Intended for healthcare professionals


Use of skin lightening creams

BMJ 2010; 341 doi: (Published 23 November 2010) Cite this as: BMJ 2010;341:c6102

Dangers of using illegal skin lightening creams

We would like to thank Professor Yetunde Olumide for highlighting the
dangers of using illegal skin lightening creams. As stated, the active
ingredients in such creams may be hydroquinone, mercury or
corticosteroids. As well as dermatological disorders, the long term use of
such creams can cause damage to other organs such as the kidneys and
nervous system.

In 2009, the Health Protection Agency (HPA) became aware of two cases
of nephrotic syndrome and one case of chronic back pain potentially
associated with chronic mercury poisoning from the use of illegal skin
lightening creams. These women, all of Asian origin, had blood mercury
levels ranging between 63 and 198 nmol/L (normal blood mercury level
<30 nmol/L). Chelation therapy was not required and blood mercury
levels reduced when the use of these creams ceased. The creams, which
contained up to 3% of mercury by weight, were purchased in the United
Kingdom (UK) in local shops and over the internet from UK suppliers.

Mercury is banned from being used as an active ingredient in
cosmetics within the European Union. However, recent investigations by
Trading Standards Agency in the UK revealed that illegally imported skin
lightening creams containing mercury are sold within the UK.

Following this incident, the HPA produced and distributed guidance
for healthcare professionals and the public about the dangers of using
illegal skin lightening creams and their possible health effects.
Healthcare professionals should remain vigilant to the possibility of use
of illegal skin lightening creams in both men and women of Black or Asian
ethnic groups presenting with renal impairment or nervous system
manifestations. Further information for healthcare professionals and
members of the public can be found at

Competing interests: No competing interests

17 February 2011
Kakoli Choudhury
Specialist Registrar
Jill Morris, Henrietta Harrison, Eamonn O'Moore
Thames Valley Health Protection Unit