The Antisocial Doctors Podcast
Join Dr. Rebecca Berens & Dr. Sonia Singh as they unpack viral health trends with curiosity, nuance, and compassion. No snark, no shame —just thoughtful conversations about what’s true, what’s hype, why we're drawn to it and how to find calm and clarity in the chaos of social media and online health advice.
The Antisocial Doctors Podcast
Episode 5: Should We All Be Switching to Clean Beauty?
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You are listening to the Antisocial Doctors Podcast, hosted by me, Sonia Singh, a board certified internal medicine physician with a Master's in nutrition and a special interest in health anxiety
Rebecca Berens MD:and me, Rebecca Barons, a board certified family medicine physician with a special interest in disordered eating.
Sonia Singh MD:We're also a millennial women anxious moms and curious humans navigating social media. We've seen firsthand how these platforms can be powerful tools for education and connection, but can also make us unwell.
Rebecca Berens MD:This podcast is meant to be the antidote to your doom. Scrolling, a solve for the anxiety, stress, guilt, shame, and confusion that comes from social media's messaging around health. In each episode, we discuss a health related talk trending on social media with curiosity, nuance, evidence, humility, and compassion.
Sonia Singh MD:This is not your average debunking podcast. We wanna explore not just what is trending on social media, but why? Why are so many people drawn to this? What is the nugget of truth here? What are the facts? What can we learn from this as patients and doctors? No shame. No blame, no snark.
Rebecca Berens MD:We're so glad you're here. Hey Sonia. Hey, Rebecca. So, this week you have a case to share with us tell us about the case we're talking about this week. Yeah, so this is a patient I just saw a few
Sonia Singh MD:weeks ago and she messaged me and said, oh my gosh, I've broken out in this rash. It's all over my face. I'm breaking out. I'm itchy. It's red. I look so terrible. I dunno what's going on. I don't dunno what it could be, can I come see you? And I was like, yes, please. Let's check it out. So she came in and prior to this, her skin had been totally clear. She had no prior skin issues. And when I looked at her skin and kind of the pattern, the distribution, basically to me, it looked like an allergic contact dermatitis. And I immediately asked her Have you put anything different on your face? Because it just looks like right in the distribution of where you might put a face cream, you seem to have this rash. And she said, oh yeah, I started using this new product, but it's all natural ingredients. So like I don't think that would be the cause. And I was like, well, sometimes natural ingredients. Can also be allergenic. So send me, a picture of the product or a link and we can talk about maybe if this could have been the cause. Immediately, just based on the timing and the fact that she was using a new product, I was very suspicious about this and so she sent it to me and the main ingredients of the product were like beef telo, olive oil, lavender oil, tea, tree oil, beeswax, all natural, substances. And to her it seemed like, how could these possibly be the cause? And she had told me that she had actually recently threw out all her old skincare because she was making an effort to buy cleaner products. And so that was what kind of inspired her to use this other thing even though she had no issues with her skin. And it turned out it wreaked havoc on her skin and gave her this terrible rash. So, it kind of got me thinking about this whole movement around clean beauty and, not just beauty, but really skincare, personal care products, like this whole category. And we did cover clean eating in one of our episodes, so this is kind of like a sister episode to that. Coming at it from a slightly different angle. What is the claim? I guess the claim is that conventional beauty products are potentially harmful or toxic, and that quote, clean beauty and personal care, products are superior and less harmful. I think other claims that get thrown in with this are that they're safer, they're better for the environment, they're more sustainable. Maybe they're vegan, maybe they're organic, maybe they're cruelty free, maybe they're, less irritating. Maybe they are less likely to cause long-term health issues such as hormonal issues, cancers, et cetera. So that is the topic we're gonna cover and review today. Have you, I'm curious if you've seen a lot of clean beauty and clean personal care. Stuff on social media.
Rebecca Berens MD:Yes, I definitely, I've definitely noticed the trend and like you said, it it's very corollary to our clean eating episode. It goes hand in hand. Yeah. It's like this idea of a cleaner lifestyle, whatever that means mm-hmm. Is somehow better and more virtuous. Yeah. Yeah. And I think there's gonna be a lot of overlap, so I'm really curious to hear Yeah. What you found on this. So, so why do we think this is a viral topic?
Sonia Singh MD:Yeah. So, I think it's really important for us to recognize that. There are numerous examples in history where, beauty and personal care products have actually turned out to be harmful. So this is a fair, legitimate concern. A few examples that probably a lot of us, have some memory of or knowledge of is, Johnson and Johnson have those lawsuits, uh, over talc based powders. They found ultimately that. Using those powders in the genital region and women was associated with a small increased risk of ovarian cancers. There was a lot of fallout from that. Those were taken off the market. There have been multiple incidents with particularly skin lightning creams, oftentimes in products that are imported to the us like Korean beauty products and other, beauty products. From outside of the United States found to contain Mercury. I think they referenced this on the pit, or it was like some kind of heavy metal contaminated cream that somebody was using as part of their like Korean skin skincare regimen. And then, in the background of some of these safety concerns, there's also been. This documented increase in the incidence of certain cancers in younger patients. I feel like a lot of people are talking about that and concerned about that. And I think science in the medical community is still kind of trying to figure out why that might be happening and coming up with answers for those. It's probably multifactorial, but of course people wonder how our environmental exposures playing a role in this. And I think all of us are looking for ways that we can mitigate our risk and reduce our risk. And so. I think part of the appeal of clean beauty is like, here, here's a way that you can make a safer choice that feels very, within reach for you. I think the overall message is very, it feels very empowering. It's like, Hey, we especially women, children, like populations whose safety may have not been, as valued, has been, are demanding better, cleaner, safer products. And so it feels like, yeah, we want more from our beauty products and we want things that are cleaner and safer. It feels very empowering. And I think this also touches on this theme of, there's some uncertainty, fear, anxiety around something. And then this trend presents a solution to that to that fear. And oftentimes it's a consumeristic solution. Yeah. Yeah. So that's basically why, I think there's a lot of good reason that people would be wanting safer and higher quality products for their personal care.
Rebecca Berens MD:Yeah. And I definitely hear a lot of, of fear, particularly around the cancer risk from my patients. And, and for myself too, I wish I had more information to share with people about where this is coming from. Like you said, I think we're still. Trying to understand all of the pieces that are influencing that. Yeah. But it's definitely concerning. Yeah. Especially as I get closer to, the ages where you start hearing about it. Right. Yeah. So what is the nugget of truth behind all of this? Yeah,
Sonia Singh MD:so this was honestly a really hard episode to research for because, there's just so much science and there's so many different ingredients and so many different chemicals. But I'm gonna go over a few broad strokes and broad themes. So, it does seem like there's a variety of substances that are present in beauty and personal care products that have been linked to various adverse. Health outcomes in both animal studies, in vitro studies and epidemiological studies specific effects and cause and effect are really hard to prove and especially hard to quantify, like exactly how much each thing is affecting your risk because there are so many ingredients. And then even within a category of ingredients like. Endocrine disrupting chemicals or parabens, there are multiple types of those that may have different risk profiles, and so it's really hard to just change one variable and study the effect of that. You're looking at all of these things that are all over the environment and that we're all essentially being exposed to all the time. And so to isolate one particular substance and to look at the effect of that particular substance is really, really challenging to do scientifically. In terms of what are the things that clean beauty claims to. Avoid or not have in it? Or what are the toxic things that people are trying to get away from? I would say they fall into three broad categories, and there's a little bit of overlap. So the broad categories that I came across were endocrine disrupting chemicals, so those are things like parabens and phthalates, PFAS, um, potential carcinogens like formaldehyde, and then heavy metals, mercury, lead, there's a bunch of those. I'm gonna focus today's discussion a little bit more on endocrine disrupting chemicals, because I actually think the other two potential carcinogen and heavy metals are a little bit more well studied. They've been around for longer. The data on those does show a predictable dose effect, dose dependent relationship, and so it, they're not. Kind of quite as controversial and we do actually have some regulations in place for those. Endocrine disrupting chemicals is a very broad category that is the science on this is kind of very actively evolving and it's something that we don't have full consensus over. And I think there it is something that. Again, it's so ubiquitous and it's in so many products that it's a, a relevant topic to focus on. So, what we know is that there is evidence that many of these substances at certain levels, especially in vulnerable populations like pregnant women, babies pubescent and prepubescent children it does seem to have harmful effects in humans, especially in those vulnerable categories. Yeah. So one of the things that's interesting specifically about endocrine disrupting chemicals, actually I should define them. So endocrine disrupting chemicals or EDCs, which I'm gonna call them for short, are natural or human made chemicals that may mimic, block or interfere with the body's hormones. The interesting thing about EDCs is they potentially don't have the same dose dependent toxicity that. Things like heavy metals and some of the carcinogens have, so the idea, if you ever followed any toxicologist on social media, they always talk about how the dose makes the poison. So they always talk about how, in toxicology, you can't just hear an ingredient and say that ingredient is good or that ingredient is bad, because you really need to know the concentration the dose, the route of exposure, the frequency of use, so many other factors contribute to whether you would. Consider it safe if you just started calling everything safe or not safe. I mean, something like water is the classic example where a large amount of water, like if you drink a large amount of water, you could die, that could be deadly, but obviously a small amount of water is beneficial for you and has no harm. So, you know, they're, they're constantly telling us, okay, the dose makes the poison. So, yes, this may, this thing may be on the ingredient list, but if it's at a very low level and a little concentration, then poses, no harm to your health. The debate around EDCs is that, some people believe that perhaps EDCs don't have dose dependent effects, and it's more unpredictable if even small doses could have effects. And the theory is that they likely do in certain parts of the population or in certain people based on other factors. Genetics, where they are developmentally, all those other things. And maybe we're just not, we have not elucidated that yet in the studies. So that's the challenge. And it's interesting because a lot of times when we are doing research for these episodes, most experts will be on the same page and maybe there'll be a few fringe experts that think something else, but generally there's Good consensus. I feel like in this, like I, I actually felt like there were several different camps in terms of how people or how these different medical societies and professional organizations approach EDCs. The Endocrine Society, I think originally in 2009 and then later in 2015, basically released some pretty strongly worded position statements on EBCs. Essentially saying there's a lot of in vitro data, there's a lot of animal data there's strong epidemiological data. This is the best maybe that we're gonna get for studying this type of substance, which is all over the environment and is hard to isolate. And they, they actually supported taking a precautionary approach and starting to put regulations on some of these these products and ingredients. The a MA also supported that the American Public Health Association supported that. And then the a A P also had, similar recommendations. Basically there were several medical societies that were on board saying, we see enough evidence here that these things are harmful. More research is needed, but we should probably start regulating now. While we do that additional research as a precaution. Toxicologists on the other hand, seem to disagree with this, and they seem to feel that, the science has not yet proved a causal link. And that taking that kind of precautionary approach of saying, okay, well let's just start banning and regulating now even before we have made those links, They just don't agree with, they think that kind of goes against the fundamental tenets of toxicology. And I can kind of understand from those different perspectives, why you may feel that way. I mean, if you're part of the a P, uh, the American Academy of Pediatrics, you know, your goal is The safety and health of those children. When you're part of the endocrine society, you're looking really closely at hormone health and how those things are being affected by these things. When you are a toxicologist who is tasked with determining what is safe and not safe, if you are now going by this rule of banning anything that causes potential harm and at any level, that can get out of hand very quickly and can lead you to ban lots of things that are probably safe and have important functions. So that's the part that I wanted to make sure I touched upon here, which is unfortunately it would be impossible for me to go over every endocrin endocrine disrupting chemical or even every category of a DC. If you take for instance, parabens as an example. Parabens are essentially a preservative that's used in a lot of personal care and cosmetic products, and it's there to prevent the growth of bacteria and mold. And,. The reason parabens are so popular is because they're really effective for doing that and because they're relatively non-allergenic, so they generally don't cause reactions in people. So they are so ubiquitous and popular because they're really good at what they're used for. But let's say that you decided. There was enough, data to say that we should just ban parabens outright. The parabens you have to look at, not only what is the safety of the product with the paraben, you have to also look at what is the safety of the alternative that we're going to use, and how effective is that at actually, preserving and preventing bacterial growth in the product. So I actually found one interesting study where they looked at, all the recalls that happened over a 10 year period, of cosmetics in the United States. And there honestly weren't a ton of recalls, partially because we don't regulate very much. But of those recalls, the vast majority were recalled for some kind of microbial contamination. So this is actually the number one reason products are pulled from the market, is that something bad grows in them. And you may think oh, well, what's the harm in, my foundation going bad. Sooner and like I'll just throw it out and get a new one. I would rather that than, have this hormone disrupting chemical on my face. But the reality is like there can be real harm from, for instance, pseudomonas, growing in your compact. There was actually a, a case where mascara that had inadequate preservative ended up causing pseudomonal infections of the eye in multiple people. there's a real purpose. For a lot of these products and then there are consequences for taking it out.
Rebecca Berens MD:Yeah, and I think that's where that nuance comes in that I think we've touched on before where you have to look at the risk of not doing a certain thing in addition like with birth control, we talked about this, right? Like the risk of not taking some form of birth control is potentially unintended pregnancy and one are the risks of that, right? Right. So it's that, that's that nuance there. That's not maybe so obvious when you're just looking at the potential whole harms. Yeah. That may or may not come from this thing.
Sonia Singh MD:Yeah, exactly. I think the other challenge here besides, The fact that there isn't complete expert consensus and we have a hard time quantifying what the actual level of risk is from each of these products. The other issue is that, and I was surprised to learn this, cosmetic products in the US have very, very little safety monitoring and regulation. So the FDA doesn't have to approve any kind of cosmetic or personal care product the way it does for drugs. So it's kind of like supplements. They do do random checks of products to check for impurities and contamination. They do inspect manufacturer facilities, but they're really not doing their own independent testing to be deciding are these ingredients safe for us? There are other Societies and organizations that do that. But most of them are essentially funded by industry. They're like trade associations or industry associations that fund these societies, which they kind of, they frame themselves as independent and unbiased, but they're funded by, by the beauty companies. So it's hard to know, how unbiased the information is. But anyway, so basically all of the safety information we have is essentially post-market. And in the US there's only a very short list of ingredients that are completely banned. And those are like mercury, vinyl, chloride, zirconium, only the worst of the worst basically. And some of these other ingredients for which we have mounting data but not a absolute solid causal link. There is no regulation around essentially. And, companies are left to regulate for themselves.
Rebecca Berens MD:With all of that uncertainty Yeah. What facts do we know? Yeah. And how can we interpret the data that we do have when we're thinking about this as both like consumers and as physicians. Yeah. And, educating our patients.
Sonia Singh MD:Yeah. So basically, one thing to recognize, which was the same case for clean eating is. Clean in the context of beauty has no real definition. There's no standard definition, there's no regulation around the term. It's not a scientific term. It is mostly a marketing term that is used by companies to sell you something. So beauty companies are, largely gar guided by consumer preferences. They're not trying to make you the best quality, most wonderful, most effective, safest product. They're trying to make a product that they think you will buy. And it's very clear right now that consumers are demanding these. Clean products. And so those labels are getting slapped on a lot of things. But the question is, are they really clean? I can say, okay, well clean doesn't really mean anything, but you may say, okay, well then let me just look for specific ingredients. That are, not in the thing. So, maybe it says specifically like no parabens. Again, on the surface it may look like, okay, yeah, we as consumers we're voting with our, dollars and we're telling people we want this clean beauty and we want no parabens. And so yeah, they're taking out the parabens. But even if it says clean or no parabens. The paraben can be replaced with formaldehyde, and it doesn't say no formaldehyde, or the paraben could just get replaced with some other preservative that is newer and has a different name, and it has not been adequately studied so that it hasn't made it onto the dirty list of, various apps and blogs. And so it hasn't yet been flagged as something that's dangerous, but we don't actually know if it's any safer than the original product. So then you may say, okay, well alright. So you say if it says no, parabens still doesn't mean it's safe because, or safer because it could have other stuff. What if I go researching all the other stuff and I, go and find all the ingredients? That are potentially harmful. And then I look at all the ingredient labels and I avoid all of those. I do think a lot of people try to do this and there is a bunch of apps that are super, super popular that, millions of people are using. Have you ever played around with this? I have not. I,
Rebecca Berens MD:I gotta be honest, I just don't have the energy for any of this. So I'm really glad you did this topic'cause I feel like I need to be more educated about this. Okay,
Sonia Singh MD:So well. Hopefully the conclusion will make you feel better. But, but basically there's a lot of apps out there that say that they can help you do this. You scan the item and it will show you how many, sometimes it'll break ingredients up into green, yellow, red, and it'll show you, how many of those things it has and it'll give it a score. And so I think a lot of people are using this to help them navigate. You know how to pick products, but if you ask honestly any toxicologist about those types of ratings, it's very similar to apps that rate food quality. And if you ask a dietician or an RD to talk about those apps, they will tell you same as a toxicologist with these ingredient apps, that it is a way, a major oversimplification of, evaluating that product. Like when you're just scanning the ingredient label, you have no idea about the concentration of that thing. It's not necessarily taking into account like the frequency of use, typical use. Basically just labeling things as kind of good, bad, or even yet red, yellow, green is not really, how a cosmetic scientist or toxicologist would look at that. So basically, and a lot of those, companies, and of course the apps are monetizing this in some way, but that was gonna be my question is who's funding the app? The apps are monetizing this and they're also driving you towards certain products, which sometimes they have affiliate relationships with. And then even groups that kind of appear like they're just. Fighting for the consumer, like environmental working group, which is the group that releases like the Dirty Dozen. They have all kinds of like, oh yeah, they have all kinds of ingredient lists and shopping recommendations for products. Those, like EWG has a lot of affiliate relationships with, big organic food companies and per personal care companies. And so there, there is definitely a financial motivation for them to be. Driving you towards certain products or the way they're interpreting all of that data. So basically even if you go that extra level of downloading the app and scanning all of your products, it's not necessarily showing you something that is definitively safer. All it's doing is driving you away from certain ingredients that have been labeled bad by somebody who probably did not have a lot of toxicology training or scientific expertise. So anyway, you could do that. I think even if you, if you go to that extra step you may not be necessarily getting something safer. Okay. Some people say if there's any risk at all, why not just take it outta the product? Why take a chance? I feel like I hear this a lot when people are, when I try to explain that well, the data on this is like you say, well, I just rather not take the risk, like just take it outta the product. Again, I think you have to think about if we say we don't want that thing in the product, or we're looking for products specifically without that, what is it being replaced with? And is that replacement necessarily safer? And a response to this I hear a lot is well then why don't we just stick to natural products replace, like use oregano oil or rosemary, extract or something as your antimicrobial and don't, then you don't have to use one of these chemicals. So there's a lot of issues with that. For one, it kind of invokes this, nature is always better appeal to nature fallacy which is this assumption that a natural product is going to be safer or better and maybe even more effective. The reality is a lot of those essential oils are also endocrine disruptors. Yes. So, lavender oil, for instance,, seems to be a pretty well established endocrine disruptor. It can lead to breast development in prepubescent boys. It can lead to early breast development in girls. And so, this idea that, well if it's just, if it just gets replaced with natural ingredients that's automatically better is it doesn't really actually pan out. You can't actually be sure that's the case. And gosh, if you ask the dermatologists or the allergists, they hate products that are filled with these essential oils. Because they tend to actually be very allergenic and cause a lot of contact dermatitis, which is what happened in my patient. And like I said, the endocrinologists don't like it either because some of these are endocrine disruptors. And you also have to think about when you're using something that maybe is natural but less effective at the purpose that you're using it for, you may have to use it in a larger quantity, right? And so you're then increasing the exposure of something that may also have harmful effects. So basically, even if you pick something like my patient picked that had literally. Everything on there was something that I could pronounce was something that I, could imagine coming from a plant. And still, it caused her some harm. Okay, so I was actually surprised to find that there were some peer reviewed journal articles on Clean Beauty. Oh, interesting. Um, so I wanted to share a couple of quotes from some of those. So there's an article called The Hoax of Clean Beauty and Associated Allergens and from one of the big dermatology journals. And so they say. Clean beauty advocates often raise concerns about certain cosmetic ingredients despite no conclusive evidence of harm. Removal of these ingredients by cosmetic manufacturers may inadvertently lead to increased use of other more allergenic ingredients and play an important role in the prevalence of allergic contact dermatitis, especially to iso thio Solans al Glucocide, which apparently are two things that parabens are commonly replaced with when they're taken out of products. There was another study in a journal called Dermatitis. There's an entire journal on dermatitis and the title of it was Natural is Not Always Better, the Prevalence of Allergenic Ingredients in Clean Beauty. They actually looked at almost 1400 products from Target and Walgreens that were labeled as clean. And like I said, that's not a regulated term, so it was just marketed as clean and they analyzed them for potential allergens. And a total of 93.8% of the products had at least one allergen in, usually in the form of some kind of fragrance or botanical. I think. When you're looking at making a product swap and one says clean an important thing to remember is that is just marketing. There's probably little to no science behind it. There is plenty of financial interest there that is trying to just sell you the product rather than keep you or make you healthier. And it's honestly very hard for you as the consumer or even for you or I, even with medical knowledge to. Adequately assess a product from the ingredient list without more information, without a background in cosmetic science or toxicology. I Does that sound abysmal?
Rebecca Berens MD:Yeah. I mean, I guess to me I'm just like, okay, I feel like there's nothing safe, which is, it feels like the clean eating episode, right? Yeah. It's like you get to this place where nothing's safe for me to eat. Yes. Yes. So nothing's safe for me to put on my face and I guess some of the difference here is Some of the things we put on our face are not necessary for life versus we do have to eat food for life, right? Yes. Yes. So how does a person mitigate their risk? Because something, there are some products that we do need to use, like sunscreen, for example. Mm-hmm. Clearly without using sunscreen. My mom had melanoma when she was 40. I'm a very high risk person, so I probably don't use many personal care products, but I definitely use sunscreen. Yeah. And that does feel. Important to me, but now it's like, what is safe for me to use? So how does a person. Navigate
Sonia Singh MD:I honestly think the best. Science-based, evidence-based answer would be we need to advocate for actual experts actual toxicologists and cosmetic scientists, and endocrinologists and dermatologists to be involved in doing research that leads to regulations that ensures that. The products on the market are safe. I think we place too much emphasis on it being just about your personal choices. And it's almost a distraction. It's a way of making you feel like, yeah, you just pay more and you buy this product and you'll be fine. Yeah. But the reality is that's just somebody trying to sell you something with a thing that they know is popular right now. And it is it probably is not making a significant difference in terms of overall health. I don't know that I have a satisfactory answer other than what you are saying, which is consider the, benefit versus the risk. And the risk may be kind of fuzzy, but if there's a good reason for you to use the product, then use the product. But there's no need to have an eight step skincare routine just for the sake of having an eight step skincare routine, because the reality is these products are, have very limited regulation and we're still learning about what the long-term effects could be. So, if you don't need to use like eight different products, you just don't
Rebecca Berens MD:Yeah, because I this just to me, it just, it reminds me so much of what we talked about in the clean eating episode because there is this pressure, I think. At increasingly younger ages. I feel like now you hear about like 10 year olds going to Sephora, right? Mm-hmm. And there's this pressure to, stay young looking forever, you know, use this skincare routine to so you don't get wrinkles. So you're, all this stuff. And, and just like, there's this pressure to be thin. There's also this pressure to look young. Yeah. And it's tied so closely together and it, it's making decisions so complicated for people. And like you said, there is this. This sort of consumerist drive to oh, you need to do this. It's the most important thing ever, but every other product is dangerous except this one, so you gotta pay for this one. You know, it's just it's such, it's so heavily based on marketing that is fear-based, but it feels urgent because God forbid I look old and wrinkly. You know? It just it, it seems so closely tied to me and it seems like a lot of these products are marketed to women, right? Yes, yes. Although there is an increasing amount of skincare for men, I feel like, but it, it is this sort of like disproportionately female problem.
Sonia Singh MD:Yeah. I actually, I think about this a lot with respect to A lot of things like, or, yeah, things that are supposed to keep you looking youthful or even like deodorant. It's like, it's socially unacceptable for you to smell like body odor, but also be scared of your deodorant. But because it might be making you, it might be giving you breast cancer. Yeah. So we put women, I think, in this impossible situation where society has these expectations that you're gonna Look a certain way and feel a certain way and smell a certain way and body, your body's gonna be a certain size. And then we also provide them products that we don't regulate and then leave it up to them to determine what's safe and okay and good to use, and the other, interesting thing that you touched upon that we were just talking about is kind of simultaneous with this, like increase in interest in clean beauty has been this I don't know what the right word is. The age at which people start worrying about skin and using skincare products seems to be younger and younger. Yeah. It's this whole, phenomenon now of like middle schoolers at Sephora, starting their drunk elephant. I don't know if I should name any names, but, starting their like eight step skincare routines like. Really young before they have a single blemish or wrinkle or anything to worry about. So I don't, it's crazy, what message are we sending there where we're simultaneously like, oh, these conventional products could be toxic, but also. Start'em when you're 11, you know? Right.
Rebecca Berens MD:Well,'cause I mean, and that is also, the age where you are going through puberty. Yes. So super endocrine sensitive time. Right.
Sonia Singh MD:One of the most
Rebecca Berens MD:vulnerable periods. And it's also the age where, we start to gain weight in puberty and that's when body image stuff starts happening. So it's just like, it's so. Tightly wrapped together. Yeah. And so predatory in the marketing Yeah. From these companies, but also, when it comes to these underground con disrupting chemicals, it, it may well be a very real phenomenon. And so how do we, I mean, it feels to me I have a daughter and when she's at age, the, I feel like the conversation is maybe gonna be more around okay, we, there's some products we're gonna need to use, but. Do you actually need all of this stuff? Right? Maybe the answer is not buy the right thing, but just buy less things in general. Which I think,
Sonia Singh MD:Environmentally, ethically, you know, for like a ton of different reasons, buying less things generally is probably A good choice. Um, so, okay you know, I think when you hear all this, I, I was kind of left with okay, well should we still just try to buy things that are clean? Is that better than just doing nothing and just buying whatever, we see first, and I think this is a complicated question to answer because I really think it depends who you are. If you're somebody that can afford to buy a product that's labeled as clean and you want that product more, and you're not obsessing or stressing over it and you just decide to buy it. There's nothing wrong with that at all. But I think the issue comes when it becomes so widely accepted that oh, these are superior and these are inferior, and these are doing all kinds of terrible things to you when in fact. For all the reasons we talked about, the products labeled as clean may not actually be that much different or that much safer for you. You create this situation in which people who really don't have the resources, may feel a lot of pressure to spend money on that thing when in fact they could have applied that time and money and energy to other things that actually would have meaningful impacts on their health. And I think that's where we as doctors get Irked by some of these trends is because it feels like people are so quick to jump on board and spend money and energy doing this when if you actually look at their life as a whole, there's a lot of other places where they could have spent that time and energy more impactfully.
Rebecca Berens MD:Yeah. Yeah. And that was a similar conclusion that I think we had with clean eating. So it's just, it's so interesting'cause like when we first started talking about this topic, I was like, I don't care about that, you know? I don't, we were talking about this before started recording. I'm lucky if I wash my face with any sort of face specific cleanser. Right? Yeah. It's just there is a lot to it and it's, it's really interesting and fascinating how closely linked those things are.
Sonia Singh MD:Yeah. And I, and I think you have to really examine how much time, money, and energy are you putting into this? How does it affect your mental health and your wellbeing? And then, deciding if that really makes sense for you. Because I think on the one hand, like I definitely see patients who. Feel like they just don't have maybe the mental bandwidth to do the research some of these products and find Yeah. And find the right, the best sunscreen. And so then they have, you know, even though they're not doing anything and they're not spending more, they have this background anxiety of oh, the thing that I'm using, might give me cancer. Yeah. And that's not good for you. Um, or they don't
Rebecca Berens MD:use sunscreen'cause they've been, they just don't, I mean, that's like the new thing is oh, it's so bad for you, but it's like, yeah. But skin cancer is also really bad for you. Yes.
Sonia Singh MD:Right. Or on the other end of the spectrum, I have people who I feel like I see that invest a ton of time and energy. They really get into the nitty gritty of each ingredient and scanning everything that they're buying. And that really takes a lot of time and energy away from them. And I think you have to think about what is the opportunity cost of
Rebecca Berens MD:that?
Sonia Singh MD:You
Rebecca Berens MD:know? And I think what you touched on too is this is not an individual problem. This is a, a larger systemic problem. We as an in as individuals, cannot even control our exposure to these things.'cause even if we're not using those products, other people are using them and therefore we're still coming into contact with them on a regular basis. So it really needs to be more of a systems level. Yeah. Intervention.
Sonia Singh MD:So I think that's one of the big take home points is the science is a little fuzzy on the exact cause, infect relationships and on quantifying, exactly how much each of these different things increase our risk. But what I think we can say is that these are. Subtle population level effects that are happening. And so this is really a problem on a public health population level and these individual level swaps that I think people focus on. Like just, replacing your face wash in your moisturizer and your sunscreen with a clean face wash. The likelihood of that having a significant impact on your individual health. Is very small, in comparison to a wide variety of other things that you could be doing, choosing more plant-based and whole unprocessed foods, getting your HPV and hepatitis B vaccines, avoiding alcohol. There's a lot of other things you can do to mitigate risk of some of the things people are concerned about that. Are much more evidence-based that we really know clearly the benefits and the risks of and that don't involve constantly throwing money at something that may or may not be scientifically based. So, so anyway,, actually, before we move on to kind of what we can learn from this. One thing we lightly touched upon was how this kind of ties in with clean eating. We talked about clean eating in a different episode. Now we're talking about clean beauty. Beauty. I think these are both part of a bigger clean living movement, you know? And, and you know, people also apply this to household products and cleaning product. And it's focused on this return to nature, focusing on healthy behaviors. Avoiding toxic substances. And I didn't know this before I researched it for this episode, but it turns out that these clean living movements are somewhat cyclic and we see them repeated in history. So this is what, how Wikipedia talked about clean living, they say in the history of the United States. A clean living movement is a period of time when a surge of health reform crusades erupt into the popular consciousness. This results in individual or group reformers, such as the anti-tobacco or alcohol coalitions of the late 20th century to campaign to eliminate the health problem or to clean up society. And then it also talks about how the movements often coincide with episodes of xenophobia or moral panic in which various minorities are targeted as undesirable influences form. Medical or moral reasons, which I thought was really fascinating because we as physicians, I think, have been aware of a lot of the things that are now in the public consciousness, like chronic disease and obesity and all of these potentially, harmful endocrine disruptors. These have been around in the medical community for a while, but it's only now that they feel like they've like really surged into the public consciousness. And, I think it's worthwhile and interesting to ask why now? And is it meaningful that it's happening at the same time as some of these other. Societal shifts that are happening.
Rebecca Berens MD:Well, and we talked about this before we started recording too. There's always this discussion of oh, well, in Europe they do things this way. Yes. And it, it, there is like inherent racism baked into that comment of the rich, white affluent people of Europe must be correct.
Speaker 3:Yes. Right. And so
Rebecca Berens MD:anyone who's doing this other thing there must be some harm to it. Right. And so I think there is a lot there that's, we should unpack a little bit when we're talking about both clean eating and clean beauty and clean products in general, and just the concept of Who is clean and who is dirty, and why are we using those terms?
Sonia Singh MD:Yeah, I actually, when I was researching this, I made a, I did a story on my Instagram and I hinted at sort of how the word clean invokes this purity culture and morality in a way that I think. Has kind of darker undercurrents and I immediately got some feedback that was like, oh my gosh, that's such a broad generalization. You're totally taking it to the extreme. The reason I think it's worthwhile and relevant to talk about is. Specifically because social media algorithms take things to the extreme very quickly. So you can start off just being like, I'm gonna try to find the least toxic sunscreen. And then you know, a few videos in, you're seeing a sunscreen that maybe your dermatologist had told you about or cells in their office. And then you see that somebody says oh my God, that contains this cancer causing chemical. And then you think, oh my gosh. Well if I can't trust my dermatologist. And the thing that she's telling me to use is unsafe. I well, what about my pediatrician and her recommending the vaccines? And what about, you know, it, even though it's, it starts out as a very innocuous, harmless, search for information. The algorithm is built to feed you more and more extreme versions of the content that you seem to be interested in until you get to some, some stuff that may be totally surprising. Depend, based on what you were originally searching for. So anyway, I think that's a common theme again, we're gonna see in a lot of these episodes is something that seems very harmless and innocuous and benign on the surface can quickly turn into something more harmful and nefarious if you let the algorithm do its thing.
Rebecca Berens MD:Yeah. Well, and I think also, there's historical context for that that is very relevant and it's so easy both. Intentionally and unintentionally for social media to manipulate you. There's some, there's some people that are targeting their content with ads towards people with certain interests. Yeah. Right. Yeah. And that we've seen in the last several years how divisive things have become on social media, and I think that is taking advantage of that algorithm. So again, whether it's intentional or unintentional on the part of the algorithm, it's happening and it's important to be. Aware and thinking critically about that. I
Sonia Singh MD:came across a study, I'll have to find it again'cause I don't have it in the citations, but it was a study that where they I forget which platform it was, but they talked about when a girl within a certain age range deleted a selfie, the algorithm was built to immediately start serving her beauty products, beauty product ads. Because they had discerned that when a selfie gets deleted, the person is more likely to buy a beauty product in like the immediate aftermath of that, perhaps because they're feeling self-conscious about their appearance or their looks. And so I just think we don't even, think about or recognize the extent to which like social media platforms are like built to feed on our worst anxieties and fears and manipulate us to basically buy things. Wow. That is truly horrifying. Yeah. Anyway. All right. So what can we learn as doctors and humans from this? I think as a doctor, I think what I take away from this is that, there's growing evidence of harm here, but there's still some disagreement. And although there is not as strong a causal link as we would like. We may not ever get there with these types of, ingredients'cause they're just so ubiquitous in the environment, hard to study. I learned that regulation in the industry is lacking. So I can't assume that everything that my patients are using is safe. And I also learned that it's really hard as a consumer, whether you're a physician or a patient to really discern products from one another in an unbiased and well-informed way. So I really think the best we can do as healthcare professionals is just. Strongly advocate for more research and research funding around these topics that's independent of industry. And then, again, advocate, once we have that data for regulation, and, you know, you mentioned the whole thing about looking to Europe and like assuming that they're doing things better, but I did look at the European regulations on this and I think We as a society are a little bit quicker to just be like, just ban the parabens. Just ban them all. You know? And when I looked at the European regulations, it was very nuanced. It was these parabens are allowed, like these parabens are allowed only at this concentration. These ones require a warning. These ones are not to be used in products like marketed for children or babies. That felt to me like it was actually backed by some science. Yeah. As opposed to just blanket saying. Don't use these, you know? And so, I think there is some path forward, but I don't know how long it's gonna take to get there. And then I think as patients or just as humans we can try reflecting on where does our underlying fear or desire for these products come from? What is it that we're really afraid of? Is it cancer? Is it some metabolic outcome? Is it harming our child? What is that feeling? And maybe just acknowledging and vocalizing that. Okay. Thinking about the amount of, time, energy, and money we're putting into acquiring these safe products and, acknowledging that we don't actually have a good understanding of if those are safer and, if it's causing you, a lot of mental anxiety and worry, or you're spending a lot of time and energy or resources on it, thinking about how else you might be able to spend that, that may be more worthwhile for you.
Rebecca Berens MD:Yeah. And I think for me, like I said, my biggest thing is so much of our purchasing of these products is probably not necessary and driven Yeah. By a lot of societal standards that are maybe not so important. Societal beauty standards, anti-aging at age 10, you know? Yes. Maybe just reflecting on your total consumption in general and yeah. Could we, could we back off on some of our usage of some of these products? Again, it may not make a huge. Difference on an individual level, but if a lot of us, yeah, were to reduce our use of the product, it would also, I think force. Some what would make an overall reduction in everyone's exposure. And then also force some change in maybe at the product level as well.
Sonia Singh MD:Yeah. Or just to buy less stuff. Movement. Yeah. That's what we need. Buy less stuff. Buy less stuff. Movement if we would all be better off. Um, and then how would I talk to a patient about this? I think I would start by just validating their concerns and just being like, I totally get why you have anxiety about this. Legitimate concern, there seems to be some harm from this, but I would try to remind them that on an individual level, the harms from these are probably very small. Maybe it's more reasonable to focus your attention on vulnerable times in your life, like pregnancy or, for your children puberty and infancy. And like you said, maybe just reducing the overall number of products, asking yourself what you really need and what you're getting benefit from. But I would also, emphasize the reality that. Products labeled as clean, it's kind of a meaningless term. They may or may not be better. I would not waste a lot of time with those apps. I think they drive you towards products that, they have some bias towards. And so, unfortunately, we're leaving it up to these companies to label things that way and you can't really trust those So, anyway, and then I would probably end by asking them, what specifically is worrying them.'cause maybe they do have a specific thing where my mom died of X cancer and so I'm really worried that this product has been linked to that. And maybe just talking about, evidence-based strategies for mitigating that risk and what their real risk actually is and, talking about it. Zooming out and talking about it that way. So we're gonna include in the show notes a couple of good follows for, information on, cosmetic science and kind of evidence-based analysis of beauty products. But one thing I didn't realize is a lot of these people that I follow are not in the US and so they often refer to regulations and standards that we don't have here, which is important caveat.
Speaker 3:Mm. So that brings us to the end of the episode. Thanks, Sonia. Okay, thanks Rebecca.
Sonia Singh MD:Hey guys. Last but not least, we have a very important disclaimer. This podcast is intended for educational and entertainment purposes only. The content shared on this podcast, including but not limited to opinions, research discussions, case examples, and commentary, is not medical advice and should not be considered a substitute for professional medical evaluation diagnosis. Treatment. Listening to this podcast does not establish a physician patient relationship between you and the hosts. We are doctors, but not your doctors. Any medical topics discussed are presented for general informational purposes and may not apply to your individual circumstances. Always seek the advice of your own qualified healthcare professional regarding any questions you have about your health. Medical conditions or treatment options, never disregard or delay medical advice because of something you've heard on this podcast. While the hosts are licensed physicians, the views and opinions expressed are our own and do not represent those of our employers, institutions, organizations, or professional societies with which we are affiliated. Although we do our best to stay up to date, please note that this podcast includes discussion of emerging research, evolving medical concepts, and differing professional opinions. Medicine is not static and information may change over time. We, the hosts make no guarantees about the accuracy, completeness, or applicability of this content, and we disclaim any liability for actions taken or not taken based on the information provided in this. Podcast by listening to the Antisocial Doctors podcast. You have agreed to these terms. Thanks again for joining us.