Medley et al. 2023 — Children’s makeup and body products usage survey (US)

This Columbia/Earthjustice mixed-methods survey of 207 US parents/guardians (reporting on 312 children ≤12 years) characterizes the use, frequency, duration, and motivation behind children’s makeup and body products (CMBPs) — a broad category covering body paint, face paint, temporary tattoos, body glitter, eye products, lip products, face products, nail products, hair products, and fragrances. The paper does not measure heavy-metal content; it provides the exposure-pathway parameters (use prevalence, frequency, duration, ingestion proportion, application route) needed for any downstream metal-exposure assessment in children using these products. The paper explicitly excluded hair relaxers and skin-lightening products from the CMBP definition.

Key numbers

• Sample: n=207 parents/guardians (after exclusions); n=312 children ≤12 years reported on. 32 US states represented; top five: New York, California, Alaska, Massachusetts, New Jersey. 54% urban, 29% suburban, 14% rural communities.
• CMBP use prevalence: 219 of 312 children (70%) had ever used CMBPs. By age stratum: 0-3 yr 57% (48/84); 4-6 yr 74% (64/87); 7-9 yr 80% (68/85); 10-12 yr 70% (39/56); age-trend p=0.011.
• By child gender: female 76% (124/163) vs male 63% (93/147); p=0.014. By child race: White 78% (113/145) vs Black 61% (22/36); p=0.038. By child ethnicity: non-Hispanic 76% (145/191) vs Hispanic/Latinx 65% (72/110); p=0.051.
• Product types used among CMBP-using children (n=217 with sociodemographic data): Body 60% (130); Hair 44% (95); Face 41% (89); Nail 32% (69); Lip 30% (65); Fragrance 30% (66); Eye 18% (39); None 2% (4). Female vs male prevalence differed for eye, lip, nail (all p<0.0001).
• Proportion of CMBPs that were children-marketed vs adult products: 36% of CMBP-using children used mostly children’s products; 64% used >50% adult products.
• Frequency of CMBP use: Once a year or less 9% (20); A few times a year 34% (74); Monthly 19% (41); Every two weeks 9% (20); Weekly 14% (31); Daily or more 12% (27). Differed by ethnicity (p=0.047): Hispanic/Latinx more frequent.
• Duration of CMBP use per occasion: 0-2 h 25% (54); 2-4 h 23% (49); 4-6 h 17% (37); 6-8 h 8% (17); 8+ h 22% (47). Hispanic/Latinx vs non-Hispanic differed (p<0.001): 45% of Hispanic/Latinx children used CMBPs <2 h vs 15% of non-Hispanic.
• Ingestion of CMBPs in last year: 31% yes (67/217), 62% no (134/217), n=16 missing; differed by ethnicity p<0.001 (non-Hispanic 41% yes vs Hispanic/Latinx 11% yes).
• Who applies CMBPs (check-all-that-apply): Adult 91% (197/217) — parent 62%, caregiver 13%, event 19%; Child 62% (135/217) — self 36%, sibling 15%, friend 12%.
• Frequency of reading ingredient labels before purchase: Never 11%; Rarely 15%; Sometimes 22%; Often 29%; Always 17%. Approximately 46% “often” or “always”. Differed by ethnicity p=0.01.
• Frequency of CMBP wear outside the home: Never 4%; Rarely 24%; Sometimes 37%; Often 21%; Always 14%. Approximately 35% “often” or “always”.
• Settings of use (check-all): Celebrations 45% (98); Day-to-day 37% (81); Group play 32% (70); Solo play 19% (42); Performances 24% (53); Religious events 8% (17). Hispanic/Latinx vs non-Hispanic differed for day-to-day (p=0.008), solo play (p=0.047), performances (p<0.001).
• Play-vs-beautification motivation (1=all play, 10=all beautification): mean 5.31 (SD 2.96), median 6; most common response 1 (21% of n=219); second most common response 8 (18%). Hispanic/Latinx mean 4.70 vs non-Hispanic 5.63 (p=0.039).
• Means of introduction (n=163, check-all): Store display 37%; Another person 36%; Online media 34%; Activity (dance class/theater) 26%; Celebrations 22%; Traditional media 23%; Unknown 3%.
• Purchase locations (n=163, check-all): Large online retailer (e.g., Amazon) 49%; Big-box retailer (Walmart/Target) 37%; Pharmacy (CVS/Walgreens) 31%; Small online retailer 27%; Children’s specialty retailer (e.g., Claire’s/Justice) 20%; Dollar store 6%.
• Qualitative coding (n=98 open-text responses): Play code 26%; Health concerns 8%; Adult supervision 6%; Beauty 5%; Practical purpose 5%; Marketing 3%; Adult influence 2%. Of Spanish-language responses, 64% (7/11) coded Play vs 22% of English responses.

Methods (brief)

39-question Qualtrics survey (developed Jun-Jul 2021) administered to parents/guardians ≥18 years with at least one child ≤12 years residing in the US; recruitment Aug 2021-Apr 2022 via purposive sampling using email, social media (parental/neighborhood Facebook groups), flyers at local businesses/schools/clinics, and face-to-face events concentrated in NYC, Greater Boston, and Greater Houston. Survey offered in English and Spanish. Columbia University Irving Medical Center IRB-approved. Sociodemographic covariates: state of residence, urban/suburban/rural, parent/guardian age/gender/race/ethnicity/education, household income (pre-COVID 2019), household size, and per-child age/gender/race/ethnicity. Four child-exposure questions covered ingestion, frequency of ingredient-label reading, frequency of CMBP use, and typical duration of use. Eight product-usage and motivation questions covered ever-used, product type by body part, child-vs-adult product proportion, applier, out-of-home wear, settings, and a 1-10 play-beautification rating with optional open-text. Seven product-purchasing questions covered introduction, packaging influence, packaging appearance, purchase channel, retailer type, and purchase frequency.

CMBPs defined for respondents by body-part categories with examples: Body (face paint, body paint, temporary tattoos, stencils, body glitter, stick-on jewelry, tanning lotion, bath bombs); Eye (eyeshadow, eye liner, mascara, eyebrow pencil, false eyelashes); Lip (lip gloss, lipstick, lip tint, lip liner); Face (foundation, concealer, powder, blush, bronzer, primer, contour, highlight, face masks); Nail (nail polish, nail stickers, fake nails, press-on nails); Hair (hair sprays, spray-on hair color, hair gel, hair styling mousse/creams, hair glitter); Fragrances (perfume, cologne, body spray). Products with primarily cleansing or medicinal purposes, and hair relaxers and skin-lightening products, were excluded by definition.

Response exclusion rules: identical responses from same IP within 12 h flagged as spam (n=172); five or more identical-demographic responses within 15 min (n=255); incomplete responses (n=70); responses reporting 0 children ≤12 years (n=9). Final analytic sample n=207.

Quantitative analysis: descriptive statistics and hypothesis tests in R 1.4.1725; Wilcoxon and Kruskal-Wallis for numeric variables; Chi-square for categorical with sufficient cell sizes; Fisher’s exact for small cell sizes; α=0.05. Geographic visualization in QGIS 3.10.14 with GRASS 7.8.5. Qualitative coding of open-text responses (n=98) by two researchers using inductive code development, hierarchical theming (Motivations for use [Play/Beauty/Practical purpose], Safety [Health concerns/Adult supervision], Influence and introduction [Adult influence/Marketing], Other products [Drug/Not makeup-body product], Not usable [No new info/Not enough information]) in NVivo 12; word-frequency query with minimum character count of 3 and synonym grouping.

Implications

• Certification (HMTc): Provides the US-side exposure-pathway parameters for any heavy-metal exposure assessment of children’s makeup and body products. The 22% of children using CMBPs ≥8 h per occasion, 12% using daily-or-more, 31% reporting last-year ingestion, and 62% of applications involving a child (self/sibling/friend) collectively support treating CMBPs as a non-trivial dermal+oral exposure route for any metal present in the product, rather than as an occasional incidental contact. The product-type frequencies (Body 60%, Hair 44%, Face 41% among users) indicate which CMBP categories warrant priority in any certification-scope decision.
• Courses: Reference for the exposure-context section of any CMBP-related course module; ethnicity-stratified usage differences (more frequent use, shorter durations, lower ingestion, more play-motivated for Hispanic/Latinx children) belong in the environmental-justice framing of disparate exposures.
• App: Not directly relevant — paper provides usage-frequency parameters but no per-product contamination data.

Wiki pages this source may touch

• Children Personal Care (HMT&C Category 2 master) — umbrella exposure-context evidence: US use prevalence, frequency, duration, ingestion, application route.
• Children's Makeup (ages 0-5) — direct usage data on the category as a whole.
• Face Paint — Body category (60% of CMBP-using children) includes face paint.
• Lip products (lipstick, gloss, lip liner, adult lip balm) — Lip category (30% of CMBP-using children).
• Children's Nail Polish (ages 0-5) — Nail category (32% of CMBP-using children).

Verification notes

• No heavy-metal measurements in this paper; metals: [] and ingredients: [] are correct. The paper is exposure-pathway/usage-pattern evidence only.
• matrices: [] because the paper is a parent-reported usage survey, not a measurement of any biological or product matrix.
• The CMBP definition explicitly excludes hair relaxers and skin-lightening products (despite those being marketed-to-children-of-color cosmetic categories), so this paper does not provide usage data for products/skin-lightening-cream.
• Brand-firewall: paper names example retailers (“Amazon”, “Walmart/Target”, “CVS/Walgreens”, “Claire’s/Justice”) as purchase-channel examples; these are reported as the source frames them (retailer-channel context, not brand-contamination ranking) and do not violate Part 12. Method software vendors (Qualtrics, R/RStudio, QGIS, NVivo) are scientific-method names and are retained per the 2026-05-17 Exception 2.
• Citation count [21] in the paper refers to Li et al. 2002 on hormone-containing hair products in African American children; cross-reference for any future page on hair-product racial-disparate exposure.
• Citation count [22] (McDonald 2018) and [23] (Sprinkle 1995 on lead in imported eye makeup) are independent leads for the lead-in-imported-cosmetics literature and the early-puberty hair-product association literature respectively; not pursued here.
• Audit subagent (2026-05-17) flagged the ingestion-denominator phrasing “(67/216), (134/216)”; verified against Table 3 column header “Total (n = 217)” and the missing-data footnote “Ingestion of CMBP, n = 16” on PDF p. 8 — the source’s 31% / 62% are computed against n=217 with 16 missing reported separately. Corrected to “(67/217), (134/217), n=16 missing.”

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