October is Breast Cancer "Awareness" Month, but part of the mission behind my website is to bring education that hopefully amounts to prevention for health problems. Breast Cancer Prevention Awareness Month is more of a mouthful, but I like that much better ;-)
Breast cancer hits close to home to me since, when I was 9, one of my aunts died in her early 40s due to breast cancer. It absolutely devastated my my family and had a profound impact on my childhood because of how crushed my mom was to lose her sister, and it caused me to grow up fearful of this awful disease.
I take my own breast health very seriously and do monthly self-exams (use this app for a monthly reminder) as well as lead a lifestyle doing everything I can, equipped with the best current science, to reduce my risk. There are So. Many. Factors. that can affect your risk, I'm splitting this up into a series and will focus on common ingredients found in conventional skincare in this post, and follow up with other topics in future posts this month (and maybe beyond this month, too).
To illustrate just how huge this topic is, in doing my literature review for this post I came across this massive current review paper titled: State of the evidence 2017: an update on the connection between breast cancer and the environment. The PDF is 61 pages and it has almost 900 references. I want to try to distill all of this information into bite size pieces for you, and provide actionable items you can take to reduce your risk.
A few tidbits from the above study:
“...the breadth and strength of the evidence cited in this review, when taken as a whole, reinforce the conclusion that exposures to a wide variety of toxicants – many of which are found in common, everyday products and byproducts – can lead to increased risk for development of breast cancer.
[...]
Increasing evidence from epidemiological studies, as well as a better understanding of mechanisms linking toxicants with development of breast cancer, all reinforce the conclusion that exposures to these substances – many of which are found in common, everyday products and byproducts – may lead to increased risk of developing breast cancer.”
Drop the mic, THOSE are some strong statements.
They divide the environmental factors into 7 categories:
(1) Hormones: Pharmaceutical agents & personal care products;
(2) Endocrine disrupting compounds (EDCs);
(3) Hormones in food: Natural and additives;
(4) Non-EDC industrial chemicals;
(5) Tobacco smoking: Active and passive;
(6) Shift work, light-at-night and melatonin; and
(7) Radiation.
Rather than gloss over all of them, I thought it more important to write focused articles like this one, which covers #2. I'm particularly interested in #6 and will probably write about that next! Light exposure at night and disruption to melatonin are also factors with a huge impact on fertility as well, and I've done a lot of research on that thread for Liz Wolfe's Baby Making and Beyond course (I am the lead researcher for that project!)
If you want to go deeper in the discussion of safe skincare and makeup with me, join my Facebook group.
Side note: a lot of what I am going to tell you about breast cancer risk may ALSO apply to prostate cancer risk. And of course, men can get breast cancer, too. So ladies, gets your husbands on board with you!
Remember, I am a scientist, not a doctor, so I am just sharing science-backed information either directly from the literature or from reputable organizations, not to be confused with medical advice. Talk to your {preferably holistic-minded} healthcare provider about you breast cancer or other health concerns.
Breast Cancer Statistics
Here are some facts from to the National Cancer Institute:
40 years ago, 1 in 20 women would receive a breast cancer diagnosis in her lifetime. Today, 1 in 8 women will be diagnosed with breast cancer at some point in their lives.
Only 50% of breast cancers can be attributed to traditional risk factors, such as genetics, age, diet, and reproductive history. That leaves 50% potentially due to other lifestyle factors, including carcinogen & hormone disruptor exposure from pollution, cosmetics, personal care products, household cleaning products, plastics, and more (see quotes above!)
85% of breast cancers occur in women with no family history of breast cancer.
There are 2 major classes of chemicals that have become pervasive in both conventional personal care/household products and in the environment with links to breast cancer: parabens and phthalates.
Parabens and breast cancer
Parabens, a ubiquitous class of preservatives used in conventional cosmetics/personal care products, are xenoestrogens. Xeno means “foreign” (meaning, produced outside of the body in this context) estrogen, meaning they act like estrogen in our bodies. They are considered "weak" estrogenic compounds, but that does NOT mean their effect is non-significant. The opposite, actually.
Parabens have been shown to increase the rate of proliferation of breast cancer cells even at low concentrations - concentrations that many people who are using dozens of conventional skincare, cosmetics, personal care products, and household cleaners each day would be exposed to under normal life circumstances.
Sometimes scientific studies use megadoses of compounds/drugs/etc. to evaluate their effects, but with parabens typical real-world exposure levels have been shown to increase the rate of proliferation of breast cancer. Not good!
Here's another quote for you: "long-term exposure (>20 weeks) to parabens leads to increased migratory and invasive activity in human breast cancer cells, properties that are linked to the metastatic process." (source)
Parabens are also found in 99% of breast cancer tumors. Previously, the significance of this was not known. Parabens can actually be found in tissues throughout the body.....so is there a special reason they're in breast cancer tissue? Do they migrate to the malignant tissue for some reason? Are they there because they cause the cancer to develop in the first place? These are the questions scientists have been asking.
Well, in the last few years, more "evidence that parabens can enable development in human breast epithelial cells" has been emerging. This is an active area of research and there is no concrete data yet to show that parabens definitively can cause breast cancer, but the existing evidence is certainly enough for me to avoid them, especially since better, safer preservative options exist.
Of note, the study above is one that Breast Cancer UK uses in their argument to support phasing out parabens from products designed to be applied to the skin. So I am not the only one who thinks this is a big deal!
In an animal model, puberty has been shown to be a critical time window for exposure to parabens to cause changes in breast tissue that increase the risk of developing breast cancer (source). And puberty is exactly when most young girls start applying multiple products daily that contain parabens. I know I sure did!
Phthalates and breast cancer
Phthalates are a class of chemicals used to make plastics flexible and stable, and are used in the personal care product industry in nail polishes (to reduce cracking and make them less brittle), hair sprays (to prevent stiffness and for a flexible firm hold), and fragrances, including conventional perfumes and colognes and the ingredient listed as “fragrance” or “parfum” on skincare and cosmetics.
Phthalates are used in fragrance to make it unnaturally "sticky". You know how it never wants to come out of your hair, clothes, or wash off your skin, but essential oils will dissipate naturally after a few hours? That's thanks to the phalates, most likely diethylphthalate (DEP).
Phthalates are known as "endocrine disrupting chemicals" (EDCs) or "hormone disruptors" and they actually can affect how both estrogens and androgens function in the body. They are linked to a lot of gnarly negative health consequences....in some ways the link to breast cancer is the least bad.....but they're all bad.
Since this post is about breast cancer, I'll focus on that. Phthalates have been shown to induce proliferation, migration, invasion, and tumor formation of estrogen receptor negative breast cancers. What's interesting about that is that it shows that they have negative health consequences beyond their ability to disrupt hormones.
Phthalate metabolites (the compounds that our bodies turn them into before they are excreted) in the urine are linked to an increased risk of both breast cancer and uterine fibroids (d'oh! I wonder if they contributed to my case!)
Phthalates are linked (here too) to early breast development (thelarche) in girls, and early breast development increases the risk of breast cancer (and other diseases, too).
Non-cancer phthalate health effects? Let me quote a section of this paper’s introduction for you. I’m leaving the citations intact in case you’d like to follow up with your own reading to better understand each aspect:
“Phthalates have been previously determined to be endocrine disruptors, and exposure has been found to be associated with a number of adverse health outcomes. In particular, in utero exposure assessed in prospective studies has been linked with preterm delivery [Ferguson et al., 2014], pre-eclampsia [Cantonwine et al., 2016], decreased birth size [Whyatt et al., 2009], sex-specific changes to childhood growth and blood pressure [Valvi et al., 2015], poorer neurodevelopment [Engel et al., 2010; Kim et al., 2011; Factor-Litvak et al., 2014], and decreased male reproductive health [Cai et al., 2015; Swan et al., 2015]. Moreover, maternal and paternal preconception exposure to phthalates has been associated with poorer birth outcomes [Smarr et al., 2015], and exposure in 6–8 year old girls has shown a relationship with BMI and waist circumference increase at 7–13 years [Deierlein et al., 2016]. Cross-sectional studies also demonstrated an association between phthalate exposure and thyroid hormone levels during pregnancy [Huang et al., 2016] and with adult body composition [Corbasson et al., 2016]. Overall, prenatal and lactational exposure to phthalates have been associated with endocrine disrupting effects in animals and adverse birth outcomes in humans, indicating that early life phthalate exposures may contribute to the fetal origins of disease.”
And here is a quote from the mammoth review paper that inspired me to write this article in the first place:
“The endocrine-disrupting properties of this class of chemicals have been well established in the offspring of mother rats who had been treated with phthalates while pregnant. Phthalates disrupt the development and functioning of male and female reproductive systems by interfering with the production of testosterone and estradiol, respectively. Abnormalities in male offspring exposed prenatally included nipple retention, shortened ano-genital distance and increased cryptorchidism . Exposure of human mothers to phthalates, as measured by analysis of their urine samples, has also been associated with shortened ano-genital distances in their newborn sons — a measure of feminization of external genitalia.”
See, I told you it was bad. Phthalate exposure has also been associated with smaller penis size in male newborns in Mexico.
Are parabens and phthalates absorbed through the skin?
Interestingly, the CDC states that contact with the skin can be the most significant route of exposure to harmful chemicals, since what comes in contact with your skin gets absorbed into your bloodstream via a process called diffusion, in which the substance/chemical travels from an area of higher concentration to an area of lower concentration.
As you can see in the images on their site, the mechanism by which this happens is one of three ways: by seeping in between skin cells (intercellular lipid pathway), infusing directly into the skin cells (transcellular permeation), or by seeping in through the hair follicles or glands. Rate of absorption depends on many factors, including (adapted from the CDC link above):
Skin integrity (damaged vs. intact)
Location (thickness and water content of the outer skin layer have an effect)
Skin temperature
Physical/chemical properties of the chemical
Concentration of the chemical
Duration of exposure (that's gonna be all day for cosmetics/skincare...)
Surface area of skin exposed (a body lotion that goes head to toe vs. under eye cream)
Think about it: transdermal (translation: through the skin) patches of drugs are extremely effective. Birth control patches, nicotine patches, fentanyl patches...these all work extremely well. Anyone who works in the medical field like I did will already know this. Same goes for cosmetics, personal care products, soaps, and anything else you put on your body: certain ingredients absolutely absorb into your bloodstream.
And on the CDC link above it lists professions with the highest hazard risk for exposure to harmful chemicals, and guess who is on that list??! COSMETOLOGISTS. People working with conventional cosmetics, hair care, and nail polish.
Side note/rant: the "factoid" that gets passed around a lot as an internet meme is that "everything you put on your skin gets absorbed in 26 seconds". This is totally not supported by science as you can see above. But, to be clear, parabens and phthalates definitely get absorbed and can be measured in the urine (you already knew that, though, since it’s mentioned earlier in this article) According to this study, parabens or their metabolites may be found in as many as 96% of adults' urine, and this study found 7 different phthalate metabolites in the urine of 100% of their study subjects. Yikes!
But to be clear, not every ingredient in skincare and cosmetics can be absorbed into your bloodstream. Just think about it for a moment: if everything was absorbed in 26 seconds, how would any skincare product have effects on the skin?! If it all disappeared into your bloodstream in 26 seconds, it wouldn’t be very effective at causing improvements in the skin ;-)
How to avoid parabens and phthalates to reduce breast cancer risk
Avoiding parabens is the most straightforward: Look for the following ingredients on the labels of ANY cosmetics, personal care products, soaps, deodorants, toothpaste, haircare, household cleaners, etc:
methylparaben (ESPECIALLY avoid this one)
propylparaben
ethylparaben
butylparaben
and anything else ending in -paraben
Parabens are also used in some processed foods, so read those labels too! Methylparaben and propylparaben are both designated by the FDA as “generally recognized as safe” (GRAS)
Avoiding phthalates is much more difficult, because they do not have to be listed on the labels of cosmetics and personal care products, and they are used in many other household products and even toys.
When it comes to cosmetics and personal care products, you have to rely on the company to disclose whether or not they use phthalates in their formulas or not. Be sure to look for this information (or call/email the company to ask) for any of these products:
Perfumes and colognes
Any product with the word "FRAGRANCE" or "PARFUM" on the label (this is most conventional skincare, body care, and many cosmetics, too)
Hair spray
Nail polish
This is not an exhaustive list, but phthalates may also be found in all of these items as well:
Vinyl shower curtains (PEVA/EVA is the next best plastic option, you can also opt for hemp, polyester, or cotton)
Vinyl floors
Mini-blinds
Air fresheners (including plug-ins, sprays, and reed diffusers)
Detergents
Adhesives
Insecticides
Soft-sided lunch boxes
Plastic food wrap and bags
Plastic food containers
Plastic toys
Automobiles (ugh!)
Since phthalates are ubiquitous in the environment now I think that makes it all the more important to take steps to reduce exposure where you can. You have 100% control over the products you apply to your skin each day, so use that control to eliminate phthalates from your daily routine.
Use the Environmental Working Group's Skin Deep Database https://ewg.org/skindeep. You can learn a TON of information with this website (or the companion app called Healthy Living - you can use this app to scan products with your phone!). You can search for products by name and also learn about specific ingredients. Set a goal to overhaul your products to ALL be in the green: rated 1-3, or better yet, EWG Verified (which means they meet the strictest standards for safety). Start by eliminating the WORST offenders first (in the red, 7-10).
I totally get it that it is a process to do this.....and it is expensive to replace products. But the sooner you can reduce your toxic load of exposure to these chemicals, the better. Every step in the right direction counts.
Sweating for Phthalate Detoxification
Even if you take steps to clean up your home environment, you are still going to be exposed to phthalates when you venture outside your home. Thankfully, one of the most effective ways to help your body eliminate phthalates is easy: through sweating.
Sweat lodges and saunas have a long history of use for their incredible health benefits. We modern humans can add to the list their ability to help us excrete phthalates (and a number of other modern toxic chemicals). This study found that the concentration of phthalates was twice as high in sweat as compared to urine, and the authors conclude that inducing sweating is an excellent way to eliminate (their words) "toxic phthalate compounds" from the body.
Now You Understand why I am so passionate about safe cosmetics and skincare.
I knew about parabens and phthalates in 2010 when I overhauled my diet and lifestyle to regain my health. I did my darndest to avoid parabens and phthalates.
I went the crunchy route and did no 'poo for my hair (read more about that here), washed with castille soap only, made my own deodorant and toothpaste, attempted to make my own makeup, used coconut oil for #AllTheThings, replaced household cleaners with distilled vinegar, vodka, and hydrogen peroxide (this still works great for me, btw), replaced laundry detergent with soap nuts, got rid of non-stick pans, replaced all plastic food storage containers with glass, etc.
Some of these things worked well for me, but most of them ended up being frustrating and made me look.....less than polished, let's just put it nicely.
Back then, there were VERY few options for safe cosmetics and skincare. I felt that to truly protect myself and my husband I had to take this extreme approach and buy minimal products and/or make my own.
I even took the first steps in launching my own natural skincare line......but that ended up falling through. (I still have killer deodorant & sun care lotion (can't call it sunscreen) recipes, though, maybe I'll blog them one day!)
Luckily, today, the industry is changing. Lots of brands are stepping up and making changes. We've even got mega retailers like CVS, Target, and Wal-Mart declaring a commitment to more transparency and safer products on their shelves.
Please, Switch to Safer Skincare and Cosmetics
Again, use the Skin Deep Database/Healthy Living app to find safer options.
The EWG site/app above makes it really easy for you to make an educated decision about brand(s) you come across. But I know that this can be an overwhelming topic to tackle, so if there is ANYTHING to help you, please comment below or email me via the contact form in the home bar. I am passionate about bringing education to improve lives, and really truly happy to do anything I can to help you make better choices.
I get asked all the time, so I will tell you: Beautycounter is by far my favorite option for for safer, high performing cosmetics, hair care, and skincare. I use Cote nail polish and Primally Pure charcoal deodorant (you can take 10% off your first order with my code, too: CURIOUS)
I was so done with the days of raccoon eyes by lunch with other safer brands of eye makeup and my DIY disasters. And I was not willing to put my health at risk to continue using conventional paraben- and phthalate-laden cosmetics. That’s why I was so grateful for Beautycounter’s ultra high-performance products.
I proudly joined the Beautycounter mission as a consultant to get safer products into the hands of EVERYONE back in 2016. Note that the mission isn't to get Beautycounter in everyone's hands, it's to radically shake up the entire industry so that ALL products must meet much higher safety standards. Beautycounter is incredibly politically active working hard to get our antiquated cosmetics laws updated for the modern era.
I will advise you, though, that I am not aware of any other brands currently that take the extreme levels of caution that Beautycounter does with their ingredient screening and product formulation. If you do know of any, please tell me! But here are the things you should inquire of any skincare brand.
Ask the tough questions (Beautycounter passes all of these, by the way):
Do you 3rd party test every batch of all mineral ingredients for heavy metal contamination?
If so, what is your threshold for rejecting a batch?
Are there hormone disruptors present in your packaging?
Do you disclose all fragrance ingredients?
Do you include parabens or phthalates in the formulas of your products?
Are there other endocrine disrupting chemicals in your products?
Do you test on animals?
Stay tuned for more posts in this series. Drop any questions or topic requests in the comments below!
