The never-ending safety hazards of eyelash extension treatments

On February 17, 2010, NCAC published "Safety hazards caused by eyelash extension treatment" to alert consumers and call on the Consumer Affairs Agency to take steps to prevent recurrence and spread of these hazards. In response, the Consumer Affairs Agency called on the Ministry of Health, Labour and Welfare (MHLW) to further strengthen hazard prevention measures. Their review of safety maintenance, etc. in eyelash extension treatments has now ignited efforts to improve education in cosmetologist training programs and provide consumers with better information, etc.

Since FY2010, PIO-NET (Practical Living Information Online Network System)¹ has received 599 harmful incident reports² (e.g. eye pain) as a result of eyelash extension treatments, with over 100 incidents reported annually. The Medical Facilities Network³ has also received reports on three such incidents.

Eyelash extension is a cosmetic procedure and persons performing it must have a cosmetology license.⁴ According to the National Police Agency, however, there was a significant increase in 2013 in the number of arrests for violations of the Cosmetologists Act for eyelash extension.⁵

1. ¹ PIO-NET (Practical Living Information Online Network System) connects NCAC and local consumer centers across Japan, etc. through an online database of information on consumer-related inquiries and complaints.
2. ² Harmful incident reports are those in which consumers have been harmed (i.e. suffered bodily injury and/or illness) in connection with a product, service, or facility. Includes data received after FY2010 and registered through March 31, 2015.
3. ³ The Medical Facilities Network is a joint project by the Consumer Affairs Agency and the NCAC which started operating from Dec. 2010. The network collects accident reports on people receiving treatment at medical facilities after suffering life-threatening or bodily injuries in their daily lives. Includes data registered between December 2010 and March 31, 2015.
4. ⁴ "Eyelash Extension-Related Accident Reports," Ministry of Health, Labour and Welfare (MHLW) http://www.mhlw.go.jp/bunya/kenkou/seikatsu-eisei30/ According to the Cosmetologists Act, "Cosmetologists must perform cosmetology at a cosmetology facility."
5. ⁵ Data courtesy of Director for Economic Crime Investigations, Community Safety Bureau, National Police Agency.

Photo: Eyelash extension procedure example

Outline of inquiries and summaries

• Gender of the victims was female except for those falling under "unknown" and "no response".
• More than 90% of the victims were in the age range of 20-49 (38.2% in 20s, 35.7% in 30s, and 17.2% in 40s).
• "Painful eyes", "bloodshot eyes", "swollen/irritated eye lids", "itchy eyes", etc. were most common.
• According to the breakdown by the severity of harm, "less than one week of medical treatment" accounted for 31.4%, and "did not see a doctor" accounted for35.2%. There were also cases of "one month or longer medical treatment", accounted for 4.0%.

Typical cases involving accidents

[Case1] Fluid got in my eyes during the procedure, after which my eyes hurt, became bloodshot, and wouldn't stop tearing. The person performing the procedure was an amateur without a cosmetology license.

Two days ago, I underwent eyelash extension, introduced by an acquaintance. Fluid got in my eyes during the procedure and I said "It hurts", but the person performing the procedure said "The procedure will end soon. Be patient". Even after the procedure, my eyes still hurt, bloodshot and wouldn't stop tearing. What should I do? The person performed the procedure is doing business at home and does not have a cosmetology license. Isn't it illegal?

(Woman in her 30s)

[Case2] My eyes became swollen the day after the procedure. When the doctor examined me, I was told it was an allergic reaction to the adhesive used in the procedure.

One week ago, I underwent eyelash extension which was advertised in a free magazine. My eyes became swollen the day after the procedure and I saw a doctor. I was diagnosed as "allergic conjunctivitis caused by adhesive used for the eyelash extension". The symptoms are getting relieved thanks to the doctor's treatment.

(Woman in her 20s)

Key research findings

Questionnaire survey on harm to health, etc. from eyelash extension

NCAC surveyed 1,000 women between the ages of 10-59 who had undergone eyelash extension within the last year. Questions addressed their use of salons, harm to their health, and so on.

• Nearly 70% of respondents had undergone eyelash extension not once but multiple times.
• More than 70% of respondents knew that persons performing the eyelash extension must have a cosmetology license but, when choosing a salon, only about 20% considered it important that the person be a cosmetologist.
• Approximately 6% answered that the person who performed the procedure did not have a cosmetology license, while nearly half of all respondents did not check whether the person did or did not have a cosmetology license.
• Just over 50% indicated that the risks of harm to one's health "were explained and fully understood," yet only about 40% were instructed to seek help at a medical facility if something was abnormal with their body or they felt strange.
• One in four people who underwent eyelash extension experienced something abnormal or felt strange.
• "Painful eyes/foreign object in eyes", "itchy eyes/eyelids", and "bloodshot eyes" were most common.
• Many of the people who experienced something abnormal or felt strange did so within two to three days of the procedure.
• Many people believed that the technique of the person performing the procedure was the cause (e.g. "adhesive got in eyes during the procedure," "adhesive touched eyes and/or eyelids," etc.).
• More than half of respondents did not inform the salon that they experienced something abnormal or felt strange.

Study of adhesives used in the procedure

NCAC studied composition and labeling of 15 brands of adhesive for use in salons (commercial-grade) available for purchase over the internet.

• The substance ethyl cyanoacrylate was detected in 14 of the 15 brands, and butyl cyanoacrylate detected in two of the 15 brands.
• Three of the 15 brands failed to list active ingredients anywhere on the container, package or included documentation.

Advice for Consumers

• Eyelash extension can harm your eyes and the area around them. Due caution should be exercised whenever undergoing the procedure.
• If you experience something abnormal with your eyes or the area around them, seek assistance at a medical facility immediately.
• If you are harmed as the result of an eyelash extension procedure, report it.

Request to the industry and businesses

• NCAC requests the relevant industry and businesses to develop safer adhesive for use for eyelash extension treatments and to disclose information on ingredients for adhesive so that in case of trouble they can find out the cause.
• NCAC requests the relevant industry and businesses to confirm each customer if the eyelash extension treatment is acceptable for him/her and to give clear and adequate explanation on risks including health damages. In addition, NCAC requests them to inform customers that they should seek help at a medical facility if something was abnormal with their body or they felt strange during or after the procedure.
• NCAC requests the relevant industry and businesses to promptly and steadily foster cosmetologists with technique and knowledge on eyelash extension.

Request to the government

• NCAC requests the government to consider countermeasures to ensure safety of adhesive for use for eyelash extension treatments.
• NCAC requests the government to urge the industry again to promptly foster cosmetologists with technique and knowledge on eyelash extension as well as to thoroughly instruct the industry to provide users with information on risks including health damages.
• According to the inquiries and complaints, some salons and beauticians might violate the Cosmetologists Act. NCAC requests the government to continue the survey as well as to instruct problematic businesses.

Voices from the industry

Tecnico Inc.

We seriously take to heart the details of harmful incidents and the request for safety of adhesive.
Main ingredients for the adhesive examined are ethyl cyanoacrylate and butyl cyanoacrylate, which are in high demand as adhesive ingredients. Nonetheless, we as a manufacturer should seriously take the fact that troubles over adhesives have not decreased and need to provide safer products.

In order to decrease troubles, we think it is essential to establish a rule among a kind of manufacturers association, such as Matsuren, which we are affiliated with. It would not be possible for just one company to decrease these troubles.

Moreover, we think that proper technical treatments and explanation of risks during counseling can considerably decrease troubles.

As a company developing products and running a technical school, we would like to further enhance reaching out cosmetologists by providing information and holding technical seminars.

Tecnico Inc.(the second response)

We have read the released document "The never-ending safety hazards of eyelash extension treatments" and seriously take to heart the details of harmful incidents and the request for safety of adhesive.

Our company has been a member of Matsuren, a Japanese federation of eyelash extension manufacturers, and follows the following standard:

• Do not sell adhesive mainly composed of "methyl" cyanoacrylate
• Primary skin irritation test
• Formaldehyde test
• Labeling of ingredients for the adhesives, retaining safety data sheet (SDS) in Japanese.

Regarding technical aspects, we have indicated on an instruction manual that adhesive shall not touch the skin, keeping 1-2 mm space from the root of eyelash. From now on, we will regularly introduce cases of harmful incidents including those reported this time on our leaflets/website to invite users to check required skills.

In response to the request, we decided to clearly state on our online shopping site that the eyelash extension treatment is required to be performed by a licensed cosmetologist in a salon.

Beauty Products

Thank you for your efforts to prevent recurrence and spread of hazards associated with eyelash extension treatments.

We seriously take to heart the status and problems written on the released document "The never-ending safety hazards of eyelash extension treatments" based on your survey and analysis of actual harms due to eyelash extension treatments.

Here we would like to introduce our efforts as a manufacturer and dealer for improving safety of consumers in response to the request from NCAC.

Firstly, regarding safety of products, we manufacture and sell only adhesives which meet a voluntary standard defined by Matsuren (a Japanese federation of eyelash extension manufacturers, general incorporated association) and always put an ingredients label on each product. In addition, we develop and sell adhesives which generate less formaldehyde based on a stricter corporate standard.

Secondly, regarding safety of treatments, we frequently hold seminars for cosmetologists and businesses across Japan (about 15 times a year) to support improving skills of cosmetologists and to recommend hygiene management while treating products and sufficient ventilation during the procedure. On our website, we established a section titled "What is eyelash extension?" so that visitors can promptly recheck basic knowledge and get safety-related information, which helps prevent damages due to lack of skills/knowledge. This section also provides information necessary for consumers to be prepared for eyelash extension treatments.

In June 2015, we started to post a counselling sheet on our website (free for download) so that people can easily understand the process of eyelash extension treatments and key points thereof, with a view to preventing troubles in salons.

We think that the importance of safety in eyelash extension treatments cannot be overstated among businesses. We keep working on development of safer adhesives and improvement of technical environment with a view to solving problems informed by NCAC.

Matsukaze Co. Ltd.

We agree to the ideas of "Advice for consumers", "Request to the industry and businesses" and "Request to the government" in the document titled "The never-ending safety hazards of eyelash extension treatments" released by NCAC to decrease consumer damages due to eyelash extension treatments based on the analysis of recent harmful incidents collected through PIO-NET and the survey of actual status of users and adhesives for use for eyelash extension treatments. We believe that the released information contributes to and guides safety improvement activities to decrease consumer troubles, so we fully support it. We as a manufacturer and dealer seriously take to heart NCAC's request to "develop safer adhesives for use for eyelash extensions" and will work on developing safer products.

We sell only adhesives meeting a voluntary standard defined by Matzusen (a Japanese federation of eyelash extension manufacturers, general incorporated association). We have written on each instruction manual that the adhesives may generate formaldehyde and the treatment may cause allergy symptoms. As the minimum responsibility for a manufacturer and dealer, we have also provided cosmetologists and technical instructors in salons with information necessary for seeking safety in the procedure.

Since we seriously take the fact that information necessary for seeking safety in the procedure has not yet fully disseminated, we provide a "training manual" on our official website (totally free access) and at knowledge-sharing seminars (totally free of charge) as a guide on eyelash extension treatments for cosmetologists, technical instructors in salons and dealers.

Moreover we conduct "the examination activity for instructors certified by our company" targeting ambitious cosmetologists willing to check knowledge gained and promptly correct false recognition to provide safer treatments. Those who are interested in and participate in this activity are cosmetologists attentive to safety. They never provide risky treatments leading to troubles, which are far from seeking safety in the procedure (e.g. adhesion to fledgling eyelashes, adhesion to skin/pores, procedures by which adhesive gets in eyes, use of a hair bundle which cannot be combed by a brush, etc.).