Talc, or talcum, is a naturally occurring mineral; it is one of the hydrated magnesium silicates. Cosmetic talc, which has been safely used for over 120 years, is not the same as industrial talc. Cosmetic talc is prepared by milling talc from mines specifically selected for the high quality and purity of the talc seams. In addition, the mined talc is repeatedly checked for purity before being classified as cosmetic grade.
You may have seen articles that challenge the safety of cosmetic talc and linking it with cancer. However, no causal link has been shown between cosmetic talc and cancer
What is cosmetic talc?
Talc, or talcum, is a naturally occurring mineral which is mined; it is one of the hydrated magnesium silicates and can be found in a range of colours including white, grey and green.
Talc, in its natural un-milled form is made up of very thin sheets compressed one on top of the other. Once milled, the sheets break up into millions of tiny plates that easily glide over one another. This is what gives talc its soft, slippery feel.
There are many grades of talc, each of which is categorised according to levels of purity. At the top of this purity scale is cosmetic grade talc. Only talc which meets very high levels of quality and purity is permitted for use in cosmetics.
Cosmetic talc is prepared by milling talc from mines specifically selected for the high quality and purity of the talc seams. In addition, the mined talc is repeatedly checked for purity before being classified as cosmetic grade. Cosmetic talc, which has been safely used for over 120 years, is not the same as industrial talc which frequently has very low real talc content and may contain impurities. Industrial talc is not used in cosmetic products.
What is cosmetic talc used for?
Cosmetic talc is a versatile ingredient used in a wide variety of cosmetic products and has many different uses. Talc is good at absorbing moisture and so is used in body powders (also known as talcum powder or baby powder). It is also a good filler, so it is used in face and body powders to fill the tiny nooks and crannies on the skin surface, creating a soft, even feel. Cosmetic talc also functions as a very good base material for colour cosmetics such as eye shadows and powder blushers. These are only a few of the ways in which this highly versatile ingredient is used in cosmetics.
The same material is also described as Pharmaceutical grade talc and is used in both medicines (in tablets) and in foods such as chewing gum.
Is cosmetic talc safe?
Over the years, the safety of talc has sometimes been questioned through reports in the media. One of the most common claims is that talc use increases the risk of ovarian cancer, this in spite of no causal link between cosmetic talc and cancer ever having being shown.
Can talc migrate to the ovaries from outside the body?
In 1994, a joint workshop was held by the US Food and Drug Administration (FDA), the International Society of Regulatory Toxicology and Pharmacology (ISRTP) and the US Cosmetic Toiletry and Fragrance Association (subsequently known as the Personal Care Products Council). During this workshop, participants agreed that there was no evidence to conclude that talc is capable of reaching the ovaries.
In 2015, the Expert Panel of the US Cosmetics Ingredient Review review of talc safety [1] again agreed that there is no known physiological mechanism by which talc can plausibly migrate from the perineum to the ovaries.
In 2023, a peer-reviewed systematic review conducted by Lynch et al [2] concluded that “for talc to be associated with ovarian and other reproductive cancers, talc would first need to migrate from the respiratory tract into general circulation then to the reproductive organs (a pathway with little to no evidence).”
In the past, some researchers have claimed to have found particles of talc in surgically removed ovarian cancer tissue. However, finding particles believed to be talc in the tissues of patients must be interpreted with caution. There is every chance that particles, which may or may not be talc, can be found in healthy samples too. Careful investigations in the past have shown that such particles are present everywhere in the environment, even in hospital operating theatres, and may even be in the substances used to prepare the tissue samples for analysis.
[1] Fiume MM et al (2015) Safety Assessment of Talc as used in cosmetics. International Journal of Toxicology 34 (supp1) 66S-129S
[2] Lynch HN, Lauer DJ, Leleck OM, Freid RD, Collins J, Chen K, Thompson WJ, Ierardi AM, Urban A, Boffetta P and Mundt KA (2023) Systematic review of the association between talc and female reproductive tract cancers. Front. Toxicol. 5:1157761. doi: 10.3389/ftox.2023.1157761
Are talc and asbestos the same?
No. Sometimes negative attention is given to cosmetic talc because of confusion over the difference between talc and asbestos. It is true that they are both hydrated magnesium silicates, but diamonds and barbeque charcoal briquettes are both made of carbon and no-one would think they are the same!
One vitally important difference between talc and asbestos is in their crystal structure. While talc is made up of tiny flat plates, asbestos is formed as thin fibres. It is the specific fibrous structure of asbestos which contributes to its potentially harmful effects. Talc particles do not share this characteristic.
Is cosmetic talc contaminated with asbestos?
It is sometimes rumoured that cosmetic talc is contaminated with asbestos fibres. This is simply not the case. Some low-grade industrial talcs may contain many impurities including asbestos fibres but these grades of talc are not permitted for use in cosmetics. Only asbestos-free cosmetic grade talc of the highest quality and purity is used in cosmetics.
Selective mining, testing and the application of rigorous quality standards ensure cosmetic talc is free of asbestos fibres. Cosmetic manufacturers only source talc from reputable suppliers with strict testing controls.
Does inhaling cosmetic talc cause mesothelioma or other lung disease?
Mesothelioma is caused by breathing in asbestos fibres, which can become embedded in the lung and cause harm.
Cosmetic talc is a very pure, high quality talc that is only obtained from specially selected mines and must undergo a rigorous process to ensure it is free from asbestos. Harmful asbestos occurs as fibres, whereas cosmetic talc is made from overlapping sheets, which make it soft and smooth. Therefore, talc and asbestos are very different.
Two recent studies investigating whether cosmetic talc could cause mesothelioma analysed all previous studies which found an association between people diagnosed with mesothelioma and cosmetic talc use, to determine the likelihood that cosmetic talc did in fact cause the disease. Both studies found no causal link.
The peer-reviewed study by Ierardi, Urban and Marsh [3], published in the Journal of Toxicology and Applied Pharmacology in 2022 concluded that cosmetic talc is not related to the development of mesothelioma. The study used a well-established scientific framework, which was first developed by the scientist who discovered that smoking is an important cause of lung cancer, to determine whether there could be any other reasons behind an association between talc and mesothelioma, other than one causing the other. This framework doesn’t necessarily tell us what the other reasons could be, but whether it is statistically likely that talc causes mesothelioma. In this case, the researchers found it only 1.29% likely that talc causes mesothelioma.
Another study by Lynch et al [4], also published in a peer-reviewed scientific journal, analysed 25 studies that assessed exposure to talc and pulmonary cancer risk. Using another systematic review framework which is also used by US regulatory authorities, the authors found it unlikely that cosmetic talc causes lung cancer or mesothelioma. The authors comment that there is no convincing biological mechanism by which talc could cause these effects and the amount of evidence that exists and demonstrates no increased cancer risks associated with even the highest “real world” human-relevant exposures
This lack of causal link is borne out by the ample evidence that that cosmetic talc mines do not contain detectable asbestos and other studies which have investigated cosmetic talc miners all over the world, including those who mine in Norway, Italy, USA and France, finding that even people working with cosmetic talc on a daily basis had no increased risk of developing mesothelioma.
[3] Michael Ierardi, Ania Urban, Gary M. Marsh, A quantitative weight of evidence assessment of Hill's guidelines for causal inference for cosmetic talc as a cause of mesothelioma, Toxicology and Applied Pharmacology, Volume 417, 2021, doi.org/10.1016/j.taap.2021.115461
[4] Lynch HN, Lauer DJ, Thompson WJ, Leleck O, Freid RD, Collins J, Chen K, Ierardi AM, Urban AM, Cappello MA, Boffetta P, Mundt KA. Systematic review of the scientific evidence of the pulmonary carcinogenicity of talc. Front Public Health. 2022 Oct 11;10:989111. doi: 10.3389/fpubh.2022.989111
Why has the International Agency for Research on Cancer (IARC) Classified Talc as ‘Probably Carcinogenic’?
The World Health Organisation's (WHO) International Agency for Research on Cancer (IARC) has recently issued a new classification for talc. The IARC Working Group evaluated talc as probably carcinogenic to humans (Group 2A) on the basis of limited evidence for cancer in humans, sufficient evidence in experimental animals, and strong mechanistic evidence in human primary cells and experimental systems.
The limited evidence for cancer in humans is based on studies showing an association between use of cosmetic talc and ovarian cancer. However, “the Working Group concluded that a causal association could not be fully established,” meaning that these studies do not show that talc causes ovarian cancer.
The mechanistic evidence, in laboratory animals or experimental systems, provides an important indication for further investigation. However, it needs to be interpreted carefully to ensure it is relevant for how humans are exposed to talc, and to ensure it reflects the amount of talc to which humans are exposed.
The Science Media Centre features commentary on the IARC classification from Professors of Cancer Epidemiology and Statistics. Prof Paul Pharoah, Professor of Cancer Epidemiology, Cedars-Sinai Medical Center, said: “My interpretation of all the evidence is that women who have used genital talc in the past should not worry about their future risk of ovarian or other cancers.”
Evidence for cosmetic talc safety
Journal of the American Medical Association (JAMA)
In 2020, a US Government funded study, published by O’Brien et al [5] on a quarter of a million women and thought to be the largest of its kind on this topic, has found no link between talc and ovarian cancer. According to Prof Iain McNeish, Director of the Ovarian Cancer Action Research Centre at Imperial College London, it is a “very well-conducted study by a highly respected group of researchers.” You can read more about this study from an In the news on the topic.
[5] O'Brien KM, Tworoger SS, Harris HR, Anderson GL, Weinberg CR, Trabert B, Kaunitz AM, D'Aloisio AA, Sandler DP, Wentzensen N. Association of Powder Use in the Genital Area With Risk of Ovarian Cancer. JAMA. 2020 Jan 7;323(1):49-59. doi: 10.1001/jama.2019.20079. PMID: 31910280; PMCID: PMC6990816
US Food and Drug Administration
In 1994, a joint workshop was held by the US Food and Drug Administration (FDA), the International Society of Regulatory Toxicology and Pharmacology (ISRTP) and the US Cosmetic Toiletry and Fragrance Association (subsequently known as the Personal Care Products Council). The intention was to review all the available data on talc safety. After a two-day hearing, the conclusion was that no hazards to health had been demonstrated in connection with the normal use of cosmetic talc.
In 2015, following a Petition by the US Cancer Prevention Coalition (CDC) seeking warning labelling on cosmetic talc products, the FDA performed a review of the safety of cosmetic talc, using all the relevant scientific literature, and found no evidence of a causal association between talc use in the perineal area and ovarian cancer. The Petition from the CDC was denied and FDA concluded that talc was safe as used in cosmetic products.
US National Toxicology Program
The National Toxicology Program (NTP) in the US considered talc for possible listing in the 12th Report on Carcinogens in 2004. The purpose was to review the human epidemiology studies investigating both the personal use of talc and exposure to talc in the workplace. In October 2005, the NTP ruled that existing scientific data were insufficient to identify talc as a cancer-causing agent and talc was withdrawn from its review process.
Cosmetic Ingredient Review Expert Panel
In 2015, the US Cosmetic Ingredient Review Expert Panel published a safety assessment of talc [1] as used in cosmetics. It concluded that talc is safe for use in cosmetics in the present practices of use.
[1] Fiume MM et al (2015) Safety Assessment of Talc as used in cosmetics. International Journal of Toxicology 34 (supp1) 66S-129S
Scientific Studies
Many scientific research papers and epidemiology studies have been published since the early 1990s either supporting or opposing links between talc and ovarian cancer. Despite this, no scientific study has ever shown that talc causes ovarian cancer.
There are two types of epidemiology studies - 'retrospective' and 'prospective'.
'Retrospective studies' have many drawbacks
The vast majority of epidemiology studies that have investigated talc cancer risk are what scientists call 'retrospective studies' which look at how people's behaviour relates to disease. This requires the subjects to remember what they did in the past, as much as 20 or more years ago, and are likely to result in what statisticians describe as 'recall bias'.
In any epidemiology study it is vital to have a test and a control group that are exactly matched to make sure any 'confounding factors' are addressed, such as lifestyle choices and biased recall of personal habits over a period of time. However the published retrospective studies on talc and ovarian cancer have been criticised in that they were not matched with controls.
'Prospective studies' are more statistically robust
In more recent years there have been a number of 'prospective studies' which start at the beginning of the evaluation period and obtain all the required information at the beginning of a long term follow up.
Since the population groups of test and controls can be personally interviewed at the start of a study that will last for many years, any 'confounding factors' can be reduced or eliminated, meaning the studies are much more statistically robust.
There have been several large prospective studies on talc and ovarian cancer. The first was called the Nurses Health Study [6] published in 2000 and the second the Women's Health Study [7] published in 2014. Both looked at a many thousands of women over many years. The 2020 O’Brien study [5] also used prospective observational data.
These show no causal relationship between talc use and ovarian cancer.
Prospective studies are the basis for the conclusion by both the US FDA and Cosmetic Ingredient Review that talc does not cause ovarian cancer.
[6] Gertig DM, et al (2000) Prospective study of talc use and ovarian cancer. Journal of the National Cancer Institute 92 (3), 249-252
[7] Houghton SC, et al (2014) Perineal powder use and risk of ovarian cancer. Journal of the National Cancer Institute 106 (9)
