Hello!! Just wanted to say your blog is very very informative and I've made several purchases following the information on your reviews. Since you're so into looking at ingredients of cosmetics too I was wondering what your thoughts are regarding talc-based products, especially bronzers and loose face powders. With the recent news about Johnson and Johnson's baby powder case it's sort of alerted me a little to think about this. I know that we don't use make up in the genital area hence ovarian cancer risks are unlikely but there's also mixed evidence about chronic inhalation of talc maybe causing lung cancer. What are your views in this area? It has raised my concern as I believe effects are cumulative but I've also realised a lot of big brands such as Bobbi Brown, Benefit and 3CE all have talc based powders and bronzers. Please share your opinion :)
From her question, it's clear that there is concern about talc on multiple fronts - applied on skin, inhalation, and also perineal use (aka, using talc down there in the genital area). Although Joanna was specifically asking about talc with respect to inhalation, I thought, in view of current events, as well as other questions I've been getting, I'll just look at all 3 concern areas of skin, inhalation, and perineal use - that way, I have a neat, more complete summary of what the science says on talc in general that will hopefully be more helpful!
Talc has been in the news lately due to J&J's lawsuits, prompting questions as to talc's safety (Image source)
First though, before I start, I would like to say that this is not in any way meant to detract from the suffering of women who do have ovarian cancer. It is a serious disease with far-reaching effects, and my sympathy goes out to all ovarian cancer sufferers and their families, and they deserve our support. But for the purpose of this blogpost, I am most interested in responding to Joanna’s question, which is specifically about talc in cosmetics. So although this question certainly is prompted by current events, the scope of this blogpost is not to talk about the J&J lawsuit, but just to look at what the science says about the safety of talc in cosmetics. So, I hope that noone takes offense the narrow scope of this blogpost. Trust me, this pretty narrow scope is already quite a lengthy blogpost!
The molecular structure of talc, showing its "sandwich"-like platelet structure (Image source)
What is Talc?
First off, what is talc, anyway? Talc is a type of mineral, a hydrous magnesium silicate, with the chemical formula H2Mg3(SiO3)4 or Mg3Si4O10(OH)2. As far as origin, talc is pretty natural – it occurs naturally in the ground, and along with other silicate minerals, "occur abundantly in the earth's crust, are present in practically all natural waters,animals, and plants, and are part of the normal human diet". We often hear about talc and cosmetics, but talc is used for a whole range of activities and purposes – it’s use in the manufacture of plastics, ceramics, paints, paper, roofing, and rubber, just to name a few. A form of talc, known as soapstone, is also often carved into ornaments and the like. It is also actually approved for use as a food additive in both the USA, Europe and Japan, where it is present in rice, chewing gum, and other products as an anticaking agent, preventing food from sticking together, or as a glazing agent, to give food a shiny appearance. So although we hear about talc and cosmetics a lot, the truth is that we do come into contact with talc not just through cosmetics - in fact, in the USA, cosmetics account for only 7% of talc use, with the bulk of it going to the manufacture of plastics, ceramics and paint.
Why is talc so commonly used, and why is it used in cosmetics?
Talc happens to have a number of very useful physical and chemical properties which make it useful for multiple applications, of which cosmetics is one. It is chemically inert (meaning that it won’t react when added to other things), has a soft texture, helps to hold fragrance, absorbs oil and grease, repels water, and so on. In cosmetics particularly, all of the above properties are useful, but one particularly useful feature is also its plate-like structure. Basically, as you can see from the image above, the way talc is structured, is that it is a brucite sheet (Mg12O12H4) sandwiched between two silica (SiO2) sheets, and this means that the talc platelets have a very nice "slip" when applied skin - the platelets slide over each other and give it that "spreadable", smooth texture on skin. When added to makeup it often improves the texture of the product, which is why you often see it in powder products.
Talc's smooth texture, ability to absorb oil, and other aesthetic properties are why it is commonly found in cosmetic products (Image source)
Why is there concern about talc and its safety? I heard talc has asbestos in it?
On occasion I come across some sites on the Internetz talking about how talc and asbestos are related, or how talc has asbestos. This was probably the source of the "talc causes cancer" rumours, because asbestos has indeed been recognized as causing cancer. The concern about talc and asbestos goes way back, and fortunately for us, is unfounded as far as cosmetics we use today are concerned, because cosmetics containing talc don't contain asbestos, and asbestos and talc are not the same thing.
The first misunderstanding about talc and asbestos is that talc contains asbestos as a contaminant, and therefore causes cancer because of the asbestos. This in term stems from a misunderstanding of the mining process. While talc and asbestos are indeed both mined from the ground, they don't actually occur mixed up together like some people think, because they "form under different geological conditions and are separated into adjacent, but disparate, strata". What this means is that "by utilizing proper mining methodologies, asbestos contamination is avoided". As a matter of fact, since 1976, cosmetic-grade talc (along with food and pharmaceutical grade talc) is not allowed to have asbestos, and must be of a very high purity to be acceptable for such uses. In fact cosmetic talc now normally contains 98% talc, so the likelihood of contamination with asbestos is very, very low. The FDA conducted a survey on both cosmetic talc supplied by mining companies, as well as finished cosmetics (eyeshadow, body powder, face powder) that have talc sold by cosmetic companies, and found that in every single sampled product, asbestos was not detected.
One of the common misconceptions about talc is that it is related to asbestos and thus has the same properties (Image source)
The second misunderstanding about talc and asbestos is just mistaking one for the other, or thinking they are the same thing. Again, some of this is due to the fact that talc and asbestos are both minerals found in the ground, but also, the chemical similarity between talc and asbestos provided the rationale in the 1970’s for suspecting that talc could also cause cancer in humans. Fortunately, it is now well-established that while talc and asbestos may have some similarities, they have very different crystal structures, which are responsible for the differences in properties between talc and asbestos. The structure of talc is, as we've seen, is in the form of platelets of brucite sheets sandwiched between two silica sheets. Asbestos, on the other hand, has "thin, hair-like fibers with enhanced strength, flexibility, and durability", which talc does not have. This is the difference in structure between why asbesetos causes cancer and talc doesn't - it is these long fibers that, when inhaled, can get trapped in the lungs and remain there, eventually accumulating and causing scarring and inflammation. But since talc does not have these fibers, it doesn't behave in the same way when inhaled.
A SEM of the fibrils of asbestos, which are the key reason why it causes cancer. Talc has no such fibrils. (Image source)
Is Talc Dangerous? Will Talc Cause Cancer?
For this, since there seem to be various ways people get exposed to talc, let's look at three main areas: topical application (which is what would happen if you're using cosmetics), inhalation, and perineal application (which is what happens if you use talc to freshen your underwear). Although Joanna didn't mention perineal application, as she was mostly concerned with inhalation and topical application, I thought perhaps for completeness' sake I would just touch on it briefly too.
Multiple legal firms are getting in on that sweet, sweet talc lawsuit $ - but what does the science say? (Image source)
1. Topical Application of Talc in Cosmetics
As users of cosmetics and makeup, topical application of talc is probably our greatest exposure to it. Fortunately, as far as topical application goes, basically there is virtually no risk. Talc doesn't get absorbed by the skin when applied topically, so basically, when applied, it just sits on top of the skin, absorbing oil and releasing fragrance, and basically doing whatever it's supposed to do in cosmetics. There is no evidence whatsoever to indicate that there is any harm from exposing yourself to talc applied topically.
Talc also does not cause sensitivity or allergies in skin - in studies with guinea pigs, talc was not a sensitizer, and in comparison with starch glove powder and a control, the glove powder was actually more irritating than talc. (For those who need a quick recap, glove powder is a starch that coats the inside of surgical gloves to make them easier to put on, as well as to prevent the gloves from sticking together, and corn starch is often used for such purposes.)
Talc doesn't get absorbed by the skin when applied topically, so as long as you're not applying it to open wounds, you're safe (Image source)
Perhaps the only caution you should take when applying talc on skin is to make sure that you're not applying it to open wounds, burns, or to an otherwise compromised epidermal barrier. There is evidence that "application of talc on wounds can give rise to scab formation, possible infection, and foreign body granulomas in the dermis". So, just don't apply it to open wounds on burns or a compromised skin barrier, but otherwise, the risks of topical application are very low.
2. Inhalation of Talc
Our next concern is the inhalation of talc. There is some concern over the inhalation of talc, but the risks appear to be limited to people who are actually continuously exposed to talc, and this is typically people who work in an environment that exposes them to talcum dust. This includes talc miners and millers, as well as employees who work in factories where talc is a part of the manufacturing process (in this case a chocolate factory). In some of the studies looking at miners and millers, particularly those who were exposed to talc decades ago (meaning 1920s - 1950s, when working conditions and safety regulations were less than ideal) when workers were not just exposed to talc, but also possibly to some of the impurities often found alongside talc, such as asbestos, then there were some cases of lung cancer documented. However, more recent studies (after stricter safety regulations were put in place) don't turn up the same concerns and epidemiological investigations report no statistically significant increase in mortality from lung cancer or mesothelioma in workers occupationally exposed to “pure” talc.
Most of us, with no occupational exposure to talc, are at no such risk, and in fact the American Cancer Society notes that "no increased risk of lung cancer has been reported with the use of cosmetic talcum powder". For one, the amount of time consumers are exposed to talc during cosmetics application is very short, ranging from 17 sec to 31 sec per application, and also, exposure is very low - the ASEAN Cosmetics Association argues (using baby usage as an example) that "toxicology data shows that, if used at each of 5 diaper changes, the quantity of talc exposure is over 6,000 times less than the quantity that would create any minimum reaction". In the US, the CIR has also arrived at this same conclusion, noting that even if we consistently use cosmetic talc, our respiratory and pulmonary systems are more than capable of handling the talc: "the use of talc at concentrations up to 35% in spray products, as reported for aerosol make-up bases, or even at 100% in powders, as reported for face powders, would not overwhelm pulmonary clearance mechanisms and would, therefore, not cause pulmonary overload or adverse respiratory effects attributable to cosmetic talc use".
Inhalation of cosmetic talc that is free of asbestos has not been linked to lung cancer (Image source)
It's interesting to note that, for the most part, the particle sizes of cosmetic talc are not likely to be considered inhalable anyway. In order for a particle to be potentially inhaled, its diameter should be smaller than 10µm (or 10 micrometers). The CIR notes that "typical cosmetic talcs have average particle sizes ranging between 4 and 15 μm when measured by sedimentation methods, with only minor fractions consisting of particles considered respirable", and the IARC notes that "the most common designations for fineness are based on US Sieve Series and Tyler equivalence and include 200 mesh (95–98% smaller than 74 μm in size), 325 mesh (95–99% smaller than 44 μm in size) and 400 mesh (95–99% smaller than 37 μm in size)". The mesh standards are those used by the cosmetics industry to assess the quality of their talc, and different talc particle sizes have different uses, 200-mesh talc is preferred for body powders, while 400-mesh talc might be used for pressed powders. So even in finer 400 mesh talc applications, the particles, while required to be small in size (37μm and under), are unlikely to be so small as to be respirable, because "the particle size of talc in loose powders, such as baby powders, is generally larger than that of inhalable particles". Furthermore, when used, loose particles may also agglomerate into larger particles, thus further increasing the overall particle size, making them even less inhalable.
In fact, Cancer Research UK has also noted that even when applied directly to the lungs, talc doesn't cause lung cancer. They note that "talc is used in a medical technique called pleurodesis that can help relieve symptoms of some lung problems. Doctors apply sterile talc directly to the lining of the lungs in this technique. And there is no evidence that this direct application of talc to the body causes cancer". And in the US, the FDA has also approved talc for use in this same process, for the treatment of malignant pleural effusion, an accumulation of fluid in the area between the layer lining the chest cavity and the membrane covering the lungs. So it seems that any danger from inhalation of cosmetic talc is pretty low.
3. Perineal Application of Talc
Here is where it gets slightly thorny. There are some studies that indicate that indicate a possible correlation between the use of talc on the perineal area and ovarian cancer, but other studies don't indicate any such correlation. A meta-analysis of multiple studies put the average relative risk at 1.3 (i.e. a 30% greater chance on average) of talc users developing ovarian cancer. However, as has been pointed out in multiple science-based sources looking at the studies, a "majority of studies looking at talc and cancer relied on people remembering things they did a long time ago" - for example, they would ask women to recall their usage of talc powder. Of course, self-reporting, with a significant time lag in between the reporting date and talc use date, is not the most reliable way to get accurate data, as the subjects' memories could be inaccurate, or there could be recall bias - for example, wommen with cancer might recall a potentially hazardous exposure more readily—and challenges in determining exposure. In fact, the more rigorous studies tend to not show a link between talc use and ovarian cancer, including two propective cohort studies (which follow the subjects over time, so recall error is lessened).
The science is mixed on this one, but on balance, probably not (Image source)
It's also worth noting that unlike other cancer-causing activities (for example smoking - where the more you smoke, the more likely you are to develop lung cancer), there is no correlation between using more talc, and developing ovarian cancer, which is what you might expect to see if talc use indeed caused ovarian cancer. This is important because for a causal link to be established, higher doses should lead to increased risk (dose-response). But in the case of talc, "as the effect was not dose dependent, interpretation of the result should be cautious". The CIR notes this very succiently in their report: "If perineal talc use can cause ovarian cancer in a dose-dependent manner, then there should be also be associations between such talc use and both cervical and uterine cancer, where talc exposure would be expected to be greater than ovarian exposure. No such associations have been reported.".
So while at first sometimes the headlines and scaremongering websites might might seem alarming, the science itself is actually less certain. In fact, the American Cancer Society has concluded that "if there is an increased risk, the overall increase is likely to very be small", and UK Cancer Charity Ovacome is also of the opinion that "this weak link between talc and ovarian cancer is just speculation at the moment. With no convincing results from research studies, it is hard to imagine that talc is a significant cause of ovarian cancer". Cancer Research UK has also reached a similar conclusion noting that "The evidence for a link is weak, but even if talc does increase the risk of ovarian cancer studies suggest it would be by around a third. This is a modest increase in risk and ovarian cancer is a relatively rare disease. Increasing a small risk by a third still gives a small risk." The organization also notes that other factors, such as smoking, or taking hormonal medications, such as the contraceptive Pill or Hormone Replacement Therapy, can also affect a woman's risk of developing ovarian cancer. So for what it's worth, it might be better to quit smoking rather than stop using talc if ovarian cancer is indeed a concern.
Furthermore, because we don't want to confound causation with correlation, it's important for us to know how talc causes cancer, if indeed it does. For example, as in the case of asbestos, we know how it causes cancer - it is the long fibrils of the asbestos that often cause cancer by staying in the lungs when inhaled (as in the case of lung cancer). But for talc, there isn't really a mechanism by which talc can cause ovarian cancer. How would talc migrate from your perineum into your body, and up all the lady organs there and into the ovaries, and even if it reached the ovaries, what would it do - does it accumulate there, attach there, cause any harm? As of now, we don't really know, and there isn't any anything to suggest that it could cause cancer even if inside the body. The CIR notes that, in order to make that move, the talc particles would have to "pass from the perineum through the vagina and cervical canal, move across the uterus and against the ciliary motion of the Fallopian tubes, cross the peritoneal space between the fimbriae and ovaries, escape phagocytosis in the peritoneal space, and attach to the surface of the ovaries to accumulate in the ovaries." And as far as we know, none of these things happen, and "no plausible biological mechanism has been identified to explain how exposure to talc containing no asbestos or other asbestiform fibers could cause ovarian cancer". So basically, even assuming talc causes ovarian cancer, there isn't really an explanation for how it might do this.
Talc Actually Has A Long History of Being Evaluated for Safety, and is Considered Safe in the US and Abroad
If you've made it this far in my blogpost, then you'll realize that there actually is quite a lot of data on talc and its safety - it seems like everyone and their mother has studied this in some form or another, in all sorts of ways, including in ways I've not looked at, such as the ingestion of talc. And I'm aware that a lot of fearmongering sites often like to make it sound that either 1) talc has been proven to cause cancer, which certainly is not what the majority of the science indicates, or that 2) there isn't enough data for us to be sure, because there are too many data gaps. I've already focused on the former previously, in looking at the potential risks of talc through various types of exposure (topical, inhalation, perineal), and I'd like to just clarify any doubts about the latter.
For example, the below is some highlights (not all) of what the US has done to assess the safety of talc:
- In 1992, the Environmental Protection Agency (EPA) issued a ‘‘Health Assessment Document for Talc.’’ The review concluded that talc is not carcinogenic following inhalation exposure or intraperitoneal (ip), intrapleural, or intrabursal administration to rats, hamsters, and mice.
- In 1994, the FDA and the International Society of Regulatory Toxicology and Pharmacology held an open workshop to review all the available data on talc safety. They concluded that no health hazards had been demonstrated in connection with the normal use of cosmetic talc.
- In 2004, the National Toxicology Program in the US considered listing talc in its report on carcinogens after a review in 2000 found considerable confusion over the mineral nature and consequences of exposure to talc. In October 2005, however, the NTP stated that the existing scientific data were insufficient to identify talc as a cancer-causing agent and withdrew it form their process.
- In 2009 – 2010, the FDA conducted an exploratory survey of cosmetic-grade raw material talc, as well as some of the cosmetic products containing talc, marketed at the time. The survey found no asbestos fibres or structures in any of the samples of cosmetic-grade raw material talc or cosmetic products containing talc.
- In 2010, the International Agency for Research on Cancer (IARC) Working Group published that there is limited evidence in experimental animals for the carcinogenicity of talc not containing asbestos or asbestiform fibers. The Working Group found there is inadequate evidence in humans for the carcinogenicity of inhaled talc not containing asbestos or asbestiform fibers and there is limited evidence in humans for the carcinogenicity of perineal use of talc-based body powder.
- In 2013, the CIR Expert Panel released its report on the safety assessment of talc used in cosmetics. It concluded that it is safe in the current practices of use and concentration; talc is reported to be used at up to 100% in cosmetics.
Talc is Also Considered Safe in Other Countries
This is a common misconception I've across, and I'd like to just clear it up. I’ve come across online articles on the Internetz claiming that the US regulatory agencies suck, and that other “safer” countries, particularly those in Europe, actually ban talc or restrict its use (particularly the oh-so-credible “9 ingredients you use that are BANNED OVERSEAS” kind of listicles). This happens so often that my personal theory is that whenever an ingredient is “controversial” (for whatever reasons, justified or not), this is one of the common lores that will spread about the ingredient du jour – parabens, which are perfectly safe, and which I’ve blogged about before, have also been unjustifiably maligned by such rumours. This really isn’t true at all, and can be easily disproved by looking up the pertinent regulations in other countries, which are often available online, so I don’t know why such beliefs persist.
So, let’s look up what some of the key regulators say. In the US, talc is deemed safe for use, at levels of up to 100% in cosmetics, which you mostly find in things like face powders and baby powders. How does this compare to other jursidictions?
Yes, other countries do allow talc too! This Japanese-brand baby powder is talc, zinc oxide, and fragrance. (Image source)
In Europe (one of the supposed “this ingredient is banned here but not in the US” jurisdictions), there is actually no restriction on the maximum amount of talc that can be used in cosmetics – so they are also deemed safe for use at levels of up to 100%. The only restriction is that for “powdery products intended to be used for children under three years of age” only, such products should carry a label that says “Keep powder away from children's nose and mouth”. So yes, technically it is true that the EU does “restrict” the use of talc more than the US – but this restriction is really more about labelling baby powder than about actually not allowing talc for use in cosmetics, as baby powder can be comprised of 100% talc in the EU. As far as cosmetics are concerned, it’s also allowed for use at up to 100% without any labelling necessary, but a lot of fearmongering sites stretch the truth and make it sound that the EU is in some way limiting the use of talc in cosmetics in a way that the US is not.
In Canada, there is also regulation similar to that of the EU. In Canada, for “products in powder form intended for infants and children”, the product must carry labels like “Keep out of reach of children" and "Keep powder away from child's face to avoid inhalation which can cause breathing problems." So like the EU, there is also special labelling required for baby powder, and there is also no limit on the maximum amount of talc allowed in baby powder. And, like the EU, as far as cosmetics is concerned, there is no restriction on the maximum amount of talc allowed in the use of cosmetics, and also no special labelling requirements necessary.
On the other side of the globe, in Japan, the system is slightly different, and works by exclusion. Japan has a “negative list", meaning that all cosmetic ingredients are allowed, unless they are on the list. This negative list includes both banned ingredients (which are not allowed at all) as well as ingredients that are allowed, but up to a maximum limit (e.g. a preservative might be allowed but not in amounts exceeding 0.1%). The negative list contains no mention of talc at all, so clearly talc is safe for use in Japan as well.
TL;DR: Talc is safe to use, but if you want to be cautious, avoid perineal usage (Image source)
TL;DR: So, should I still use talc, and products with talc?
Looking at what we've established, and what the science on balance says, we know that:
1. Talc is not similar to asbestos
2. Talc as used in cosmetics today doesn't have asbestos
3. Talc doesn't cause skin irritation, or lung cancer
4. The link between talc and ovarian cancer in perineal use is mixed and somewhat tenuous
5. Talc has a long history of being studied for its safety, and it has mostly been found to be safe
So, given what we know, my personal view is that:
1. If you're using talc in cosmetics, it's fine
Talc applied to skin has low irritation, and it isn't going to cause lung cancer. So, just don't apply it to places with burns, cuts, open wounds, or an otherwise compromised skin barrier, and you're probably alright.
2. If you're applying it perineally, the science is mixed, but if you're concerned, then don't use it down there
While the science is mixed, on balance, the more rigorously conducted studies do tend to not show any link between ovarian cancer and use of talc. And furthermore, we don't actually know how even talc might get all the way from your undies to your ovaries deep inside your body, so the link for causation is quite tenuous. So if you're using talc on your underwear and are happy to continue doing so, then by all means, feel free to continue. But, if you want to be cautious and discontinue the use of talc perineally, then by all means, feel free to do so, and use some other alternative, like a pantyliner, perhaps. Given the news and ongoing events, I certainly won't blame anyone for acting out of caution.
Ultimately, I recognize that different people have different comfort levels - some are happy to continue using talc anyway, while others would like to discontinue the use of talc altogether, while yet others are comfortable using talc in cosmetics but not applied to the genital area. But, as far as the science goes, talc in cosmetics is safe, with only a mixed, tenuous link between talc use in the perineum and ovarian cancer. I hope this information is useful to you in understanding the hype and fearmongering around us, as well as hopefully providing a stronger background for understanding current events too.
Annex: Scientific Sources on Talc
Below are a list of sources I referred to that are science-based. One of the issues with controversial (rightly or wrongly) ingredients is that a casual Google search often throws up all the sites that get the most traffic, which are often unfortunately not the sites that are factually accurate, science based, or reliable (I guess fearmongering and hype is always more popular than science). So I have listed the sources I've used and come across that are more reliable. Most of these are a mix of science articles and regulatory findings.
1. FDA page on Talc and Asbestos Contamination
2. The Scientist article "Can Talc Cause Cancer?"
3. IARC Monographs on the Evaluation of
Carcinogenic Risks to Humans - the relevant part on talc is page 287 onwards
4. Cancer Research UK page on Cosmetics and Toiletries, including Talc
5. American Cancer Society "Talcum Powder and Cancer"
6. Ovacome Fact Sheet: Is there a link between ovarian
cancer and talcum powder?
7. Cancer Research UK Article: Talcum powder and ovarian cancer – what’s going on?
8. Cancer Council Western Australia Factsheet "Cancer myth: Talcum powder and cancer"
9. CIR Safety Assessment of Talc as Used in Cosmetics
10. ASEAN Cosmetics Association "Opinion on Talc, February 2016"
11. EU CosIng Database - I couldn't link directly to the entry on talc but you can search for it here
12. Japanese "Negative List"
13. Health Canada List of Ingredients that are Restricted for Use in Cosmetic Products
14. National Cancer Society "FDA Approval for Talc" - on the use of talc for treating malignant pleural effusions
15. Perineal application of cosmetic talc and risk of invasive epithelial ovarian cancer: a meta-analysis of 11,933 subjects from sixteen observational studies
16. Perineal Talc Use and Ovarian Cancer: A Critical Review
17. Introduction to Cosmetic Formulation and Technology - not a science article, but a textbook with a short paragraph or two on talc