Health Advisory: Skin Creams Containing Dangerous Levels of Mercury

The Texas Department of State Health Services (DSHS) recently received a report of one case of mercury poisoning related to use of a tainted skin lightening cream. People should only buy cosmetics in sealed containers from reputable retailers and should not buy cosmetics that appear to have been altered in any way. Anyone who believes they may have been exposed to mercury through skin creams should contact their healthcare provider or the Texas Poison Center Network at 1-800-222-1222.

In June 2024, a family from West Texas was exposed to mercury through a skin cream product purchased in Mexico. It was labeled as Nunn skin cream, and mercury was not listed on the label as an ingredient. After using the face cream, one family member developed mild nonspecific symptoms. In the past, Texas and other states have identified cases of mercury poisoning through skin cream.

Mercury may be added to skin creams claiming to lighten the skin, treat acne, or fade freckles, blemishes, and age spots. These products are often manufactured abroad, and the mercury is not usually added by the original manufacturer but by a third party. The products are sold illegally in the United States, often in shops catering to the Latino, Asian, African, or Middle Eastern communities or promoted and sold through social media or mobile apps. For more information, please see the FDA webpage: Skin Products Containing Mercury and/or Hydroquinone | FDA.

Mercury is dangerous and can cause serious adverse health effects in both adults and children. Mercury exposure is especially of concern for children and pregnant women or nursing mothers, because mercury may be passed to fetuses and infants.

Clinical Presentation

The symptoms associated with mercury poisoning are often non-specific and can be difficult to diagnose often leading to misdiagnosis.

General symptoms include shaking, tremors, impaired balance or coordination, headaches, hypertension, depression, insomnia, weight loss, fatigue, nervousness, irritability, anxiety, memory loss, difficulty concentrating, or numbness or tingling in hands, feet, and lips.

In children, prolonged exposure to mercury may present as excessive salivation or thirst, inflammation of the gums (gingivitis), irritability, anorexia, poor muscle tone, leg cramps, hypertension, rash, peeling or flaking skin, or pink extremities (e.g., hands and feet).

Long-term mercury exposure may cause damage to the gastrointestinal tract, nervous system, and kidneys. Symptoms may present as extreme fatigue, muscle aches, weakness, and sores in the mouth, in addition to the symptoms listed above. For more information, please see Mercury | ToxFAQs™ | ATSDR (cdc.gov).

Healthcare providers should:

• Consider inorganic mercury exposure from skin lightening products when conducting workup for renal, dermatologic and neurologic diseases.
• Ask patients suspected of mercury poisoning if they use skin creams purchased in Mexico or other countries.
• If the product was not purchased from a major retailer in these countries, or was unsealed upon purchase, urge patients to stop use immediately.
• Contact the Texas Poison Center Network at 1-800-222-1222 for questions about mercury poisoning medical management.

If a patient is suspected of using skin creams containing mercury, DSHS recommends healthcare providers conduct mercury analysis on blood and urine specimens and contact public health for assistance in testing the product. For more information, please see Evaluating Mercury Exposure: Information for Health Care Providers | ATSDR (cdc.gov).

• People should only purchase skin care products in original, sealed containers sold by reputable retailers.
• People should not buy skin care products at swap meets, at flea markets, or from individual online sellers.
• People should not buy or use products that may have the following words in ingredient list- “mercury,” “mercurio,” “calomel,” or mercury compounds such as “mercurous chloride.”
• People who believe they may have been exposed to mercury through skin creams should contact their healthcare provider or the Texas Poison Center Network at 1-800-222-1222.

To see products that contain mercury tested by other states, please see:

• Skin creams containing mercury – California Department of Health

• Skin Lightening Products Found to Contain Mercury (PDF) - Minnesota Department of Health
• Hazardous Products: Mercury in Soaps and Creams  - New York City Department of Health

If individuals have skin cream products containing mercury in their homes, the closed containers should be discarded at a household hazardous waste facility. If there is not a household hazardous waste facility available in their community, then the product may be tightly closed, placed in a sealed zipper bag labeled “Mercury: Do Not Touch” and discarded with household garbage.

To find a household hazardous waste facility near you, please visit:    www.tceq.texas.gov/p2/hhw

Mercury in Skin Creams Fact Sheet

For questions about medical management related to mercury poisoning, please contact the Texas Poison Center Network at 1-800-222-1222.

To report cases and for questions about the proper disposal of products containing mercury please contact DSHS Environmental Surveillance and Toxicology Branch at
512-776-7269 or epitox@dshs.texas.gov.