Cosmetic Safety Practices and Adverse Effects Among Female Students: A Cross-Sectional Study

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While users are often aware of potential risks, their actual safety behaviors remain inconsistent. Methods: This cross-sectional study surveyed 803 female students at An-Najah National University, Palestine, using a self-administered questionnaire with voluntary participation. The survey covered demographic details, types of facial cosmetics used, usage patterns, safety behaviors (such as consulting healthcare professionals, allergy testing, hygiene practices, reading product instructions, and discarding expired products), reported side effects, and how these were managed. Ethical clearance was secured, confidentiality upheld, and data analyzed with SPSS using descriptive statistics and Chi-squared tests ( p < 0.05 considered significant). Results: Although most participants selected products according to skin type and preferred professional retail sources, many failed to consult specialists or conduct allergy tests. Hygiene behaviors like cleaning application tools and removing makeup before sleep were widely practiced, yet reading product instructions and discarding expired items were often overlooked, even though nearly 90% acknowledged potential harm from cosmetics. Adverse reactions such as skin irritation and acne were significantly more common in those who ignored skin-type compatibility or specialist consultation. Extended cosmetic use (> 3 years) was associated with increased acne and clogged pores. Certain products—especially face whiteners, primers, moisturizers, and foundation—were strongly linked to specific side effects. Notably, routine actions like allergy testing or bedtime removal did not significantly reduce adverse outcomes. Conclusion: Despite high awareness of cosmetic risks, many users fail to adopt appropriate safety measures. Improved education, product reformulation, clearer labeling, and healthcare engagement are essential to reduce harm. Introduction The word "cosmetics" originates from the Greek term “Kosm tikos,” which means having the ability to arrange or decorate, derived from “kosmein” (to adorn) and “kosmos” (order, harmony) ( 1 ). According to the FDA, cosmetics are defined as products (excluding pure soap) applied to the human body for cleansing, beautifying, promoting attractiveness, or altering appearance ( 2 ). These products can be categorized into several types: personal cleansing items like soaps and shampoos; skin and hair care products such as toothpaste and intimate care items; beautification products including perfumes and lipsticks; protective items like sunscreens; corrective products such as masks and dyes; maintenance items like shaving cream; and active cosmetics such as antiseptics and fluoridated toothpaste ( 3 ). Facial cosmetics are specifically those used on the face to add color or enhance appearance. Although cosmetics fall under the unregulated over-the-counter product category, they serve multiple purposes including improving cleanliness, appearance, and protecting against environmental damage ( 4 ). For instance, consistent and proper use of sunscreens may help in reducing the risk of skin cancer caused by ultraviolet radiation exposure ( 5 ). Cosmetic application, especially decorative products used to mask skin disfigurements, has been shown to enhance patients’ quality of life effectively and with good tolerance ( 6 ). Moreover, makeup has been linked to increased self-confidence without impacting perceptions of competence ( 7 ). Factors such as self-esteem, marital status, religion, and socioeconomic status can influence the use of cosmetic products. The increasing desire for enhanced appearance, along with limited awareness about product safety, has led to a rise in cosmetic use ( 8 ). Technological advancements and the vast number of new cosmetic products have heightened consumer exposure to numerous chemicals, thereby increasing the incidence of adverse reactions ( 8 ). Studies have confirmed that cosmetic products can cause harmful effects, regardless of public awareness of their safety ( 3 ). Given their role in daily personal care, cosmetic and skincare products are expected to be safe. According to the World Health Organization (WHO), an adverse drug reaction from cosmetics is defined as an unintended harmful response occurring after proper use, while an adverse cosmetic event (ACE) refers to a potentially harmful reaction linked to the use of cosmetics ( 9 ). Unfortunately, the frequent use of these products has resulted in negative outcomes due to chemical exposure, including heavy metals that may accumulate in the body, potentially leading to conditions like allergic contact dermatitis or other systemic issues ( 9 ). Cosmetic products are a frequent cause of contact dermatitis, a common skin condition that can greatly impact an individual’s quality of life. Most of these adverse reactions present as eczematous skin changes ( 10 ). Mild skin irritation, such as erythema, often arises from preservatives like formaldehyde releasers and propylparaben ( 11 ). Additionally, eye cosmetics (e.g., mascaras, eye shadows, eyeliners) may cause upper-eyelid dermatitis due to irritant or allergic contact dermatitis, and are also associated with dry eye and tear film instability ( 12 ). Certain traditional products, such as kohl, have been linked to lead toxicity and periocular pigmentation ( 13 ). Evidence also points to a connection between skincare product use and an increased risk of breast cancer, due to endocrine-disrupting ingredients, particularly heavy metals, which cause skin and mucous membrane damage ( 14 ). Cosmetic products may also worsen facial acne, although when used correctly as part of a treatment plan, they might support acne management—incorrect usage, however, may exacerbate the condition ( 15 ). The severity of adverse skin reactions depends on the product type; for example, some skincare products can cause stinging or redness shortly after application ( 16 ). Prolonged use of heavy makeup has been linked to symptoms such as headaches, fatigue, and nausea ( 9 ). Bleaching agents like hydroquinone can cause adverse effects such as acne, eczema, scabies, and fungal infections ( 17 ). Furthermore, D and C red dyes commonly used in blushers may have comedogenic effects, which can explain acne outbreaks on the cheeks ( 18 ). Titanium dioxide nanoparticles, widely used in sunscreens and other cosmetics, are generally considered low in toxicity( 19 ). Studies suggest that nano titanium dioxide does not penetrate the skin's outer layer or enter the bloodstream, making it safe for topical use ( 20 ). However, its potential to generate reactive oxygen species raises concerns about carcinogenic effects and cellular damage, which vary based on its chemical properties( 21 ). Octocrylene, another sunscreen component, is generally safe, with rare sensitization cases and limited endocrine disruption, though it may cause photo-contact allergies ( 22 ). Medical makeup is designed for safe use even on compromised skin, being hypoallergenic, non-comedogenic, and offering high sun protection. Unlike fashion-driven cosmetics, these corrective products prioritize medical requirements and skin sensitivity, serving both men and women to conceal lesions, as seen with newer formulations like face compact creams ( 23 ). In the United States, cosmetic ingredients do not require pre-market approval (except for color additives). The FDA regulates these products under laws like the Food, Drug, and Cosmetic Act and the Fair Packaging and Labeling Act, which prohibit adulteration and misbranding ( 24 ). A recent study from Saudi Arabia found that over half of the participants had experienced at least one adverse reaction related to cosmetic use in the past two years. On average, each individual reported multiple reactions, with the most frequently mentioned problems being skin redness, pimples, and itching ( 25 ). A study conducted in Chongqing, China, reported a large number of adverse skin reactions, the vast majority occurring in women. Contact dermatitis emerged as the most common diagnosis, followed by acne. Most of these reactions were linked to skin care products, especially those intended for skin whitening and sun protection ( 10 ). Despite the widespread use of cosmetics, especially facial products, there remains a significant gap in knowledge regarding their usage and associated adverse effects in Palestine. This study therefore aims to examine the adverse effects linked to cosmetic products and to identify optimal usage habits, focusing on behaviors, safety, and management, to help minimize these effects. Ultimately, the findings will contribute to reducing the harmful consequences of facial cosmetics among Palestinian women by improving awareness of practices that lead to adverse outcomes and encouraging safer usage behaviors. Methods A cross-sectional study was conducted among 803 female students at An-Najah National University, Nablus, Palestine. The study was based on a self-administered questionnaire, and the sampling method used was voluntary response sampling. Female students who currently use facial cosmetics were included in the study, while those who do not use facial cosmetics were excluded. The questionnaire consisted of six sections: demographic information (age, college, year of study, place of residence); types of cosmetics used; cosmetic use behavior (cosmetics utilization, mode of purchasing, consistency in product quality, product selection based on skin type, consulting a physician or pharmacist before use); safety measures related to cosmetic habits (duration of cosmetics use, product disposal practices, allergy testing, reading instructions before use, cleaning tools before applying cosmetics, awareness of harmful ingredients, use of makeup remover, removing cosmetics before sleep); adverse reactions related to cosmetic use; and management of adverse effects (changing the cosmetic type, consulting a physician, or using alternative products when problems appear). There were no expected risks to either the researchers or the participants. Privacy and confidentiality were strictly maintained, and no personal identifiers such as names or emails were collected. Participation in the study was entirely voluntary. At the beginning of the questionnaire, a consent box was provided. By ticking the box labeled "I agree to participate in this study," participants confirmed their informed consent and willingness to take part in the research. The study was approved by the Institutional Review Board (IRB) of An-Najah National University, Nablus, Palestine, and was conducted in accordance with the ethical principles of the Declaration of Helsinki. All statistical analyses were performed using SPSS software. Categorical data were described using frequencies and percentages. Numerical data were presented as mean ± standard deviation (SD) for normally distributed variables, and as median with interquartile range for non-normally distributed variables. The Chi-squared test was used to analyze categorical variables. All p-values were two-sided, and a p-value of less than 0.05 was considered statistically significant. Results The study examined cosmetic use and safety practices among 803 participants, revealing both responsible behaviors and notable gaps. Most participants chose products based on their skin type (79.2%) and bought them from professional stores (70.61%), though brand loyalty was low (40.47%). Daily or regular cosmetic use was common, and nearly half had been using cosmetics for 1–3 years. While good hygiene practices were observed in tool cleaning (86.05%) and makeup removal before sleep (77.21%), many participants did not consult specialists (73.72%), test for allergies (63.89%), or read product instructions (54.42%). Additionally, although a majority discarded expired products (60.02%), a significant portion did not. Notably, 89.41% acknowledged potential harm from cosmetics, indicating high awareness despite inconsistent safety practices. Table 1 Cosmetic Use Behaviors and Safety Practices Among Female Participants Category Response N (%) Choosing products based on skin type No 167 (20.80) Yes 636 (79.2) Consulting a specialist before use No 592 (73.72) Yes 211 (26.28) Buying cosmetics from professional stores No 236 (29.39) Yes 567 (70.61) Sticking to the same brand No 478 (59.53) Yes 325 (40.47) Frequency of cosmetic use Daily 322 (40.1) 2–3 Days 280 (34.87) In Parties 201 (25.03) Duration of cosmetic use ˂1 year 261 (32.5) 1–3 years 368 (45.83) ≥ 3 years 174 (21.67) Discarding expired products No 321 (39.98) Yes 482 (60.02) Testing for allergies before use No 513 (63.89) Yes 290 (36.11) Reading product instructions No 437 (54.42) Yes 366 (45.58) Using clean tools No 112 (13.95) Yes 691 (86.05) Belief that cosmetics may be harmful No 85 (10.59) Yes 718 (89.41) Using makeup remover No 280 (34.87) Yes 523 (65.13) Removing makeup before sleep No 183 (22.79) Yes 620 (77.21) The analysis revealed that adverse cosmetic reactions varied significantly with product selection and usage practices. Skin irritation was more common among those not consulting specialists (29.0% vs. 22.2%, p = 0.001) and those not choosing products based on skin type (34.1% vs. 25.7%, p = 0.001). Acne was significantly higher among users who ignored skin type (26.1% vs. 16.4%, p = 0.004) and did not seek professional advice (19.7% vs. 15.6%, p = 0.003), with slightly fewer cases among those buying from non-professional sources ( p = 0.016). Similarly, clogged pores and pimples were more prevalent in those not considering skin type or consulting specialists ( p = 0.001 for both), while eye irritation, peeling, rash, and changes in skin color also showed higher incidence among those neglecting skin-type alignment or professional consultation, despite fewer statistically significant differences with store type. Overall, consulting a specialist and choosing products according to skin type were consistently associated with lower rates of cosmetic-related adverse effects. Table 2 Association Between Cosmetic Purchasing and Usage Behaviors with Reported Adverse Skin Reactions Adverse Reaction Buy from professional stores Chosen based on Skin Type Consulting Specialist before use Yes N(%) No N(%) P-value Yes N(%) No N(%) P-value Yes N(%) No N(%) P-value Skin Irritation 169 (29.8) 55 (23.3) 0.074 181 (29.0) 37 (22.2) 0.001 72 (34.1) 152 (25.7) 0.001 Eye Redness/ Irritation 60 (10.6) 26 (11.0) 0.955 68 (10.9) 16 (10.7) 0.001 26 (12.3) 60 (10.1) 0.001 Peeling and Dryness 109 (19.2) 37 (15.7) 0.277 112 (17.9) 31 (18.6) 0.001 46 (21.8) 100 (16.9) 0.002 Rash 32 (5.6) 14 (5.9) 1.000 33 (5.3) 12 (7.2) 0.001 15 (7.1) 31 (5.2) 0.001 Acne (New or Worsening) 120 (21.2) 32 (13.6) 0.016 123 (19.7) 25 (15.6) 0.003 55 (26.1) 97 (16.4) 0.004 Skin Color Change 64 (11.3) 33 (14.0) 0.343 78 (12.5) 18 (11.2) 0.001 28 (13.3) 69 (11.7) 0.001 Clogged Pores/Pimples 117 (20.6) 34 (14.4) 0.050 114 (18.3) 34 (20.4) 0.001 46 (21.8) 105 (17.7) 0.001 Increased Skin Luster 59 (10.4) 20 (8.5) 0.480 67 (10.7) 10 (6.0) 0.002 24 (11.4) 55 (9.3) 0.001 Fine Lines on Face 17 (3.0) 12 (5.1) 0.216 21 (3.4) 8 (4.8) 0.001 4 (1.9) 25 (4.2) 0.003 Chapped Lips 46 (8.1) 16 (6.8) 0.617 48 (7.7) 11 (6.6) 0.001 15 (7.1) 47 (7.9) 0.001 Side effect analysis revealed significant associations with duration of cosmetic use and hygiene practices. Participants using cosmetics for over three years reported higher rates of acne breakouts (27.0%, p = 0.010) and clogged pores or pimples (27.0%, p = 0.009) compared to those with shorter usage durations. Additionally, participants who did not clean their application tools experienced more frequent peeling or dry skin (19.5%, p = 0.019). In contrast, other safety practices—including allergy testing, reading product instructions, using makeup remover, and removing makeup before sleep—showed no statistically significant association with any specific side effect. Skin irritation was the most commonly reported issue (31.6% among long-term users), yet it was not significantly linked to any of the examined practices. Notably, allergy testing and bedtime makeup removal did not reduce reported side effects (e.g., skin irritation: 31.4% in allergy-tested vs. untested, p = 0.116; 28.5% in removers vs. non-removers, p = 0.731), and no significant differences were found for other effects such as eye irritation, rashes, discoloration, or chapped lips. Table 3 Impact of Usage Duration and Hygiene Behaviors on Cosmetic-Related Adverse Effects Reported Side Effect Users > 3 Years Allergy Tested Reading Instructions Cleaning Tools Makeup Remover Bed time Cleaning Skin Irritation 31.6% (p = 0.234) 31.4% (p = 0.116) 29.8% (p = 0.312) 28.2% (p = 0.692) 30.2% (p = 0.055) 28.5% (p = 0.731) Eye Irritation / Redness / Swelling 8.6% (p = 0.375) 10.0% (p = 0.711) 12.3% (p = 0.224) 10.7% (p = 1.000) 12.2% (p = 0.073) 11.1% (p = 0.778) Dry or Peeling Skin 18.4% (p = 0.882) 19.0% (p = 0.736) 19.4% (p = 0.468) 19.5% (p = 0.019*) 18.4% (p = 0.937) 19.5% (p = 0.148) Rashes 5.2% (p = 0.800) 4.8% (p = 0.504) 6.3% (p = 0.640) 6.2% (p = 0.201) 5.7% (p = 1.000) 5.5% (p = 0.541) Acne Breakouts 27.0% (p = 0.010*) 19.7% (p = 0.763) 21.3% (p = 0.137) 18.8% (p = 0.938) 20.3% (p = 0.219) 19.7% (p = 0.449) Skin Discoloration / Dark Spots 13.2% (p = 0.886) 12.1% (p = 1.000) 12.0% (p = 1.000) 11.7% (p = 0.538) 12.0% (p = 1.000) 12.6% (p = 0.703) Pimples / Clogged Pores 27.0% (p = 0.009*) 16.2% (p = 0.186) 20.5% (p = 0.303) 17.8% (p = 0.093) 19.9% (p = 0.329) 18.9% (p = 0.853) Increased Skin Glow 10.3% (p = 0.602) 12.4% (p = 0.086) 10.9% (p = 0.406) 10.1% (p = 0.603) 10.5% (p = 0.449) 10.5% (p = 0.503) Facial Fine Lines 2.3% (p = 0.573) 3.1% (p = 0.702) 2.7% (p = 0.302) 3.9% (p = 0.399) 4.2% (p = 0.300) 4.4% (p = 0.108) Dry / Chapped Lips 6.9% (p = 0.861) 5.9% (p = 0.178) 7.7% (p = 1.000) 7.7% (p = 1.000) 8.2% (p = 0.557) 7.3% (p = 0.495) The analysis identified multiple significant associations between cosmetic products and specific side effects. Face whitening products were strongly linked to skin irritation, acne, rash, eye irritation, peeling, and chapped lips ( p < 0.05 for all). Primers and contour products also showed consistent associations with increased rates of acne, clogged pores, peeling, rash, and skin irritation. Moisturizing creams were significantly associated with peeling, acne, and irritation, while foundation use correlated with skin darkening, irritation, clogged pores, and rash. Lip balm and lipstick were tied to chapped lips and skin changes, including darkening and fine lines. Cleanser, mascara, powder, and concealer users reported more clogged pores and acne, with powder and concealer additionally linked to fine lines and discoloration. Scrub use was associated with acne, clogged pores, and dryness; tint with rash and peeling; highlighter with clogged pores and dryness; and blusher with chapped lips, skin darkening, and increased luster. These findings highlight how specific cosmetic types are differentially associated with adverse dermatological outcomes. Table 4 Reported Skin Reactions by Cosmetic Type Among Users and Nonusers Cosmetic Type Side Effect User (%) Nonuser (%) p-value Face Whitening Skin irritation 48.3% 25.4% < 0.001 Acne 33.3% 17.2% < 0.001 Rash 12.6% 4.9% 0.007 Eye irritation 18.4% 9.8% 0.023 Peeling/dryness 28.7% 16.9% 0.011 Chapped lips 13.8% 7.0% 0.042 Primer Acne 32.5% 17.4% 0.002 Eye irritation 21.2% 9.5% 0.003 Chapped lips 16.5% 6.8% 0.005 Peeling/dryness 30.0% 16.9% 0.006 Clogged pores 30.0% 17.6% 0.011 Rash 12.5% 5.0% 0.013 Skin irritation 38.8% 26.7% 0.032 Contour Skin irritation 48.1% 26.5% 0.001 Acne 34.6% 17.8% 0.005 Peeling/dryness 32.7% 17.2% 0.009 Clogged pores 30.8% 18.0% 0.036 Rash 13.5% 5.2% 0.030 Chapped lips 17.3% 7.1% 0.016 Moisturizing Cream Peeling/dryness 21.9% 11.3% < 0.001 Acne 22.6% 12.1% < 0.001 Skin irritation 31.9% 20.6% 0.001 Foundation Skin color darkening 18.2% 8.3% < 0.001 Skin irritation 34.5% 23.8% 0.001 Clogged pores 24.8% 15.1% 0.001 Peeling/dryness 22.5% 15.5% 0.017 Rash 8.5% 4.0% 0.013 Lip Balm Chapped lips 12.8% 5.3% < 0.001 Skin irritation 33.1% 25.5% 0.031 Lipstick Chapped lips 9.6% 4.0% 0.008 Skin color darkening 14.2% 8.1% 0.017 Fine lines appearance 4.7% 1.5% 0.032 Cleanser Clogged pores 21.3% 13.2% 0.008 Skin irritation 30.6% 22.0% 0.016 Acne 21.3% 13.6% 0.013 Mascara Clogged pores 22.0% 11.1% 0.001 Skin color darkening 13.9% 7.7% 0.029 Powder Clogged pores 26.8% 15.7% < 0.001 Fine lines appearance 7.0% 2.3% 0.002 Skin color darkening 17.1% 10.1% 0.008 Peeling/dryness 23.2% 16.2% 0.025 Concealer Clogged pores 28.0% 15.4% < 0.001 Acne 25.7% 16.5% 0.004 Peeling/dryness 24.3% 16.0% 0.009 Fine lines appearance 6.1% 2.7% 0.041 Eye irritation 14.5% 9.3% 0.050 Scrub Acne 26.1% 16.2% 0.002 Clogged pores 24.8% 16.6% 0.011 Peeling/dryness 22.9% 16.4% 0.042 Tint Rash 11.7% 4.9% 0.011 Peeling/dryness 26.2% 17.0% 0.033 Highlighter Clogged pores 26.2% 17.5% 0.031 Peeling/dryness 26.2% 16.7% 0.018 Blusher/Blush Chapped lips 11.1% 5.9% 0.014 Skin color darkening 16.4% 9.8% 0.008 Increased skin luster 12.9% 8.2% 0.048 Discussion The study of 803 participants provides valuable insights into cosmetic use behaviors and safety practices, revealing a complex picture of high awareness coupled with inconsistent safety implementation. A high proportion of participants selected products based on skin type (79.2%) and purchased from professional stores (70.61%), with relatively low brand loyalty (40.47%), reflecting practical consumer priorities similar to those observed in the US and EU ( 26 , 27 ) and contrasting with stronger brand attachment in markets like South Korea ( 28 ). Usage patterns showed that cosmetics are deeply integrated into daily routines, 40.1% used them daily and 45.83% had used them for 1–3 years, aligning with global increases in cosmetic use ( 29 ). Encouragingly, hygiene practices were relatively strong: 86.05% cleaned tools and 77.21% removed makeup before sleep, surpassing rates reported in comparable studies ( 30 , 31 ). However, significant safety gaps were identified: only 26.28% consulted specialists, 36.11% conducted allergy testing, and 45.58% read instructions, while 39.98% used expired products. These figures mirror concerning global patterns, patch testing remains underutilized ( 27 , 32 ), professional consultation is rare ( 33 ), instruction reading is often neglected ( 34 , 35 ), and expired product use is common ( 3 , 36 ). A paradox emerged wherein 89.41% of participants were aware of cosmetic risks, yet neglected key safety practices—a gap attributed to factors like perceived inconvenience or optimism bias, consistent with findings in health behavior literature ( 37 , 38 ). In synthesis, while the population demonstrated good foundational hygiene and informed purchasing behaviors, their failure to implement essential safety measures poses avoidable risks. These findings are consistent with international data and emphasize the universal challenge of bridging the awareness-practice gap ( 32 , 33 ), though stronger-than-average hygiene practices and notably low brand loyalty offer unique insights into regional consumer behavior. Based on the findings of this study and comparison with existing literature, the results strongly align with established dermatological and cosmetic science knowledge, highlighting skin type misalignment and lack of professional consultation as critical risk factors for adverse reactions. Products not selected based on skin type were associated with significantly higher rates of skin irritation (34.1% vs. 25.7%, p = 0.001), acne (26.1% vs. 16.4%, p = 0.004), and clogged pores (21.8% vs. 17.7%, p = 0.001), supporting Draelos ( 39 ), who identified mismatched products as the cause of cosmetic reactions, and Lugovic-Mihic et al. ( 40 ), who emphasized the importance of tailoring product use to individual skin characteristics. Similarly, participants who did not consult specialists experienced higher rates of irritation (29.0% vs. 22.2%, p = 0.001) and acne (19.7% vs. 15.6%, p = 0.003), underscoring the value of expert guidance. This aligns with Farage ( 41 ), who argued that dermatologists play a critical role in identifying skin sensitivities and guiding product choice, and with FDA reports linking lack of consultation to severe reactions ( 42 ). While purchasing from professional stores showed a protective effect for acne (21.2% vs. 13.6%, p = 0.016), effects on other reactions were less consistent—mirroring findings by Xu et al. ( 43 ), who noted that purchase location has greater impact for complex products, and consumer reports, which highlighted variable staff expertise ( 44 ). The study also confirmed that irritation, acne, and clogged pores were most strongly linked to poor selection practices, while less common reactions like rash, eye irritation, or pigmentation changes followed similar trends with varying statistical significance. These patterns are consistent with surveillance data from NACDG and ESSCA, which identify irritant contact dermatitis and acneiform eruptions as the most prevalent cosmetic adverse effects, typically triggered by unsuitable formulations and individual susceptibility factors ( 45 ). Together, the findings affirm two evidence-based principles: first, that personalized product selection based on skin type is essential to reduce adverse effects; second, that expert consultation plays a central role in mitigating risk, often more so than store type alone. While professional store purchases may offer some protective value, it is the expertise embedded in personalized consultation that offers the greatest benefit. These findings reinforce the broader scientific consensus and support targeted consumer education to minimize avoidable cosmetic-related skin issues ( 39 – 41 ). This analysis reveals that long-term cosmetic use (> 3 years) significantly increases the incidence of acne breakouts (27.0%, p = 0.010) and clogged pores (27.0%, p = 0.009), likely due to cumulative follicular occlusion, product residue accumulation, and microbial biofilm formation. Additionally, poor hygiene, particularly failure to clean application tools, is associated with a higher prevalence of peeling or dry skin (19.5%, p = 0.019), consistent with evidence linking contaminated applicators to low-grade inflammation and skin barrier disruption ( 46 ). In contrast, widely recommended safety practices, including allergy testing, bedtime makeup removal, reading instructions, and using makeup removers, showed no statistically significant protective effects against any adverse reactions, such as skin irritation (31.4% in allergy-tested vs. untested, p = 0.116; 28.5% in bedtime removers vs. non-removers, p = 0.731). These findings challenge conventional skincare advice, aligning instead with research showing that most cosmetic-related reactions are irritant rather than allergic in nature and that modern formulations are increasingly designed to minimize occlusion and irritation ( 47 ). Notably, skin irritation remained the most reported adverse effect (31.6%), yet lacked significant associations with any specific behavior, suggesting a multifactorial or idiopathic origin. Together with previous findings on product selection, this synthesis suggests a clear risk hierarchy: skin-type-matched products and professional consultation are broad-spectrum protective strategies; cleaning tools specifically reduces dryness( 48 ); prolonged cosmetic use worsens acne risk; and ritualized behaviors such as universal bedtime removal or allergy testing may offer limited protection ( 49 ). Accordingly, consumers should shift toward evidence-based prevention, prioritizing non-comedogenic, skin-appropriate product selection, professional guidance, restricted use of high-residue items, and strict hygiene of tools, while reconsidering less effective practices promoted by tradition rather than outcome data. This analysis highlights distinct product-specific adverse effect profiles, with face whitening products exhibiting the broadest toxicity spectrum—significantly associated with skin irritation (48.3% vs. 25.4%, p < 0.001), acne (33.3% vs. 17.2%), and eye irritation (18.4% vs. 9.8%)—corroborating literature that implicates barrier-disrupting agents such as hydroquinone, corticosteroids, and mercury in these reactions ( 50 , 51 ). Primers and contours were linked to high rates of acne and clogged pores (30–34.6%), consistent with comedogenic occlusion attributed to silicones and film-forming agents ( 52 ). Interestingly, moisturizers increased both peeling (21.9% vs. 11.3%) and acne (22.6% vs. 12.1%), likely due to comedogenic emulsifiers or irritant preservatives present in certain formulations. Lipsticks were associated with chapping and pigmentation changes (e.g., darkening in 14.2% of users), echoing known sensitivities to eosin, phenol, and other colorants ( 53 ). Powders and concealers showed a higher prevalence of facial fine lines (7.0% vs. 2.3%), likely due to repetitive mechanical friction and product settling in skin creases ( 54 ). Notably, this study found mascara significantly associated with clogged pores on the face (22.0% vs. 11.1%, p = 0.001)—a novel observation, as prior reports have focused almost exclusively on ocular effects ( 55 ). Similarly, blusher use was unexpectedly linked to chapped lips (11.1% vs. 5.9%, p = 0.014), possibly through inadvertent transfer of powders to the perioral region. Foundations were linked to significantly higher rates of skin darkening (18.2% vs. 8.3%, p < 0.001), exceeding previously reported levels (≤ 12%) and suggesting formulation-dependent oxidation or melanin-stimulating effects ( 56 ). Collectively, these findings reinforce those adverse cosmetic effects are closely tied to the unique chemical composition and application patterns of each product type, underscoring the need for targeted, product-specific safety recommendations rather than solely relying on generalized hygiene or use practices. Conclusion and limitations This study highlights a clear disconnect between users’ awareness of cosmetic risks and their actual safety practices. While most participants acknowledged potential harms, key behaviors such as consulting specialists, performing allergy tests, and avoiding expired products were often overlooked. Adverse effects were more likely when products were mismatched to skin type or used over extended periods, especially with items known to cause occlusion or irritation. Specific product categories—such as face whiteners, primers, and moisturizers—were associated with a distinct pattern of side effects, underscoring the importance of formulation and application methods. Interestingly, widely promoted routines like bedtime makeup removal and allergy testing did not consistently reduce adverse outcomes, supporting emerging evidence that many reactions stem from irritation rather than allergy. Despite generally good hygiene practices, the persistence of preventable side effects suggests a need for targeted education, clearer labeling, safer formulations, and more proactive clinical inquiry into cosmetic use. Bridging the gap between knowledge and behavior requires a coordinated effort from consumers, health professionals, and the cosmetic industry. Declarations Ethics and Guidelines: The ethical approval was obtained from the Institutional Review Board (IRB) at An-Najah National University, and the study was conducted in accordance with the ethical principles outlined in the Declaration of Helsinki. Consent to Participate: A written consent was signed by all participants. Consent for publication: The approved consent to publication was obtained from all participants. Availability of data and materials: The authors declare that the data underpinning the findings of this study are included within the article. For further details or inquiries, please contact the corresponding author. Competing interests: The authors have no conflicts of interest to declare. Funding: This project was funded by An-Najah National University, Nablus, Palestine. Authors' contributions: All authors contributed to the conceptualization, methodology, data collection, formal analysis, writing of the original draft, and review and editing of the manuscript. All authors were involved in visualization and project administration. Supervision was provided by IA. All authors have read and approved the final version of the manuscript. Acknowledgment: The authors extend their sincere gratitude to all participants who participated in this study. References Butler H. Cosmetics through the ages. Poucher’s perfumes, cosmetics and soaps: Springer; 2000. p. 13-63. Baki G. Introduction to cosmetic formulation and technology: John Wiley & Sons; 2022. Nohynek GJ, Antignac E, Re T, Toutain HJT, pharmacology a. Safety assessment of personal care products/cosmetics and their ingredients. 2010;243(2):239-59. Halla N, Fernandes IP, Heleno SA, Costa P, Boucherit-Otmani Z, Boucherit K, et al. Cosmetics preservation: a review on present strategies. 2018;23(7):1571. Saraiya M, Glanz K, Briss PA, Nichols P, White C, Das D, et al. Interventions to prevent skin cancer by reducing exposure to ultraviolet radiation: a systematic review. 2004;27(5):422-66. 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European Handbook of Dermatological Treatments: Springer; 2023. p. 1771-85. Horton E, Uter W, Geier J, Ballmer‐Weber B, Bauer A, Bircher A, et al. Developing a cosmetic series: results from the ESSCA network, 2009‐2018. 2021;84(2):82-94. Lee YB, Byun EJ, Kim HSJJocm. Potential role of the microbiome in acne: a comprehensive review. 2019;8(7):987. Francisco Cantón P. Cross-cultural marketing of beauty products in countries with cultural and religious differences. 2023. Shaaban H, Alhajri WJJoe, health p. Usage patterns of cosmetic and personal care products among female population in Saudi Arabia: important factors for exposure and risk assessment. 2020;2020(1):8434508. Smith VS. Clean: A history of personal hygiene and purity: Oxford University Press; 2008. Fransway AF, Zug KA, Belsito DV, DeLeo VA, Fowler Jr JF, Maibach HI, et al. North American contact dermatitis group patch test results for 2007–2008. 2013;24(1):10-21. Zirwas MJJCRiA, Immunology. Contact dermatitis to cosmetics. 2019;56:119-28. Lionetti N, Rigano LJC. Labeling of cosmetic products. 2018;5(1):22. Amberg N, Fogarassy CJR. Green consumer behavior in the cosmetics market. 2019;8(3):137. Jalilian F, Ahmadpanah M, Karimi M, Salehi I, Vahidinia AA, Emdadi SJD, et al. Prevalence and reasons for cosmetic products use among female students in Hamedan universities. 2012;3(1). Alinaghi F, Bennike NH, Egeberg A, Thyssen JP, Johansen JDJCd. Prevalence of contact allergy in the general population: a systematic review and meta‐analysis. 2019;80(2):77-85. Jovanovic MJMP. CONTACT SENSITIZATION AND ALLERGENS IN THE COMPOSITION OF COSMETIC PRODUCTS-CURRENT KNOWLEDGE/KONTAKTNA SENZIBILIZACIJA I ALERGENI USASTAVU KOZMETICKIH PROIZVODA-POSTOJECA SAZNANJA. 2021;74(5-6):159-67. Draelos ZD. Cosmetic dermatology: products and procedures: John Wiley & Sons; 2021. Lugović-Mihić L, Filija E, Varga V, Premuž L, Parać E, Tomašević R, et al. Unwanted Skin Reactions to Acrylates: An Update. 2024;11(4):127. Farage MAJHoCS, Technology. Sensory, Clinical, and Physiological Factors in Sensitive Skin. 2022:47-59. Jacob SL, Cornell E, Kwa M, Funk WE, Xu SJJcs. Cosmetics and cancer: adverse event reports submitted to the food and drug administration. 2018;2(2):pky012. Xu S, Kwa M, Lohman ME, Evers-Meltzer R, Silverberg JIJJd. Consumer preferences, product characteristics, and potentially allergenic ingredients in best-selling moisturizers. 2017;153(11):1099-105. Lee H-J, Kim M-YJJotKSoC, Textiles. Cosmetic Store Selection Differences Depending on Make-up Preference Image. 2007;31(2):206-16. Verallo-Rowell VMJD. The validated hypoallergenic cosmetics rating system: its 30-year evolution and effect on the prevalence of cosmetic reactions. 2011;22(2):80-97. Madnani N. Atlas of vulvovaginal disease in darker skin types: CRC Press; 2023. Matsunaga K, Aiba S, Goossens AE. Contact dermatitis: Principles, mechanisms, and allergies related to cosmetics. Handbook of Cosmetic Science and Technology: CRC Press; 2022. p. 75-86. Naylor M, Robinson JKJAod. Sunscreen, sun protection, and our many failures. 2005;141(8):1025-7. Mohiuddin AJDCR. Acne protection: measures and miseries. 2019;5(1):272-311. Couteau C, Coiffard LJC. Overview of skin whitening agents: Drugs and cosmetic products. 2016;3(3):27. Friedmann PS, Pickard CJCD. Quantifying human susceptibility to contact sensitization; risk assessments now and in the future. 2010;63(5):237-47. Bonté F, Girard D, Archambault J-C, Desmoulière AJB, science cboaPIc. Skin changes during ageing. 2019:249-80. Westfall A. Evaluation of the efficacy of anthocyanins as biologically active ingredients in lipstick formulations: The Ohio State University; 2015. Akhtar A, Kazi TG, Afridi HI, Khan MJRt, pharmacology. Human exposure to toxic elements through facial cosmetic products: Dermal risk assessment. 2022;131:105145. Barar J, Javadzadeh AR, Omidi YJEoodd. Ocular novel drug delivery: impacts of membranes and barriers. 2008;5(5):567-81. Solano FJNJoS. Melanins: skin pigments and much more—types, structural models, biological functions, and formation routes. 2014;2014(1):498276. Additional Declarations No competing interests reported. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-6997761","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":518174636,"identity":"749a261c-4d21-4ab4-93bc-88cc864e8efc","order_by":0,"name":"Iyad 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Greek term \u0026ldquo;Kosm tikos,\u0026rdquo; which means having the ability to arrange or decorate, derived from \u0026ldquo;kosmein\u0026rdquo; (to adorn) and \u0026ldquo;kosmos\u0026rdquo; (order, harmony) (\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e). According to the FDA, cosmetics are defined as products (excluding pure soap) applied to the human body for cleansing, beautifying, promoting attractiveness, or altering appearance (\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e). These products can be categorized into several types: personal cleansing items like soaps and shampoos; skin and hair care products such as toothpaste and intimate care items; beautification products including perfumes and lipsticks; protective items like sunscreens; corrective products such as masks and dyes; maintenance items like shaving cream; and active cosmetics such as antiseptics and fluoridated toothpaste (\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e). Facial cosmetics are specifically those used on the face to add color or enhance appearance. Although cosmetics fall under the unregulated over-the-counter product category, they serve multiple purposes including improving cleanliness, appearance, and protecting against environmental damage (\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e). For instance, consistent and proper use of sunscreens may help in reducing the risk of skin cancer caused by ultraviolet radiation exposure (\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e). Cosmetic application, especially decorative products used to mask skin disfigurements, has been shown to enhance patients\u0026rsquo; quality of life effectively and with good tolerance (\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e). Moreover, makeup has been linked to increased self-confidence without impacting perceptions of competence (\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e). Factors such as self-esteem, marital status, religion, and socioeconomic status can influence the use of cosmetic products.\u003c/p\u003e\u003cp\u003eThe increasing desire for enhanced appearance, along with limited awareness about product safety, has led to a rise in cosmetic use (\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e). Technological advancements and the vast number of new cosmetic products have heightened consumer exposure to numerous chemicals, thereby increasing the incidence of adverse reactions (\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e). Studies have confirmed that cosmetic products can cause harmful effects, regardless of public awareness of their safety (\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e). Given their role in daily personal care, cosmetic and skincare products are expected to be safe. According to the World Health Organization (WHO), an adverse drug reaction from cosmetics is defined as an unintended harmful response occurring after proper use, while an adverse cosmetic event (ACE) refers to a potentially harmful reaction linked to the use of cosmetics (\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e). Unfortunately, the frequent use of these products has resulted in negative outcomes due to chemical exposure, including heavy metals that may accumulate in the body, potentially leading to conditions like allergic contact dermatitis or other systemic issues (\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e). Cosmetic products are a frequent cause of contact dermatitis, a common skin condition that can greatly impact an individual\u0026rsquo;s quality of life. Most of these adverse reactions present as eczematous skin changes (\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e). Mild skin irritation, such as erythema, often arises from preservatives like formaldehyde releasers and propylparaben (\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e). Additionally, eye cosmetics (e.g., mascaras, eye shadows, eyeliners) may cause upper-eyelid dermatitis due to irritant or allergic contact dermatitis, and are also associated with dry eye and tear film instability (\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e). Certain traditional products, such as kohl, have been linked to lead toxicity and periocular pigmentation (\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e). Evidence also points to a connection between skincare product use and an increased risk of breast cancer, due to endocrine-disrupting ingredients, particularly heavy metals, which cause skin and mucous membrane damage (\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eCosmetic products may also worsen facial acne, although when used correctly as part of a treatment plan, they might support acne management\u0026mdash;incorrect usage, however, may exacerbate the condition (\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e). The severity of adverse skin reactions depends on the product type; for example, some skincare products can cause stinging or redness shortly after application (\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e). Prolonged use of heavy makeup has been linked to symptoms such as headaches, fatigue, and nausea (\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e). Bleaching agents like hydroquinone can cause adverse effects such as acne, eczema, scabies, and fungal infections (\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e). Furthermore, D and C red dyes commonly used in blushers may have comedogenic effects, which can explain acne outbreaks on the cheeks (\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e). Titanium dioxide nanoparticles, widely used in sunscreens and other cosmetics, are generally considered low in toxicity(\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e). Studies suggest that nano titanium dioxide does not penetrate the skin's outer layer or enter the bloodstream, making it safe for topical use (\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e). However, its potential to generate reactive oxygen species raises concerns about carcinogenic effects and cellular damage, which vary based on its chemical properties(\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e). Octocrylene, another sunscreen component, is generally safe, with rare sensitization cases and limited endocrine disruption, though it may cause photo-contact allergies (\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eMedical makeup is designed for safe use even on compromised skin, being hypoallergenic, non-comedogenic, and offering high sun protection. Unlike fashion-driven cosmetics, these corrective products prioritize medical requirements and skin sensitivity, serving both men and women to conceal lesions, as seen with newer formulations like face compact creams (\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e). In the United States, cosmetic ingredients do not require pre-market approval (except for color additives). The FDA regulates these products under laws like the Food, Drug, and Cosmetic Act and the Fair Packaging and Labeling Act, which prohibit adulteration and misbranding (\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eA recent study from Saudi Arabia found that over half of the participants had experienced at least one adverse reaction related to cosmetic use in the past two years. On average, each individual reported multiple reactions, with the most frequently mentioned problems being skin redness, pimples, and itching (\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e). A study conducted in Chongqing, China, reported a large number of adverse skin reactions, the vast majority occurring in women. Contact dermatitis emerged as the most common diagnosis, followed by acne. Most of these reactions were linked to skin care products, especially those intended for skin whitening and sun protection (\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eDespite the widespread use of cosmetics, especially facial products, there remains a significant gap in knowledge regarding their usage and associated adverse effects in Palestine. This study therefore aims to examine the adverse effects linked to cosmetic products and to identify optimal usage habits, focusing on behaviors, safety, and management, to help minimize these effects. Ultimately, the findings will contribute to reducing the harmful consequences of facial cosmetics among Palestinian women by improving awareness of practices that lead to adverse outcomes and encouraging safer usage behaviors.\u003c/p\u003e"},{"header":"Methods","content":"\u003cp\u003eA cross-sectional study was conducted among 803 female students at An-Najah National University, Nablus, Palestine. The study was based on a self-administered questionnaire, and the sampling method used was voluntary response sampling.\u003c/p\u003e\u003cp\u003eFemale students who currently use facial cosmetics were included in the study, while those who do not use facial cosmetics were excluded. The questionnaire consisted of six sections: demographic information (age, college, year of study, place of residence); types of cosmetics used; cosmetic use behavior (cosmetics utilization, mode of purchasing, consistency in product quality, product selection based on skin type, consulting a physician or pharmacist before use); safety measures related to cosmetic habits (duration of cosmetics use, product disposal practices, allergy testing, reading instructions before use, cleaning tools before applying cosmetics, awareness of harmful ingredients, use of makeup remover, removing cosmetics before sleep); adverse reactions related to cosmetic use; and management of adverse effects (changing the cosmetic type, consulting a physician, or using alternative products when problems appear).\u003c/p\u003e\u003cp\u003eThere were no expected risks to either the researchers or the participants. Privacy and confidentiality were strictly maintained, and no personal identifiers such as names or emails were collected. Participation in the study was entirely voluntary. At the beginning of the questionnaire, a consent box was provided. By ticking the box labeled \"I agree to participate in this study,\" participants confirmed their informed consent and willingness to take part in the research. The study was approved by the Institutional Review Board (IRB) of An-Najah National University, Nablus, Palestine, and was conducted in accordance with the ethical principles of the Declaration of Helsinki.\u003c/p\u003e\u003cp\u003eAll statistical analyses were performed using SPSS software. Categorical data were described using frequencies and percentages. Numerical data were presented as mean\u0026thinsp;\u0026plusmn;\u0026thinsp;standard deviation (SD) for normally distributed variables, and as median with interquartile range for non-normally distributed variables. The Chi-squared test was used to analyze categorical variables. All p-values were two-sided, and a p-value of less than 0.05 was considered statistically significant.\u003c/p\u003e"},{"header":"Results","content":"\u003cp\u003eThe study examined cosmetic use and safety practices among 803 participants, revealing both responsible behaviors and notable gaps. Most participants chose products based on their skin type (79.2%) and bought them from professional stores (70.61%), though brand loyalty was low (40.47%). Daily or regular cosmetic use was common, and nearly half had been using cosmetics for 1\u0026ndash;3 years. While good hygiene practices were observed in tool cleaning (86.05%) and makeup removal before sleep (77.21%), many participants did not consult specialists (73.72%), test for allergies (63.89%), or read product instructions (54.42%). Additionally, although a majority discarded expired products (60.02%), a significant portion did not. Notably, 89.41% acknowledged potential harm from cosmetics, indicating high awareness despite inconsistent safety practices.\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eCosmetic Use Behaviors and Safety Practices Among Female Participants\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"3\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u003cp\u003eCategory\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eResponse\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003eN (%)\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e\u003cb\u003eChoosing products based on skin type\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e167 (20.80)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e636 (79.2)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e\u003cb\u003eConsulting a specialist before use\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e592 (73.72)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e211 (26.28)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e\u003cb\u003eBuying cosmetics from professional stores\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e236 (29.39)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e567 (70.61)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e\u003cb\u003eSticking to the same brand\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e478 (59.53)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e325 (40.47)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e\u003cp\u003e\u003cb\u003eFrequency of cosmetic use\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eDaily\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e322 (40.1)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e2\u0026ndash;3 Days\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e280 (34.87)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eIn Parties\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e201 (25.03)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e\u003cp\u003e\u003cb\u003eDuration of cosmetic use\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e˂1 year\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e261 (32.5)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e1\u0026ndash;3 years\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e368 (45.83)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u0026ge;\u0026thinsp;3 years\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e174 (21.67)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e\u003cb\u003eDiscarding expired products\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e321 (39.98)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e482 (60.02)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e\u003cb\u003eTesting for allergies before use\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e513 (63.89)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e290 (36.11)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e\u003cb\u003eReading product instructions\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e437 (54.42)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e366 (45.58)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e\u003cb\u003eUsing clean tools\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e112 (13.95)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e691 (86.05)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e\u003cb\u003eBelief that cosmetics may be harmful\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e85 (10.59)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e718 (89.41)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e\u003cb\u003eUsing makeup remover\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e280 (34.87)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e523 (65.13)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e\u003cb\u003eRemoving makeup before sleep\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e183 (22.79)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e620 (77.21)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003eThe analysis revealed that adverse cosmetic reactions varied significantly with product selection and usage practices. Skin irritation was more common among those not consulting specialists (29.0% vs. 22.2%, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.001) and those not choosing products based on skin type (34.1% vs. 25.7%, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.001). Acne was significantly higher among users who ignored skin type (26.1% vs. 16.4%, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.004) and did not seek professional advice (19.7% vs. 15.6%, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.003), with slightly fewer cases among those buying from non-professional sources (\u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.016). Similarly, clogged pores and pimples were more prevalent in those not considering skin type or consulting specialists (\u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.001 for both), while eye irritation, peeling, rash, and changes in skin color also showed higher incidence among those neglecting skin-type alignment or professional consultation, despite fewer statistically significant differences with store type. Overall, consulting a specialist and choosing products according to skin type were consistently associated with lower rates of cosmetic-related adverse effects.\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eAssociation Between Cosmetic Purchasing and Usage Behaviors with Reported Adverse Skin Reactions\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"10\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c8\" colnum=\"8\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c9\" colnum=\"9\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c10\" colnum=\"10\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003eAdverse Reaction\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colspan=\"3\" nameend=\"c4\" namest=\"c2\"\u003e\u003cp\u003eBuy from professional stores\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colspan=\"3\" nameend=\"c7\" namest=\"c5\"\u003e\u003cp\u003eChosen based on\u003c/p\u003e\u003cp\u003eSkin Type\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colspan=\"3\" nameend=\"c10\" namest=\"c8\"\u003e\u003cp\u003eConsulting Specialist before use\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003cp\u003eN(%)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003cp\u003eN(%)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u003cp\u003eP-value\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c5\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003cp\u003eN(%)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c6\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003cp\u003eN(%)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c7\"\u003e\u003cp\u003eP-value\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c8\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003cp\u003eN(%)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c9\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003cp\u003eN(%)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c10\"\u003e\u003cp\u003eP-value\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eSkin Irritation\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e169\u003c/p\u003e\u003cp\u003e(29.8)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e55\u003c/p\u003e\u003cp\u003e(23.3)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e0.074\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e181 (29.0)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e37 (22.2)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e\u003cp\u003e0.001\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e72 (34.1)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e\u003cp\u003e152 (25.7)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c10\"\u003e\u003cp\u003e0.001\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eEye Redness/ Irritation\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e60\u003c/p\u003e\u003cp\u003e(10.6)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e26\u003c/p\u003e\u003cp\u003e(11.0)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e0.955\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e68 (10.9)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e16 (10.7)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e\u003cp\u003e0.001\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e26 (12.3)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e\u003cp\u003e60 (10.1)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c10\"\u003e\u003cp\u003e0.001\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003ePeeling and Dryness\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e109\u003c/p\u003e\u003cp\u003e(19.2)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e37\u003c/p\u003e\u003cp\u003e(15.7)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e0.277\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e112 (17.9)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e31 (18.6)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e\u003cp\u003e0.001\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e46 (21.8)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e\u003cp\u003e100 (16.9)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c10\"\u003e\u003cp\u003e0.002\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eRash\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e32\u003c/p\u003e\u003cp\u003e(5.6)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e14\u003c/p\u003e\u003cp\u003e(5.9)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e1.000\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e33 (5.3)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e12 (7.2)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e\u003cp\u003e0.001\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e15 (7.1)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e\u003cp\u003e31 (5.2)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c10\"\u003e\u003cp\u003e0.001\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eAcne (New or Worsening)\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e120\u003c/p\u003e\u003cp\u003e(21.2)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e32\u003c/p\u003e\u003cp\u003e(13.6)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e0.016\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e123 (19.7)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e25 (15.6)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e\u003cp\u003e0.003\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e55 (26.1)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e\u003cp\u003e97 (16.4)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c10\"\u003e\u003cp\u003e0.004\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eSkin Color Change\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e64\u003c/p\u003e\u003cp\u003e(11.3)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e33\u003c/p\u003e\u003cp\u003e(14.0)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e0.343\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e78 (12.5)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e18 (11.2)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e\u003cp\u003e0.001\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e28 (13.3)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e\u003cp\u003e69 (11.7)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c10\"\u003e\u003cp\u003e0.001\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eClogged Pores/Pimples\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e117\u003c/p\u003e\u003cp\u003e(20.6)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e34\u003c/p\u003e\u003cp\u003e(14.4)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e0.050\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e114 (18.3)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e34 (20.4)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e\u003cp\u003e0.001\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e46 (21.8)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e\u003cp\u003e105 (17.7)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c10\"\u003e\u003cp\u003e0.001\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eIncreased Skin Luster\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e59\u003c/p\u003e\u003cp\u003e(10.4)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e20\u003c/p\u003e\u003cp\u003e(8.5)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e0.480\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e67 (10.7)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e10 (6.0)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e\u003cp\u003e0.002\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e24 (11.4)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e\u003cp\u003e55 (9.3)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c10\"\u003e\u003cp\u003e0.001\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eFine Lines on Face\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e17\u003c/p\u003e\u003cp\u003e(3.0)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e12\u003c/p\u003e\u003cp\u003e(5.1)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e0.216\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e21 (3.4)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e8 (4.8)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e\u003cp\u003e0.001\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e4 (1.9)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e\u003cp\u003e25 (4.2)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c10\"\u003e\u003cp\u003e0.003\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eChapped Lips\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e46\u003c/p\u003e\u003cp\u003e(8.1)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e16\u003c/p\u003e\u003cp\u003e(6.8)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e0.617\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e48 (7.7)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e11 (6.6)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e\u003cp\u003e0.001\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e15 (7.1)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e\u003cp\u003e47 (7.9)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c10\"\u003e\u003cp\u003e0.001\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003eSide effect analysis revealed significant associations with duration of cosmetic use and hygiene practices. Participants using cosmetics for over three years reported higher rates of acne breakouts (27.0%, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.010) and clogged pores or pimples (27.0%, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.009) compared to those with shorter usage durations. Additionally, participants who did not clean their application tools experienced more frequent peeling or dry skin (19.5%, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.019). In contrast, other safety practices\u0026mdash;including allergy testing, reading product instructions, using makeup remover, and removing makeup before sleep\u0026mdash;showed no statistically significant association with any specific side effect. Skin irritation was the most commonly reported issue (31.6% among long-term users), yet it was not significantly linked to any of the examined practices. Notably, allergy testing and bedtime makeup removal did not reduce reported side effects (e.g., skin irritation: 31.4% in allergy-tested vs. untested, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.116; 28.5% in removers vs. non-removers, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.731), and no significant differences were found for other effects such as eye irritation, rashes, discoloration, or chapped lips.\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab3\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eImpact of Usage Duration and Hygiene Behaviors on Cosmetic-Related Adverse Effects\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"7\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u003cp\u003eReported Side Effect\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eUsers\u0026thinsp;\u0026gt;\u0026thinsp;3 Years\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003eAllergy Tested\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u003cp\u003eReading Instructions\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c5\"\u003e\u003cp\u003eCleaning Tools\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c6\"\u003e\u003cp\u003eMakeup Remover\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c7\"\u003e\u003cp\u003eBed time\u003c/p\u003e\u003cp\u003eCleaning\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eSkin Irritation\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e31.6% (p\u0026thinsp;=\u0026thinsp;0.234)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e31.4% (p\u0026thinsp;=\u0026thinsp;0.116)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e29.8% (p\u0026thinsp;=\u0026thinsp;0.312)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e28.2% (p\u0026thinsp;=\u0026thinsp;0.692)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e30.2% (p\u0026thinsp;=\u0026thinsp;0.055)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e28.5% (p\u0026thinsp;=\u0026thinsp;0.731)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eEye Irritation / Redness / Swelling\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e8.6% (p\u0026thinsp;=\u0026thinsp;0.375)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e10.0% (p\u0026thinsp;=\u0026thinsp;0.711)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e12.3% (p\u0026thinsp;=\u0026thinsp;0.224)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e10.7% (p\u0026thinsp;=\u0026thinsp;1.000)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e12.2% (p\u0026thinsp;=\u0026thinsp;0.073)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e11.1% (p\u0026thinsp;=\u0026thinsp;0.778)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eDry or Peeling Skin\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e18.4% (p\u0026thinsp;=\u0026thinsp;0.882)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e19.0% (p\u0026thinsp;=\u0026thinsp;0.736)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e19.4% (p\u0026thinsp;=\u0026thinsp;0.468)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e19.5% (p\u0026thinsp;=\u0026thinsp;0.019*)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e18.4% (p\u0026thinsp;=\u0026thinsp;0.937)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e19.5% (p\u0026thinsp;=\u0026thinsp;0.148)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eRashes\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e5.2% (p\u0026thinsp;=\u0026thinsp;0.800)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e4.8% (p\u0026thinsp;=\u0026thinsp;0.504)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e6.3% (p\u0026thinsp;=\u0026thinsp;0.640)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e6.2% (p\u0026thinsp;=\u0026thinsp;0.201)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e5.7% (p\u0026thinsp;=\u0026thinsp;1.000)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e5.5% (p\u0026thinsp;=\u0026thinsp;0.541)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eAcne Breakouts\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e27.0% (p\u0026thinsp;=\u0026thinsp;0.010*)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e19.7% (p\u0026thinsp;=\u0026thinsp;0.763)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e21.3% (p\u0026thinsp;=\u0026thinsp;0.137)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e18.8% (p\u0026thinsp;=\u0026thinsp;0.938)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e20.3% (p\u0026thinsp;=\u0026thinsp;0.219)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e19.7% (p\u0026thinsp;=\u0026thinsp;0.449)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eSkin Discoloration / Dark Spots\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e13.2% (p\u0026thinsp;=\u0026thinsp;0.886)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e12.1% (p\u0026thinsp;=\u0026thinsp;1.000)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e12.0% (p\u0026thinsp;=\u0026thinsp;1.000)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e11.7% (p\u0026thinsp;=\u0026thinsp;0.538)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e12.0% (p\u0026thinsp;=\u0026thinsp;1.000)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e12.6% (p\u0026thinsp;=\u0026thinsp;0.703)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003ePimples / Clogged Pores\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e27.0% (p\u0026thinsp;=\u0026thinsp;0.009*)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e16.2% (p\u0026thinsp;=\u0026thinsp;0.186)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e20.5% (p\u0026thinsp;=\u0026thinsp;0.303)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e17.8% (p\u0026thinsp;=\u0026thinsp;0.093)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e19.9% (p\u0026thinsp;=\u0026thinsp;0.329)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e18.9% (p\u0026thinsp;=\u0026thinsp;0.853)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eIncreased Skin Glow\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e10.3% (p\u0026thinsp;=\u0026thinsp;0.602)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e12.4% (p\u0026thinsp;=\u0026thinsp;0.086)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e10.9% (p\u0026thinsp;=\u0026thinsp;0.406)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e10.1% (p\u0026thinsp;=\u0026thinsp;0.603)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e10.5% (p\u0026thinsp;=\u0026thinsp;0.449)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e10.5% (p\u0026thinsp;=\u0026thinsp;0.503)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eFacial Fine Lines\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e2.3% (p\u0026thinsp;=\u0026thinsp;0.573)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e3.1% (p\u0026thinsp;=\u0026thinsp;0.702)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e2.7% (p\u0026thinsp;=\u0026thinsp;0.302)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e3.9% (p\u0026thinsp;=\u0026thinsp;0.399)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e4.2% (p\u0026thinsp;=\u0026thinsp;0.300)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e4.4% (p\u0026thinsp;=\u0026thinsp;0.108)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eDry / Chapped Lips\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e6.9% (p\u0026thinsp;=\u0026thinsp;0.861)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e5.9% (p\u0026thinsp;=\u0026thinsp;0.178)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e7.7% (p\u0026thinsp;=\u0026thinsp;1.000)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e7.7% (p\u0026thinsp;=\u0026thinsp;1.000)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e8.2% (p\u0026thinsp;=\u0026thinsp;0.557)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e7.3% (p\u0026thinsp;=\u0026thinsp;0.495)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003eThe analysis identified multiple significant associations between cosmetic products and specific side effects. Face whitening products were strongly linked to skin irritation, acne, rash, eye irritation, peeling, and chapped lips (\u003cem\u003ep\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.05 for all). Primers and contour products also showed consistent associations with increased rates of acne, clogged pores, peeling, rash, and skin irritation. Moisturizing creams were significantly associated with peeling, acne, and irritation, while foundation use correlated with skin darkening, irritation, clogged pores, and rash. Lip balm and lipstick were tied to chapped lips and skin changes, including darkening and fine lines. Cleanser, mascara, powder, and concealer users reported more clogged pores and acne, with powder and concealer additionally linked to fine lines and discoloration. Scrub use was associated with acne, clogged pores, and dryness; tint with rash and peeling; highlighter with clogged pores and dryness; and blusher with chapped lips, skin darkening, and increased luster. These findings highlight how specific cosmetic types are differentially associated with adverse dermatological outcomes.\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab4\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 4\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eReported Skin Reactions by Cosmetic Type Among Users and Nonusers\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"5\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u003cp\u003eCosmetic Type\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eSide Effect\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003eUser (%)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u003cp\u003eNonuser (%)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c5\"\u003e\u003cp\u003ep-value\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"5\" rowspan=\"6\"\u003e\u003cp\u003e\u003cb\u003eFace Whitening\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eSkin irritation\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e48.3%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e25.4%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eAcne\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e33.3%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e17.2%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eRash\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e12.6%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e4.9%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e0.007\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eEye irritation\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e18.4%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e9.8%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e0.023\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003ePeeling/dryness\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e28.7%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e16.9%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e0.011\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eChapped lips\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e13.8%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e7.0%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e0.042\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"6\" rowspan=\"7\"\u003e\u003cp\u003e\u003cb\u003ePrimer\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eAcne\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e32.5%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e17.4%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e0.002\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eEye irritation\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e21.2%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e9.5%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e0.003\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eChapped lips\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e16.5%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e6.8%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e0.005\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003ePeeling/dryness\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e30.0%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e16.9%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e0.006\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eClogged pores\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e30.0%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e17.6%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e0.011\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eRash\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e12.5%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e5.0%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e0.013\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eSkin irritation\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e38.8%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e26.7%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e0.032\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"5\" rowspan=\"6\"\u003e\u003cp\u003e\u003cb\u003eContour\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eSkin irritation\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e48.1%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e26.5%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e0.001\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eAcne\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e34.6%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e17.8%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e0.005\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003ePeeling/dryness\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e32.7%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e17.2%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e0.009\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eClogged pores\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e30.8%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e18.0%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e0.036\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eRash\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e13.5%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e5.2%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e0.030\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eChapped lips\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e17.3%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e7.1%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e0.016\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e\u003cp\u003e\u003cb\u003eMoisturizing Cream\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003ePeeling/dryness\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e21.9%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e11.3%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eAcne\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e22.6%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e12.1%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eSkin irritation\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e31.9%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e20.6%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e0.001\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"4\" rowspan=\"5\"\u003e\u003cp\u003e\u003cb\u003eFoundation\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eSkin color darkening\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e18.2%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e8.3%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eSkin irritation\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e34.5%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e23.8%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e0.001\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eClogged pores\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e24.8%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e15.1%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e0.001\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003ePeeling/dryness\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e22.5%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e15.5%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e0.017\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eRash\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e8.5%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e4.0%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e0.013\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e\u003cb\u003eLip Balm\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eChapped lips\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e12.8%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e5.3%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eSkin irritation\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e33.1%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e25.5%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e0.031\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e\u003cp\u003e\u003cb\u003eLipstick\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eChapped lips\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e9.6%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e4.0%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e0.008\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eSkin color darkening\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e14.2%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e8.1%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e0.017\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eFine lines appearance\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e4.7%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e1.5%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e0.032\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e\u003cp\u003e\u003cb\u003eCleanser\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eClogged pores\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e21.3%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e13.2%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e0.008\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eSkin irritation\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e30.6%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e22.0%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e0.016\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eAcne\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e21.3%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e13.6%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e0.013\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e\u003cb\u003eMascara\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eClogged pores\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e22.0%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e11.1%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e0.001\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eSkin color darkening\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e13.9%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e7.7%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e0.029\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"3\" rowspan=\"4\"\u003e\u003cp\u003e\u003cb\u003ePowder\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eClogged pores\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e26.8%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e15.7%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eFine lines appearance\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e7.0%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e2.3%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e0.002\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eSkin color darkening\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e17.1%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e10.1%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e0.008\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003ePeeling/dryness\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e23.2%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e16.2%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e0.025\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"4\" rowspan=\"5\"\u003e\u003cp\u003e\u003cb\u003eConcealer\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eClogged pores\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e28.0%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e15.4%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eAcne\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e25.7%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e16.5%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e0.004\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003ePeeling/dryness\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e24.3%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e16.0%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e0.009\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eFine lines appearance\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e6.1%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e2.7%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e0.041\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eEye irritation\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e14.5%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e9.3%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e0.050\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e\u003cp\u003e\u003cb\u003eScrub\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eAcne\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e26.1%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e16.2%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e0.002\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eClogged pores\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e24.8%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e16.6%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e0.011\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003ePeeling/dryness\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e22.9%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e16.4%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e0.042\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e\u003cb\u003eTint\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eRash\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e11.7%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e4.9%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e0.011\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003ePeeling/dryness\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e26.2%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e17.0%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e0.033\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e\u003cb\u003eHighlighter\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eClogged pores\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e26.2%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e17.5%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e0.031\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003ePeeling/dryness\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e26.2%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e16.7%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e0.018\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e\u003cp\u003e\u003cb\u003eBlusher/Blush\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eChapped lips\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e11.1%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e5.9%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e0.014\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eSkin color darkening\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e16.4%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e9.8%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e0.008\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eIncreased skin luster\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e12.9%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e8.2%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e0.048\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eThe study of 803 participants provides valuable insights into cosmetic use behaviors and safety practices, revealing a complex picture of high awareness coupled with inconsistent safety implementation. A high proportion of participants selected products based on skin type (79.2%) and purchased from professional stores (70.61%), with relatively low brand loyalty (40.47%), reflecting practical consumer priorities similar to those observed in the US and EU (\u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e, \u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e) and contrasting with stronger brand attachment in markets like South Korea (\u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e). Usage patterns showed that cosmetics are deeply integrated into daily routines, 40.1% used them daily and 45.83% had used them for 1\u0026ndash;3 years, aligning with global increases in cosmetic use (\u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e). Encouragingly, hygiene practices were relatively strong: 86.05% cleaned tools and 77.21% removed makeup before sleep, surpassing rates reported in comparable studies (\u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e, \u003cspan citationid=\"CR31\" class=\"CitationRef\"\u003e31\u003c/span\u003e). However, significant safety gaps were identified: only 26.28% consulted specialists, 36.11% conducted allergy testing, and 45.58% read instructions, while 39.98% used expired products. These figures mirror concerning global patterns, patch testing remains underutilized (\u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e, \u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e32\u003c/span\u003e), professional consultation is rare (\u003cspan citationid=\"CR33\" class=\"CitationRef\"\u003e33\u003c/span\u003e), instruction reading is often neglected (\u003cspan citationid=\"CR34\" class=\"CitationRef\"\u003e34\u003c/span\u003e, \u003cspan citationid=\"CR35\" class=\"CitationRef\"\u003e35\u003c/span\u003e), and expired product use is common (\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e, \u003cspan citationid=\"CR36\" class=\"CitationRef\"\u003e36\u003c/span\u003e). A paradox emerged wherein 89.41% of participants were aware of cosmetic risks, yet neglected key safety practices\u0026mdash;a gap attributed to factors like perceived inconvenience or optimism bias, consistent with findings in health behavior literature (\u003cspan citationid=\"CR37\" class=\"CitationRef\"\u003e37\u003c/span\u003e, \u003cspan citationid=\"CR38\" class=\"CitationRef\"\u003e38\u003c/span\u003e). In synthesis, while the population demonstrated good foundational hygiene and informed purchasing behaviors, their failure to implement essential safety measures poses avoidable risks. These findings are consistent with international data and emphasize the universal challenge of bridging the awareness-practice gap (\u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e32\u003c/span\u003e, \u003cspan citationid=\"CR33\" class=\"CitationRef\"\u003e33\u003c/span\u003e), though stronger-than-average hygiene practices and notably low brand loyalty offer unique insights into regional consumer behavior.\u003c/p\u003e\u003cp\u003eBased on the findings of this study and comparison with existing literature, the results strongly align with established dermatological and cosmetic science knowledge, highlighting skin type misalignment and lack of professional consultation as critical risk factors for adverse reactions. Products not selected based on skin type were associated with significantly higher rates of skin irritation (34.1% vs. 25.7%, p\u0026thinsp;=\u0026thinsp;0.001), acne (26.1% vs. 16.4%, p\u0026thinsp;=\u0026thinsp;0.004), and clogged pores (21.8% vs. 17.7%, p\u0026thinsp;=\u0026thinsp;0.001), supporting Draelos (\u003cspan citationid=\"CR39\" class=\"CitationRef\"\u003e39\u003c/span\u003e), who identified mismatched products as the cause of cosmetic reactions, and Lugovic-Mihic et al. (\u003cspan citationid=\"CR40\" class=\"CitationRef\"\u003e40\u003c/span\u003e), who emphasized the importance of tailoring product use to individual skin characteristics. Similarly, participants who did not consult specialists experienced higher rates of irritation (29.0% vs. 22.2%, p\u0026thinsp;=\u0026thinsp;0.001) and acne (19.7% vs. 15.6%, p\u0026thinsp;=\u0026thinsp;0.003), underscoring the value of expert guidance. This aligns with Farage (\u003cspan citationid=\"CR41\" class=\"CitationRef\"\u003e41\u003c/span\u003e), who argued that dermatologists play a critical role in identifying skin sensitivities and guiding product choice, and with FDA reports linking lack of consultation to severe reactions (\u003cspan citationid=\"CR42\" class=\"CitationRef\"\u003e42\u003c/span\u003e). While purchasing from professional stores showed a protective effect for acne (21.2% vs. 13.6%, p\u0026thinsp;=\u0026thinsp;0.016), effects on other reactions were less consistent\u0026mdash;mirroring findings by Xu et al. (\u003cspan citationid=\"CR43\" class=\"CitationRef\"\u003e43\u003c/span\u003e), who noted that purchase location has greater impact for complex products, and consumer reports, which highlighted variable staff expertise (\u003cspan citationid=\"CR44\" class=\"CitationRef\"\u003e44\u003c/span\u003e). The study also confirmed that irritation, acne, and clogged pores were most strongly linked to poor selection practices, while less common reactions like rash, eye irritation, or pigmentation changes followed similar trends with varying statistical significance. These patterns are consistent with surveillance data from NACDG and ESSCA, which identify irritant contact dermatitis and acneiform eruptions as the most prevalent cosmetic adverse effects, typically triggered by unsuitable formulations and individual susceptibility factors (\u003cspan citationid=\"CR45\" class=\"CitationRef\"\u003e45\u003c/span\u003e). Together, the findings affirm two evidence-based principles: first, that personalized product selection based on skin type is essential to reduce adverse effects; second, that expert consultation plays a central role in mitigating risk, often more so than store type alone. While professional store purchases may offer some protective value, it is the expertise embedded in personalized consultation that offers the greatest benefit. These findings reinforce the broader scientific consensus and support targeted consumer education to minimize avoidable cosmetic-related skin issues (\u003cspan additionalcitationids=\"CR40\" citationid=\"CR39\" class=\"CitationRef\"\u003e39\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR41\" class=\"CitationRef\"\u003e41\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eThis analysis reveals that long-term cosmetic use (\u0026gt;\u0026thinsp;3 years) significantly increases the incidence of acne breakouts (27.0%, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.010) and clogged pores (27.0%, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.009), likely due to cumulative follicular occlusion, product residue accumulation, and microbial biofilm formation. Additionally, poor hygiene, particularly failure to clean application tools, is associated with a higher prevalence of peeling or dry skin (19.5%, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.019), consistent with evidence linking contaminated applicators to low-grade inflammation and skin barrier disruption (\u003cspan citationid=\"CR46\" class=\"CitationRef\"\u003e46\u003c/span\u003e). In contrast, widely recommended safety practices, including allergy testing, bedtime makeup removal, reading instructions, and using makeup removers, showed no statistically significant protective effects against any adverse reactions, such as skin irritation (31.4% in allergy-tested vs. untested, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.116; 28.5% in bedtime removers vs. non-removers, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.731). These findings challenge conventional skincare advice, aligning instead with research showing that most cosmetic-related reactions are irritant rather than allergic in nature and that modern formulations are increasingly designed to minimize occlusion and irritation (\u003cspan citationid=\"CR47\" class=\"CitationRef\"\u003e47\u003c/span\u003e). Notably, skin irritation remained the most reported adverse effect (31.6%), yet lacked significant associations with any specific behavior, suggesting a multifactorial or idiopathic origin. Together with previous findings on product selection, this synthesis suggests a clear risk hierarchy: skin-type-matched products and professional consultation are broad-spectrum protective strategies; cleaning tools specifically reduces dryness(\u003cspan citationid=\"CR48\" class=\"CitationRef\"\u003e48\u003c/span\u003e); prolonged cosmetic use worsens acne risk; and ritualized behaviors such as universal bedtime removal or allergy testing may offer limited protection (\u003cspan citationid=\"CR49\" class=\"CitationRef\"\u003e49\u003c/span\u003e). Accordingly, consumers should shift toward evidence-based prevention, prioritizing non-comedogenic, skin-appropriate product selection, professional guidance, restricted use of high-residue items, and strict hygiene of tools, while reconsidering less effective practices promoted by tradition rather than outcome data.\u003c/p\u003e\u003cp\u003eThis analysis highlights distinct product-specific adverse effect profiles, with face whitening products exhibiting the broadest toxicity spectrum\u0026mdash;significantly associated with skin irritation (48.3% vs. 25.4%, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.001), acne (33.3% vs. 17.2%), and eye irritation (18.4% vs. 9.8%)\u0026mdash;corroborating literature that implicates barrier-disrupting agents such as hydroquinone, corticosteroids, and mercury in these reactions (\u003cspan citationid=\"CR50\" class=\"CitationRef\"\u003e50\u003c/span\u003e, \u003cspan citationid=\"CR51\" class=\"CitationRef\"\u003e51\u003c/span\u003e). Primers and contours were linked to high rates of acne and clogged pores (30\u0026ndash;34.6%), consistent with comedogenic occlusion attributed to silicones and film-forming agents (\u003cspan citationid=\"CR52\" class=\"CitationRef\"\u003e52\u003c/span\u003e). Interestingly, moisturizers increased both peeling (21.9% vs. 11.3%) and acne (22.6% vs. 12.1%), likely due to comedogenic emulsifiers or irritant preservatives present in certain formulations. Lipsticks were associated with chapping and pigmentation changes (e.g., darkening in 14.2% of users), echoing known sensitivities to eosin, phenol, and other colorants (\u003cspan citationid=\"CR53\" class=\"CitationRef\"\u003e53\u003c/span\u003e). Powders and concealers showed a higher prevalence of facial fine lines (7.0% vs. 2.3%), likely due to repetitive mechanical friction and product settling in skin creases (\u003cspan citationid=\"CR54\" class=\"CitationRef\"\u003e54\u003c/span\u003e). Notably, this study found mascara significantly associated with clogged pores on the face (22.0% vs. 11.1%, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.001)\u0026mdash;a novel observation, as prior reports have focused almost exclusively on ocular effects (\u003cspan citationid=\"CR55\" class=\"CitationRef\"\u003e55\u003c/span\u003e). Similarly, blusher use was unexpectedly linked to chapped lips (11.1% vs. 5.9%, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.014), possibly through inadvertent transfer of powders to the perioral region. Foundations were linked to significantly higher rates of skin darkening (18.2% vs. 8.3%, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.001), exceeding previously reported levels (\u0026le;\u0026thinsp;12%) and suggesting formulation-dependent oxidation or melanin-stimulating effects (\u003cspan citationid=\"CR56\" class=\"CitationRef\"\u003e56\u003c/span\u003e). Collectively, these findings reinforce those adverse cosmetic effects are closely tied to the unique chemical composition and application patterns of each product type, underscoring the need for targeted, product-specific safety recommendations rather than solely relying on generalized hygiene or use practices.\u003c/p\u003e"},{"header":"Conclusion and limitations","content":"\u003cp\u003eThis study highlights a clear disconnect between users\u0026rsquo; awareness of cosmetic risks and their actual safety practices. While most participants acknowledged potential harms, key behaviors such as consulting specialists, performing allergy tests, and avoiding expired products were often overlooked. Adverse effects were more likely when products were mismatched to skin type or used over extended periods, especially with items known to cause occlusion or irritation. Specific product categories\u0026mdash;such as face whiteners, primers, and moisturizers\u0026mdash;were associated with a distinct pattern of side effects, underscoring the importance of formulation and application methods. Interestingly, widely promoted routines like bedtime makeup removal and allergy testing did not consistently reduce adverse outcomes, supporting emerging evidence that many reactions stem from irritation rather than allergy. Despite generally good hygiene practices, the persistence of preventable side effects suggests a need for targeted education, clearer labeling, safer formulations, and more proactive clinical inquiry into cosmetic use. Bridging the gap between knowledge and behavior requires a coordinated effort from consumers, health professionals, and the cosmetic industry.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eEthics and Guidelines:\u003c/strong\u003e The ethical approval was obtained from the Institutional Review Board (IRB) at An-Najah National University, and the study was conducted in accordance with the ethical principles outlined in the Declaration of Helsinki.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent to Participate:\u003c/strong\u003e A written consent was signed by all participants.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for publication:\u0026nbsp;\u003c/strong\u003eThe approved consent to publication was obtained from all participants.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAvailability of data and materials:\u003c/strong\u003e The authors declare that the data underpinning the findings of this study are included within the article. For further details or inquiries, please contact the corresponding author.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting interests:\u0026nbsp;\u003c/strong\u003eThe authors have no conflicts of interest to declare.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding:\u003c/strong\u003e This project was funded by An-Najah National University, Nablus, Palestine.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthors' contributions:\u003c/strong\u003e All authors contributed to the conceptualization, methodology, data collection, formal analysis, writing of the original draft, and review and editing of the manuscript. All authors were involved in visualization and project administration. Supervision was provided by IA. All authors have read and approved the final version of the manuscript.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAcknowledgment:\u003c/strong\u003e The authors extend their sincere gratitude to all participants who participated in this study.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eButler H. Cosmetics through the ages. Poucher\u0026rsquo;s perfumes, cosmetics and soaps: Springer; 2000. p. 13-63.\u003c/li\u003e\n\u003cli\u003eBaki G. Introduction to cosmetic formulation and technology: John Wiley \u0026amp; Sons; 2022.\u003c/li\u003e\n\u003cli\u003eNohynek GJ, Antignac E, Re T, Toutain HJT, pharmacology a. Safety assessment of personal care products/cosmetics and their ingredients. 2010;243(2):239-59.\u003c/li\u003e\n\u003cli\u003eHalla N, Fernandes IP, Heleno SA, Costa P, Boucherit-Otmani Z, Boucherit K, et al. 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Atlas of vulvovaginal disease in darker skin types: CRC Press; 2023.\u003c/li\u003e\n\u003cli\u003eMatsunaga K, Aiba S, Goossens AE. Contact dermatitis: Principles, mechanisms, and allergies related to cosmetics. Handbook of Cosmetic Science and Technology: CRC Press; 2022. p. 75-86.\u003c/li\u003e\n\u003cli\u003eNaylor M, Robinson JKJAod. Sunscreen, sun protection, and our many failures. 2005;141(8):1025-7.\u003c/li\u003e\n\u003cli\u003eMohiuddin AJDCR. Acne protection: measures and miseries. 2019;5(1):272-311.\u003c/li\u003e\n\u003cli\u003eCouteau C, Coiffard LJC. Overview of skin whitening agents: Drugs and cosmetic products. 2016;3(3):27.\u003c/li\u003e\n\u003cli\u003eFriedmann PS, Pickard CJCD. Quantifying human susceptibility to contact sensitization; risk assessments now and in the future. 2010;63(5):237-47.\u003c/li\u003e\n\u003cli\u003eBont\u0026eacute; F, Girard D, Archambault J-C, Desmouli\u0026egrave;re AJB, science cboaPIc. Skin changes during ageing. 2019:249-80.\u003c/li\u003e\n\u003cli\u003eWestfall A. Evaluation of the efficacy of anthocyanins as biologically active ingredients in lipstick formulations: The Ohio State University; 2015.\u003c/li\u003e\n\u003cli\u003eAkhtar A, Kazi TG, Afridi HI, Khan MJRt, pharmacology. Human exposure to toxic elements through facial cosmetic products: Dermal risk assessment. 2022;131:105145.\u003c/li\u003e\n\u003cli\u003eBarar J, Javadzadeh AR, Omidi YJEoodd. Ocular novel drug delivery: impacts of membranes and barriers. 2008;5(5):567-81.\u003c/li\u003e\n\u003cli\u003eSolano FJNJoS. Melanins: skin pigments and much more\u0026mdash;types, structural models, biological functions, and formation routes. 2014;2014(1):498276.\u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":true,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"archives-of-dermatological-research","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"","sideBox":"Learn more about [Archives of Dermatological Research](https://www.springer.com/journal/403)","snPcode":"403","submissionUrl":"https://submission.nature.com/new-submission/403/3","title":"Archives of Dermatological Research","twitterHandle":"","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"stoa","reportingPortfolio":"Springer Hybrid","inReviewEnabled":true,"inReviewRevisionsEnabled":false},"keywords":"","lastPublishedDoi":"10.21203/rs.3.rs-6997761/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-6997761/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eBackground:\u003c/h2\u003e\u003cp\u003eCosmetics, defined by the FDA as products intended to cleanse, enhance beauty, or alter appearance, serve various roles from hygiene to improving quality of life. While users are often aware of potential risks, their actual safety behaviors remain inconsistent.\u003c/p\u003e\u003ch2\u003eMethods:\u003c/h2\u003e\u003cp\u003eThis cross-sectional study surveyed 803 female students at An-Najah National University, Palestine, using a self-administered questionnaire with voluntary participation. The survey covered demographic details, types of facial cosmetics used, usage patterns, safety behaviors (such as consulting healthcare professionals, allergy testing, hygiene practices, reading product instructions, and discarding expired products), reported side effects, and how these were managed. Ethical clearance was secured, confidentiality upheld, and data analyzed with SPSS using descriptive statistics and Chi-squared tests (\u003cem\u003ep\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.05 considered significant).\u003c/p\u003e\u003ch2\u003eResults:\u003c/h2\u003e\u003cp\u003eAlthough most participants selected products according to skin type and preferred professional retail sources, many failed to consult specialists or conduct allergy tests. Hygiene behaviors like cleaning application tools and removing makeup before sleep were widely practiced, yet reading product instructions and discarding expired items were often overlooked, even though nearly 90% acknowledged potential harm from cosmetics. Adverse reactions such as skin irritation and acne were significantly more common in those who ignored skin-type compatibility or specialist consultation. Extended cosmetic use (\u0026gt;\u0026thinsp;3 years) was associated with increased acne and clogged pores. Certain products\u0026mdash;especially face whiteners, primers, moisturizers, and foundation\u0026mdash;were strongly linked to specific side effects. Notably, routine actions like allergy testing or bedtime removal did not significantly reduce adverse outcomes.\u003c/p\u003e\u003ch2\u003eConclusion:\u003c/h2\u003e\u003cp\u003eDespite high awareness of cosmetic risks, many users fail to adopt appropriate safety measures. Improved education, product reformulation, clearer labeling, and healthcare engagement are essential to reduce harm.\u003c/p\u003e","manuscriptTitle":"Cosmetic Safety Practices and Adverse Effects Among Female Students: A Cross-Sectional Study","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-09-22 18:48:57","doi":"10.21203/rs.3.rs-6997761/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"decision","content":"Revision requested","date":"2025-10-02T13:54:33+00:00","index":"","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-09-27T13:53:43+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"174250730310923525018413157202076450298","date":"2025-09-21T05:14:18+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-09-18T19:51:41+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"1835524989308295522033196409524739152","date":"2025-09-17T19:19:33+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-09-17T10:02:38+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"140827854338550797358301244650322721379","date":"2025-09-17T06:05:51+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"249829988977312772708039908495883331235","date":"2025-09-17T04:37:26+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"139413321063254148438771409194586865612","date":"2025-09-15T20:48:48+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-09-15T11:07:28+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"112541422241279620690885414354340598037","date":"2025-09-15T09:28:10+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"313029773293522598032352226041957056142","date":"2025-09-15T09:06:04+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2025-09-15T04:18:34+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2025-06-28T14:15:55+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2025-06-28T14:15:04+00:00","index":"","fulltext":""},{"type":"submitted","content":"Archives of Dermatological Research","date":"2025-06-28T12:18:38+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"archives-of-dermatological-research","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"","sideBox":"Learn more about [Archives of Dermatological Research](https://www.springer.com/journal/403)","snPcode":"403","submissionUrl":"https://submission.nature.com/new-submission/403/3","title":"Archives of Dermatological Research","twitterHandle":"","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"stoa","reportingPortfolio":"Springer Hybrid","inReviewEnabled":true,"inReviewRevisionsEnabled":false}}],"origin":"","ownerIdentity":"988a5fa9-7e93-40c1-9e78-4e86fa10cb39","owner":[],"postedDate":"September 22nd, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"under-review","subjectAreas":[],"tags":[],"updatedAt":"2026-05-06T22:09:17+00:00","versionOfRecord":[],"versionCreatedAt":"2025-09-22 18:48:57","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-6997761","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-6997761","identity":"rs-6997761","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}