Mercury poisoning from skin lightening products
Fact sheet for health care providers
The Minnesota Department of Health recently tested a random sample of skin-lightening products sold in Twin Cities stores: 11 out of 27 (41%) contained excessive levels of Inorganic mercury (ranging from 135 to 33,000 ppm).
Who is at risk?
- Patients using skin-lightening products that may contain mercury, including pregnant or nursing women and children
Signs and symptoms:
- Hypertension, edema, uremia (due to tubular and glomerular renal injury)
- Paresthesias, nervousness, irritability, tremors, memory loss, depression, weight loss, fatigue
Recommendations for doctors:
- Include questions about skin-lightening cream use in patient history.
- Discuss skin-lightening product use with patient. Mercury or other regulated chemicals (including retinoic acid or steroids) may be the active ingredient in these products.
- Conduct standard disease workup. Include inorganic mercury exposure in differential diagnoses of renal and neurological diseases.
- Stopping use of skin-lightening cream and treatment of symptoms should resolve most minor renal or neurological symptoms if disease is mercury-related.
- For symptomatic patients, please contact the Regional Poison Center at 1-800-222-1222 for consultation with a poison specialist and/or toxicologist.
Recommendations for patients using these creams:
- Read the labels of all skin-lightening products, and avoid products that either list mercury as an ingredient or list no ingredients at all. Be suspicious. The safest course of action is to discontinue use of all skin-lightening products not used at the direction of a dermatologist.
- Dispose of these products at a household hazardous waste site. (www.pca.state.mn.us)
Who should be tested for mercury poisoning?
- Most patients will require no testing; the most effective treatment is discontinuation of use.
- A 24-hour urine collection in an acid-washed container will provide the most accurate measure of mercury exposure; however, a spot urine should be sufficient for screening in most cases.
- No specific blood or urine level correlates well with toxicity. Cases exist of profound toxicity with low levels, and cases also exist with no symptoms or end organ damage with high levels.
How should I treat inorganic mercury poisoning?
- The most effective treatment is to end the exposure.
- Severe mercury poisoning can be treated with chelation after careful assessment of risk/benefit. Chelation treatment of asymptomatic or mildly symptomatic patients is unlikely to benefit patients, and may actually be harmful.
- Consult with a medical toxicologist or another experienced medical specialist (nephrologist, occupational physician) or contact the Regional Poison Center before initiating chelation treatment.
Where can I obtain more information?
- Contact the Regional Poison Center toll-free at 1-800-222-1222.