et al., 2022 ). It can be categorized into irritant contact dermatitis (ICD) and allergic contact dermatitis (ACD), both of which cause redness, swelling, and discomfort. These results suggest that pregnant women should limit their exposure to products that contain phthalates and BPA to reduce the risk of AD in their babies. Long-term exposure to certain cosmetic ingredients has been linked to more persistent skin issues, such as perioral dermatitis (a facial rash around the mouth and nose) and acneiform eruptions, which resemble acne but are often triggered by specific cosmetic products like heavy moisturizers or topical steroids ( Goel et al., 2024 ). A case-control study found that urinary BPA concentrations were significantly higher in adults with acne (mean: 7.94 μg/g creatinine) compared to healthy controls (mean: 5.62 μg/g) ( Kaya Ozden and Karadag, 2021 ). Higher BPA levels were also correlated with increased acne severity and earlier onset. Frequent use of products with high alcohol content or astringents can exacerbate dry skin, leading to further complications like irritation and peeling ( Preller et al., 2024 ). The use of heavy or occlusive ingredients in skincare can also block pores and contribute to the development of cystic acne, especially in those predisposed to the condition. Over time, the cumulative effect of exposure to harsh ingredients can worsen the skin’s condition, leading to chronic inflammatory disorders that may require medical intervention. Furthermore, in one analysis, 44% of creams exhibited microbial contamination, surpassing EU safety thresholds 1 month after opening, suggesting poor preservative control and a heightened risk of skin infections ( Irfan et al., 2022 ). Given these risks, it is increasingly important to prioritize dermatologically tested formulations, especially for those with sensitive or reactive skin. Transparent ingredient lists are crucial in helping consumers identify known irritants or allergens. Kaya Ozden and Karadag (2021) Prospective human case-control study 101 adults (18–25 years; 51 acne patients, 50 controls) BPA, BPA-glucuronide • BPA was significantly higher in acne group (7.94 vs. 5.62 μg/g) • BPA concentration positively correlated with acne severity and earlier age of onset. Controlled for confounders such as BMI, diet, and age Did not measure hormone levels directly. BPA exposure history was self-reported. Kim et al.

Cosmetics and personal care products are essential for personal hygiene and appearance; however, their safety remains a key concern due to associated adverse effects. This systematic review aims to evaluate the adverse effects and safety concerns related to skincare products and to analyze product characteristics and usage patterns for improved consumer safety. The study adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and adopted diverse database searches across PubMed, Medline, Google Scholar, and Scopus from 2014-2024. Only peer-reviewed and cross-sectional studies were included along with a data extraction sheet, and the Critical Appraisal Skills Programme (CASP) tool was utilized for quality assessment. Data synthesis involved descriptive and qualitative analysis to identify common themes and implications. Nine studies were included in the review, comprising 4,569 participants across geographically diverse regions. The common adverse effects reported included acne (36%), redness (27%), itching (19%), and skin irritation (18%). Ingredient analysis identified that fragrances, preservatives, and colorants are commonly related to adverse effects. Usage patterns like frequency and duration of usage were correlated with the likelihood of adverse effects. The review focused on significant adverse effects linked with cosmetic and personal care products, highlighting the necessity for better awareness, clear labels, and strict regulations. Enhanced customer education and following safety protocols are crucial to minimize risks and ensure product safety. Data synthesis involved descriptive and qualitative analysis to identify common themes and implications. Nine studies were included in the review, comprising 4,569 participants across geographically diverse regions. The common adverse effects reported included acne (36%), redness (27%), itching (19%), and skin irritation (18%). Ingredient analysis identified that fragrances, preservatives, and colorants are commonly related to adverse effects. Usage patterns like frequency and duration of usage were correlated with the likelihood of adverse effects. The use of these products is widespread across all demographics and regions, driven largely by consumer interests in personal appearance and hygiene [ 1 ]. An online survey by Cosmetics Europe in 2017 revealed that 71% of respondents considered cosmetics essential in their daily lives, while 72% believed these products enhanced their quality of life [ 3 ]. Studies indicate that cosmetics are formulated from a blend of ingredients and must comply with safety standards. Numerous regulations have been designed to ensure the safety and efficacy of skincare products for enhanced consumer safety and to minimize risks. Adverse effects were frequently reported and included acne (36%), redness (27%), itching (19%), and skin irritation (18%), with significant concerns about safety, particularly related to product sharing and the addition of water or saliva to cosmetics. The CASP scores for the studies varied, with most studies scoring between 7 and 9, reflecting generally high methodological quality and rigorous evaluation. Prevalence and Types of Adverse Effects Kumari et al. (2023) found that colorants, usually synthetic dyes, are majorly linked to allergic responses in most of the respondents [ 15 ]. Meharie et al. (2023) analyzed the systemic effects, including respiratory issues and gastrointestinal disturbance, and found them rare but significant in the female population. Gender differences also played a key role - a high prevalence was reported in the female population due to their frequent use of a variety of personal care products. Safety Concerns and Product Characteristics Three studies have reported the analysis of ingredients, which revealed that certain ingredients are frequently associated with adverse effects. Among them, the major ingredients were fragrances, preservatives (such as parabens), and colorants. Udayanga et al. (2015) found that the usage frequency and duration also play a key role - higher frequency or prolonged use of products usually increases the chance of developing adverse effects [ 21 , 15 ]. El Emam et al. (2022) identified that products with complex formulations or multiple active ingredients also increase the risk [ 9 ]. The presence of allergens in formulations is a key issue, and products with fewer allergens are linked with a lower incidence of adverse effects. Risk Factors and Preventive Measures Three studies identified that individual risk factors can predispose users to adverse effects. Meharie et al. Among them, skin irritation is a common cause. Allergic reactions usually included hives and eczema, which were highly reported in the studies. Systemic effects included respiratory issues, highlighted by three studies [ 6 , 8 , 11 ]. In terms of gender differences, the female population was highly vulnerable due to its frequent usage of a variety of products. Safety concerns were linked to ingredients like fragrances, preservatives, and colorants, which led to adverse effects. Individuals with existing skincare issues were more prone to adverse effects. Mitigative measures included patch-testing and strict regulations to improve product safety and minimize associated risks. This buying pattern reflects the purpose of enhancing appearance and self-esteem, echoing earlier research that women use cosmetics to improve attractiveness and mask imperfections [ 15 ]. Notably, an earlier study highlighted that facial and hair cosmetics often contain heavy metals, which can accumulate and cause toxicity [ 16 ]. Our findings align with these concerns, as most women reported using chemical-based products, which have been associated with more adverse events compared to Ayurvedic products [ 17 ]. Studies have documented various adverse effects of cosmetics [ 18 - 22 ]. Mohiuddin et al.