Studies that examine the effects of perfumes and cosmetics on human health.

Non-peer-reviewed articles.

Endocrine-disrupting chemicals (EDCs) such as parabens, phthalates, bisphenols, and other synthetic compounds frequently found in cosmetics pose significant threats to human health (Thompson, 2018). These compounds, prevalent in personal care products including perfumes, lotions, nail polishes, and hair sprays, have been shown to interfere with the endocrine system, thereby disrupting hormonal homeostasis (Anderson et al., 2022). A biomonitoring study involving 144 Norwegian adults found widespread urinary detection of parabens, bisphenols, phthalates, and UV filters, with exposure levels linked to hormone-related toxicity and metabolic disruption (Husøy et al., 2019). These substances can mimic, inhibit, or interfere with endogenous hormone signaling, thereby disrupting critical regulatory pathways associated with reproduction, metabolism, and thyroid function. EDCs can interfere with hormones such as estrogen, testosterone, thyroid hormones, and insulin, provoking physiological disturbances across multiple systems. See Table 1 for health risks associated with common cosmetic ingredients and contaminants across multiple bodily systems and functions.

Additionally, a substantial body of research has correlated EDC exposure with conditions such as obesity, diabetes, polycystic ovarian syndrome (PCOS), and infertility. Phthalates and bisphenols are particularly implicated in obesity through their impact on adipocyte differentiation, metabolic rate, and appetite regulation (Hauser and Calafat, 2005). These chemicals contribute to increased lipid accumulation and impaired appetite signaling, facilitating excessive weight gain. Phthalates have also been shown to impair insulin sensitivity and alter glucose metabolism, contributing to the pathogenesis of type 2 diabetes. Critically, the timing of exposure plays a pivotal role in determining health outcomes. Prenatal and early childhood periods represent windows of heightened vulnerability, during which EDCs can induce lasting developmental and physiological alterations. For example, bisphenol A (BPA), found in plastic packaging and some cosmetic containers, can cross the placental barrier and disrupt fetal endocrine function (Limiting lead in lipstick and other cosmetics FDA, 2024). Emerging evidence indicates that the effects of EDCs may extend across generations through epigenetic mechanisms. Maternal exposure to EDCs can induce modifications in gene expression that are heritable, even in the absence of continued exposure. These transgenerational effects may increase the risk of metabolic dysfunction, endocrine disorders, and reproductive abnormalities in descendants (Nnorom et al., 2005).

Given their widespread presence in personal care products, urgent regulatory action is warranted. While some jurisdictions have initiated restrictions on EDCs in cosmetics, enforcement remains fragmented, and many formulations still contain potentially hazardous chemicals (Allmyr et al., 2006). Regulatory frameworks must prioritize the establishment of concentration limits, pre-market safety assessments, and transparent labeling. Policies encouraging safer, non-toxic alternatives can help protect public health and reduce long-term exposure risks. Consumer engagement is also essential in mitigating EDC exposure. By selecting products free of parabens, phthalates, and bisphenols, individuals can reduce personal risk. Supporting brands that prioritize safety, and transparency encourages broader industry reform. The rising demand for clean, non-toxic cosmetics is already catalyzing a shift toward safer formulations and more sustainable manufacturing practices (Rees Clayton et al., 2010; Janjua et al., 2007). In summary, the endocrine-disrupting potential of numerous cosmetic ingredients necessitates comprehensive action from regulatory bodies, industry stakeholders, and consumers. A coordinated approach involving regulatory reform, scientific innovation, and public awareness is essential to reduce exposure and safeguard hormonal health across the lifespan.

As discussed in Section 3.1, endocrine-disrupting chemicals such as phthalates and parabens impair hormonal regulation, leading to fertility issues. In females, these compounds can compromise ovarian function, oocyte quality, and hormonal signaling pathways necessary for conception and gestation. In males, EDCs can impair spermatogenesis, reduce sperm motility, and lower sperm counts, collectively undermining fertility. Additionally, exposure to these chemicals has been associated with early-onset puberty in both sexes, which may disrupt growth trajectories, sexual maturation, and long-term reproductive outcomes (De Groot and Flyvholm, 2020).

Mechanistically, phthalates disrupt the hypothalamic-pituitary-gonadal (HPG) axis by acting as exogenous ligands that can mimic, antagonize, or modulate the activity of endogenous hormones (Di Cicco et al., 2021). Disruption of the HPG axis alters the synthesis and secretion of key reproductive hormones, leading to documented fertility impairments (Gould et al., 2024). Epidemiological studies have linked phthalate exposure to reduced semen quality in men and menstrual disturbances in women (Elsaid and Ahmed, 2021). Importantly, their reproductive toxicity extends to developmental windows of heightened vulnerability, particularly during gestation. Prenatal exposure has been linked to adverse birth outcomes, such as cryptorchidism in male infants, suggesting interference with utero-androgen signaling pathways (Khalid and Abdollahi, 2021). Similarly, Octyl Methoxycinnamate (OMC), a UV filter commonly used in sunscreens and cosmetics, has been shown to affect fetal development. In an in vivo animal study, pregnant Wistar rats exposed to OMC had significantly reduced maternal thyroxine (T4) levels, and their male offspring displayed decreased testosterone levels, lower sperm counts, and reduced weights of reproductive organs such as the prostate and testes (Axelstad et al., 2011). These effects persisted into adulthood, though the study’s applicability is limited by the lack of human data. Furthermore, disruptions in the timing of pubertal onset, either precocious or delayed puberty, have been documented in populations with elevated early-life phthalate exposure, indicating that these chemicals may perturb developmental endocrine pathways with long-term consequences for reproductive health (Lazou, 2024).

Parabens, another class of EDCs, exert estrogenic effects by binding to estrogen receptors and mimicking the activity of endogenous estrogens (Akano et al., 2024). By exhibiting estrogenic activity, they can overstimulate estrogen receptors and disrupt endocrine homeostasis (Darbre and Harvey, 2014). This interaction has raised concerns about their potential role in impairing female fertility. In vitro studies show that butylparaben and propylparaben strongly mimicked estrogen, activating both ERα and ERβ, while ethylparaben had weaker effects, and methylparaben was inactive (Gomez et al., 2005). UV filters such as OMC, 4-Methylbenzylidene camphor (4-MBC), Octyl-Dimethyl PABA (OD-PABA), and Homosalate (HMS) selectively activated ERα, indicating a risk of tissue-specific endocrine disruption. Musk ketone and galaxolide weakly activated ERα; however, they raise concern as they persist in the environment and bioaccumulate. The study used a validated receptor-specific assay and benchmarking against 17β-estradiol, the primary endogenous estrogen. While this approach characterizes receptor binding and activation potential, it does not account for the metabolic transformation of these compounds within the human body, limiting its applicability to real-world exposure scenarios.

Addressing this gap, a single-blinded human exposure study involving thirty-two healthy adults (15 young men and 17 postmenopausal women) exposed participants to sunscreen formulations containing benzophenone-3 (BP-3), OMC, and 4-MBC (Janjua et al., 2004). Despite systemic absorption confirmed by detectable levels of these UV filters in both blood and urine samples, the study found no biologically significant alterations in reproductive hormones, including FSH, LH, estradiol, testosterone, and inhibin B. The study was limited in its short exposure period, relatively small sample size, and lack of long-term follow-up. It also did not evaluate cumulative exposure effects or possible delayed endocrine outcomes. Nonetheless, the detection of UV-filters in the blood raises concern, and safety thresholds should account for systemic bioavailability of these ingredients during repeated daily use.

Inverse associations have been observed between urinary paraben concentrations and ovarian reserve markers, including antral follicle count and anti-Müllerian hormone levels (Alnuqaydan, 2024). These suggest that parabens may impair reproductive potential by compromising oocyte quality, with implications for fertility and assisted reproductive outcomes. Genetic susceptibility may also mediate individual responses to EDCs. A biomonitoring study that looked at 195 healthy young men in Denmark, with and without filaggrin (FLG) gene mutations (a gene that affects the skin’s natural barrier function) found that in men with FLG mutations, higher urinary concentrations of bisphenol A (BPA) and UV filters such as BP-1, BP-3, and 4-HBP were associated with increased serum testosterone and estradiol levels, decreased follicle-stimulating hormone (FSH), and reduced sperm motility (Joensen et al., 2018). These effects were not observed in non-carriers, showing that endocrine response could be subject to the role of genetic predisposition. No significant associations were found between urinary paraben levels and hormone levels or semen health in either group. These findings underscore the importance of personalized risk assessment based on genetic susceptibility.

The reproductive risks associated with cosmetic EDCs are compounded by widespread and repeated exposure. Daily application of multiple personal care products results in cumulative exposure, contributing to systemic bioaccumulation over time (Marusic Kristina, 2023). This risk is especially concerning for susceptible subgroups, such as pregnant individuals, adolescents undergoing pubertal development, and those with pre-existing endocrine disorders, who may exhibit heightened biological sensitivity to these compounds. Given the persistence and biological activity of EDCs in cosmetics, a precautionary approach is warranted. Regulatory frameworks should enforce rigorous safety assessments of cosmetic ingredients, mandate clear labeling of EDC content, and incentivize the development of non-disruptive alternatives. Public health campaigns must also play a role in disseminating evidence-based guidance to help consumers make informed choices about personal care product use (Mukherjee Das et al., 2022). In summary, converging evidence from mechanistic, epidemiological, and developmental studies supports a causal link between chronic exposure to phthalates, parabens, and other EDCs in cosmetics and adverse reproductive health outcomes (Hager et al., 2022). These findings underscore the need for proactive policy interventions and consumer education to mitigate risks and safeguard reproductive potential across the lifespan and for future generations (Beyuo et al., 2024).

The respiratory consequences of cosmetic product use, particularly those containing synthetic fragrances and aerosolized components, have emerged as a critical area of public health concern. Numerous products, such as perfumes, deodorants, hair sprays, and air fresheners, emit Volatile Organic Compounds (VOCs), which are recognized contributors to both indoor and outdoor air pollution (Srinivasulu et al., 2022). These VOCs not only act as primary airborne irritants but also undergo chemical reactions with other indoor pollutants, especially nitrogen oxides, to form secondary toxicants, including ozone and ultrafine particulate matter. This dynamic significantly elevates respiratory health risks, particularly in enclosed or poorly ventilated environments where pollutant concentrations can accumulate rapidly (Srinivasulu et al., 2022).

VOCs are a chemically diverse group of compounds frequently present in scented cosmetic products. They include terpenes (e.g., limonene), alcohols, aldehydes, and esters, many of which have known irritant or sensitizing properties (Dhiman et al., 2024). Inhalation of these compounds can provoke acute respiratory symptoms such as coughing, wheezing, and dyspnea by irritating the mucosal linings of the upper and lower respiratory tract (Singh et al., 2023). Of particular concern is their role in generating ground-level ozone when they interact with other ambient pollutants. Ozone is a well-established pulmonary irritant associated with airway inflammation, reduced lung function, and increased hospital admissions for respiratory conditions (Bird et al., 2021). Chronic exposure to elevated VOC and ozone levels has been implicated in the development and exacerbation of asthma, particularly among sensitive subpopulations.

Persistent exposure to aerosolized cosmetics, including spray deodorants, dry shampoos, and setting sprays is associated with structural changes in lung tissue, impaired gas exchange, and a heightened risk of respiratory infections. Vulnerable groups such as children whose lungs are still maturing and elderly individuals with pre-existing conditions like asthma or COPD are especially susceptible to these effects, with exposure linked to increased frequency and severity of exacerbations, hospital visits, and longterm morbidity (Attard et al., 2022; Ullah et al., 2023).

The implications of cosmetic-related respiratory distress extend beyond personal health, impacting healthcare systems and occupational environments. Increased incidence of asthma and other chronic respiratory diseases due to VOC and particulate exposure translates into greater demand for medical care, productivity losses, and elevated healthcare expenditures (Raza-Naqvi et al., 2022). Occupational exposure in high-risk settings, such as beauty salons, spas, and cosmetic manufacturing facilities, is particularly concerning due to the intensity and duration of exposure. Workers in these environments often experience prolonged inhalation of concentrated chemical mixtures, frequently without adequate personal protective equipment or ventilation systems, placing them at risk for chronic respiratory conditions and occupational asthma (Manful et al., 2024).

Cosmetic products, while widely used for enhancing appearance and hygiene, can also expose users to harmful substances linked to carcinogenesis (Scopelliti et al., 2021). Mounting scientific evidence implicates several common cosmetic ingredients in cancer development, underscoring the need for stricter regulation, safer formulations, and informed consumer choices. Understanding these associations is crucial to public health protection (Lohmann, 2024).

Allergic reactions to cosmetics, particularly allergic contact dermatitis (ACD), represent a significant proportion of adverse events associated with personal care products (Lin et al., 2024). These hypersensitivity reactions are typically triggered by specific chemical constituents such as fragrances, formaldehyde-releasing preservatives, and synthetic dyes. These allergens can provoke a range of responses from localized inflammation to, in rare cases, systemic effects like urticaria and anaphylaxis (Novak-Bilić et al., 2018).

Cosmetic-induced skin disorders are widespread, particularly among individuals with sensitive skin or pre-existing conditions such as eczema, rosacea, and psoriasis. These individuals often have compromised skin barriers, making them more susceptible to irritation and allergic reactions from various cosmetic ingredients. Contact dermatitis, one of the most frequent adverse reactions, results from direct exposure to irritants or allergens (Clouston et al., 2022). It can be categorized into irritant contact dermatitis (ICD) and allergic contact dermatitis (ACD), both of which cause redness, swelling, and discomfort. People with compromised immune systems or a history of eczema are particularly vulnerable to these reactions.

Recent research suggests that certain endocrine-disrupting chemicals (EDCs) found in personal care products may also contribute to inflammatory skin conditions. A longitudinal panel study that involved 18 boys aged 3–7 with diagnosed atopic dermatitis found that elevated urinary levels of mono-n-butyl phthalate (MnBP) and bisphenol A glucuronide (BPAG) were significantly associated with worsened atopic dermatitis (AD) on both the same day and the following day (Kim et al., 2017). Although the study was limited in its small sample size and its inclusion of only boys, it employed a robust time series design using 460 pooled urine samples and daily symptom diaries, while controlling for temperature and humidity. These findings reinforce that phthalates and BPA have inflammatory effects; hence, young children’s exposure through personal care products and packaging should be limited.

Another prospective birth cohort study involving 413 Korean mother-infant pairs found that higher maternal urinary concentrations Di(2-ethylhexyl) phthalate (DEHP) metabolites were associated with significantly increased risk of AD in infants at 6 months of age, especially among girls (Lee et al., 2021). BPA did not show a strong independent association in single-pollutant models, but it contributed to increased AD risk when considered as part of a chemical mixture. The study’s use of repeated urine sampling and Bayesian Kernel Machine Regression (BKMR) strengthened its ability to evaluate interactions between exposures. These results suggest that pregnant women should limit their exposure to products that contain phthalates and BPA to reduce the risk of AD in their babies.

Long-term exposure to certain cosmetic ingredients has been linked to more persistent skin issues, such as perioral dermatitis (a facial rash around the mouth and nose) and acneiform eruptions, which resemble acne but are often triggered by specific cosmetic products like heavy moisturizers or topical steroids (Goel et al., 2024). A case-control study found that urinary BPA concentrations were significantly higher in adults with acne (mean: 7.94 μg/g creatinine) compared to healthy controls (mean: 5.62 μg/g) (Kaya Ozden and Karadag, 2021). Higher BPA levels were also correlated with increased acne severity and earlier onset. Frequent use of products with high alcohol content or astringents can exacerbate dry skin, leading to further complications like irritation and peeling (Preller et al., 2024). The use of heavy or occlusive ingredients in skincare can also block pores and contribute to the development of cystic acne, especially in those predisposed to the condition. Over time, the cumulative effect of exposure to harsh ingredients can worsen the skin’s condition, leading to chronic inflammatory disorders that may require medical intervention. Furthermore, in one analysis, 44% of creams exhibited microbial contamination, surpassing EU safety thresholds 1 month after opening, suggesting poor preservative control and a heightened risk of skin infections (Irfan et al., 2022).

Given these risks, it is increasingly important to prioritize dermatologically tested formulations, especially for those with sensitive or reactive skin. Transparent ingredient lists are crucial in helping consumers identify known irritants or allergens. Dermatologists often recommend patch testing new products to minimize the risk of adverse reactions. Formulations free of parabens, artificial fragrances, sulfates, and other common irritants are essential for maintaining skin health and avoiding unnecessary flare-ups of existing conditions. Furthermore, consumers should be aware that even seemingly “gentle” products can trigger irritation if used inappropriately or in combination with other potent ingredients. Therefore, mindful product selection and a more cautious approach to skincare can significantly reduce the likelihood of cosmetic-induced skin disorders (CDC et al., 2019).

Cosmetic products containing synthetic fragrances and volatile organic compounds (VOCs) have increasingly come under scrutiny for their potential neurotoxic effects. Neurological outcomes associated with such exposure span a continuum from acute symptoms such as headaches, migraines, and mood fluctuation to longer-term impacts involving cognitive dysfunction and emotional dysregulation. Although the exact molecular mechanisms remain incompletely understood, growing evidence suggests that certain VOCs can traverse the blood-brain barrier (BBB), a selective membrane that protects the central nervous system from harmful exogenous substances. Once within the brain, these compounds may disrupt neuronal communication, alter neurotransmitter dynamics, and induce oxidative stress, ultimately contributing to neuroinflammation and cellular injury (Mukherjee Das et al., 2022).

Acute exposure to elevated concentrations of synthetic fragrances or VOCs, particularly in confined or inadequately ventilated environments, has been correlated with immediate symptoms including vertigo, nausea, and sensory hypersensitivity. These effects are thought to arise from the stimulation of the olfactory and trigeminal nerve pathways, which are intricately connected to brain regions regulating emotion, pain, and autonomic function. In individuals with underlying vulnerabilities such as multiple chemical sensitivity (MCS) or chronic migraine syndromes, such exposures may precipitate severe exacerbations, often necessitating medical intervention and long-term symptom management (Attard et al., 2022).

Prolonged or chronic exposure to neuroactive VOCs presents a more covert threat, with potential implications for mood disorders, cognitive impairment, and even neurodegenerative conditions. Research has implicated VOCs in the dysregulation of key processes such as synaptic plasticity and neurogenesis, both of which are essential for learning, memory, and adaptive behavior. Persistent oxidative stress and inflammation triggered by VOC exposure may undermine neural integrity, resulting in behavioral disturbances, anxiety, and depressive symptoms (Vale et al., 2022). Moreover, chronic inhalation of these compounds has been shown to elevate cortisol levels and disrupt the hypothalamic-pituitary-adrenal (HPA) axis, further compromising emotional regulation and increasing the risk for affective disorders (Mukherjee Das et al., 2022). Prenatal exposure to BPA has been associated with neurodevelopmental disorders such as autism, ADHD, and learning deficits, likely due to its interference with brain and endocrine development (Chen et al., 2022). These early exposures may also impair organogenesis in systems such as the immune, reproductive, and nervous systems, with consequences that persist into adulthood.

The neurobehavioral risks associated with cosmetic VOC exposure necessitate a multidisciplinary investigative approach. Current evidence remains fragmented, and a comprehensive understanding of the dose-response relationship, susceptibility thresholds, and critical periods of exposure is lacking. Individual factors such as genetic polymorphisms in detoxification enzymes, pre-existing neurological or psychiatric conditions, and cumulative chemical exposures may significantly modulate vulnerability. Advances in neuroimaging techniques (e.g., functional MRI, PET scans) and the identification of neurotoxic biomarkers hold promise in elucidating the structural and functional brain changes attributable to cosmetic-related VOC exposure (Smith and Hotchkiss, 2023).

In conclusion, while the neurological effects of synthetic fragrances and VOCs in cosmetics are still being delineated, available evidence points to their potential role in both acute neurophysiological responses and long-term neurobehavioral dysfunction. The convergence of toxicological, neurological, and environmental research is essential to delineate causal pathways and to inform safer cosmetic formulation standards, especially for individuals with heightened neurological sensitivity.

Table 1 offers a detailed synthesis of prevalent chemical contaminants found in a wide range of cosmetic products, summarizing their common uses, typical exposure levels, associated health effects, existing regulatory limits, and the most vulnerable population groups. Substances such as parabens, phthalates, formaldehyde and its releasers, heavy metals (including lead and cadmium), triclosan, volatile organic compounds (VOCs), and UV filters like oxybenzone are frequently detected in everyday cosmetic items such as lotions, shampoos, sunscreens, deodorants, nail products, and makeup. These compounds are often added intentionally for functions like preservation, fragrance stabilization, or UV protection, while others, such as heavy metals, appear as unintentional contaminants due to raw material impurities or manufacturing processes.

Despite the often-low concentrations at which these chemicals are present, ranging from parts per million to percentages, their health implications can be significant, especially with chronic use and simultaneous exposure to multiple products. For instance, parabens and phthalates are recognized endocrine disruptors with links to reproductive toxicity and developmental issues. Formaldehyde, classified as a Group 1 carcinogen by the International Agency for Research on Cancer (IARC), is known to cause respiratory irritation and skin sensitization. Heavy metals like lead have no known safe exposure level, particularly for children, and have been associated with neurodevelopmental delays and carcinogenicity. Triclosan has been linked to antimicrobial resistance and hormonal disruption, while certain UV filters such as oxybenzone have shown estrogenic activity and potential environmental toxicity.

The table also highlights notable disparities in regulatory frameworks. While the European Union has established strict bans or concentration limits for many of these substances, the United States often permits their use with minimal restrictions, relying instead on industry self-regulation. This variation underscores a regulatory gap that may lead to increased consumer exposure in less strictly regulated markets. Vulnerable populations such as pregnant women, children, individuals with pre-existing hormonal conditions, and occupationally exposed groups like hairdressers are particularly susceptible to the harmful effects of these chemicals. Overall, the information presented in the table calls attention to the pressing need for comprehensive toxicological assessments, harmonized international regulations, and increased transparency in cosmetic product labeling. It also highlights the importance of raising public awareness about the potential health risks associated with long-term and cumulative exposure to chemical contaminants in personal care products.

Regulatory frameworks for cosmetics may vary across regions, affecting how products are evaluated, labeled, and monitored. Table 2 compares key regulatory components across the United States, European Union, Canada, and ASEAN, highlighting differences in premarket requirements, safety assessments, ingredient restrictions, labeling, and enforcement mechanisms.