LETTER TO THE EDITOR
| [Download PDF]
|Year : 2013 | Volume
| Issue : 2 | Page : 207--208
Fair or foul?
Neeta Dhar Grover
Department of Pharmacology, Bharati Vidyapeeth Deemed University Medical College and Hospital, Sangli, Maharashtra, India
Neeta Dhar Grover
Department of Pharmacology, Bharati Vidyapeeth Deemed University Medical College and Hospital, Sangli, Maharashtra
|How to cite this article:|
Grover ND. Fair or foul?.Indian J Pharmacol 2013;45:207-208
|How to cite this URL:|
Grover ND. Fair or foul?. Indian J Pharmacol [serial online] 2013 [cited 2021 Dec 5 ];45:207-208
Available from: https://www.ijp-online.com/text.asp?2013/45/2/207/108335
I would like to direct the attention of the readers to a report published on the US Food and Drug Administraton (FDA) website under the consumer updates section. In the report dated August 2012, the US FDA has warned the users of skin lightening creams and anti-aging products that these products may contain very high concentrations of mercury.  The link between cosmetics and mercury poisoning is not new. In 1995, a cosmetic cream produced in Mexico and marketed in the USA as "Crema de Belleza-Manning", was found to contain 'calomel' or mercurous chloride in a concentration of about 6-10% by weight.  In a more recent publication, 31 relevant reports of mercury poisoning after cosmetic use from 1950 to 2011 were identified by an author from Medline. It was reported that the absorption of mercury from the skin depends upon the concentration of mercury.  The permissible levels of mercury as a preservative in certain eye ointments and creams is only 0.0065%. 
Inorganic mercury is often used in skin lightening creams, since mercury has an inhibitory effect on melanin formation.  Mercury poisoning can have consequences ranging from renal damage, mucosal damage to central nervous system damage. It is possible that non-specific complaints like tingling, numbness, forgetfulness, irritability and depression that are seen with chronic mercury exposure may not be attributed to mercury exposure at all by the clinician. In children, mercury poisoning may present as acrodynia (painful redness of palms and soles), irritability, restlessness and loss of muscle tone. Although inorganic mercury has poor lipid solubility and hence does not cross the blood brain barrier in cases with chronic exposure to mercury, it has been seen to accumulate in the brain and cause neurological damage.
These cosmetics can harm not only the user, but also other people who come in contact with the user. Household contacts of people using such products on a regular basis, even though never having used the product themselves, were also found to have high mercury levels. At special risk are children, who may get poisoned by these cosmetics used by the parents by merely touching them. Urine mercury levels greater than 25 mg/L are considered as suggestive of poisoning and it is used as a diagnostic test for exposure to inorganic mercury. 
There are no clear cut guidelines regarding the urinary mercury levels at which chelation therapy is indicated. The chelating agents used for mercury poisoning are dimercaprol, DMSA (meso-2-3-dimercaptosuccinic acid) and DMPS (sodium 2,3-dimercapto-1 propanesulfonate). It is unclear whether the use of chelating agents will reverse the renal and neurological damage. 
In India, many brands of 'fairness-creams' and 'anti-ageing' creams are available and are targeted at both men and women. Even though these Indian brands were not listed in the above mentioned report, they were not tested either. It would be prudent if these products were subjected to stringent testing in India and the contents mentioned in the label. Synonyms of mercury like calomel, hydrargyrum may be used on the labels at times. Being cosmetics, they come under the Drugs and Cosmetics Act. Obsession with fair skin could land up the users in unacceptably high-risks.
|1||Mercury poisoning linked to skin products. Available from: http://www.fda.gov/For Consumers/ConsumerUpdates/ucm294849.htm. [Last accessed 2012 Oct 01].|
|2||Centers for Disease Control and Prevention (CDC). Mercury poisoning associated with beauty cream-Texas, Mexico, and California, 1995-1996. MMWR Morb Mortal Wkly Rep 1996;45:400-3.|
|3||Chan TY. Inorganic mercury poisoning associated with skin-lightening cosmetic products. Clin Toxicol (Phila) 2011;49:886-91.|
|4||Olumide YM, Akinkugbe AO, Altraide D, Mohammed T, Ahamefule N, Ayanlowo S, et al. Complications of chronic use of skin lightening cosmetics. Int J Dermatol 2008;47:344-53.|
|5||Risher JF, Amler SN. Mercury exposure: Evaluation and intervention the inappropriate use of chelating agents in the diagnosis and treatment of putative mercury poisoning. Neurotoxicology 2005;26:691-9.|