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COSMETIC BENEFIT AND RISK IN PERSPECTIVE

The effects of skin disorders on personal appearance often lead to distress comparable to that associated with far more threatening systemic illness.' Others judge us by appearances, and social acceptability is a powerful driving force. Nowadays a great deal of attention is rightly given to consumer product safety, according to the principle that risks should be assessed according to potential benefit. This is a persuasive argument, but benefit should not be envisaged only in terms of therapeutic efficacy. Many, if not most, of the things that make life worth living have no obvious relationship to health care and virtually every human activity involves some degree of risk. Benefits accruing from the use of cosmetics and toilet preparations are mainly psychological. Historically, though, the idea of a benefit-to-risk ratio developed in the drug field, where benefit is measured in terms of objective clinical merit. If cosmetics are deemed to offer no real benefit, we are forced to adopt a "zero risk" attitude; this is unattainable, and so the problem simply has to be approached from a different angle. Subjective benefit must be taken into account, just as it is taken into account when justifying numerous outdoor sporting activities with undeniable risks to life and limb.