Childhood Effects of Prenatal and Postnatal Exposure to Mercurial Skin Lightening Agents. Literature Review
Keywords:Mercury compounds, Inorganic mercury poisoning, Skin lightening preparations, Maternal-fetal exchange, Prenatal exposure delayed effects
Children's exposure to mercurial skin lightening agents at any time during their development, from intra-uterine to early developmental life, can lead to severe detrimental health effects. This is because these skin lightening agents contain inorganic mercury as their active ingredient at varying concentrations that exceed acceptable levels. Mercury does not confer any physiological benefit to the human body, and as such, it has only been linked to numerous adverse effects on users and may pose a possible health risk for children born to, living with, and in contact with skin bleaching agent users. Although studies have shown that inorganic mercury exposure may be detrimental to children, there is a paucity of data, to the best of our knowledge, on reviews exploring specifically the possible routes of exposure to and effects of mercurial skin lightening agents on children. Since prevention is the only key to reducing mercury poisoning and toxicity, this study aims to extensively review the literature on prenatal and postnatal exposure to mercury in children from cosmetic skin lightening agents and discuss possible detrimental effects.
Charles C. Skin Bleaching, Oppression and Black Resistance Social Science Research Network; 2014 Nov Available from: https://dx.doi.org/10.2139/ssrn.2519822. Last updated January 6 2016; cited August 4 2020.
Al-Saleh I, Shinwari N, Al-Amodi M. Accumulation of Mercury in Ovaries of Mice After the Application of Skin-lightening Creams. Biol Trace Elem Res. 2009 Oct;131(1):43–54.
Lewis K, Robkin N, Gaska K, Njoki L. Investigating Motivations for Women's Skin Bleaching in Tanzania. Psychol Women Q. 2011 Mar 1;35:29–37.
Mahe A, Ly F, Aymard G, Dangou JM. Skin diseases associated with the cosmetic use of bleaching products in women from Dakar, Senegal. Br J Dermatol. 2003 Mar;148(3):493–500.
Risher JF, De Rosa CT. Inorganic: the other mercury. J Environ Health. 2007 Nov;70(4):9–16; discussion 40.
Voegborlo RB, Agorku SE, Buabeng-Acheampong B, Zogli E. Total Mercury Content Of Skin Toning Creams And The Potential Risk To The Health Of Women In Ghana. J Sci Technol. 2008;
Al-Saleh IA. Health implications of mercury exposure in children. Int J Environ Health. 2009 Jan 1;3(1):22–57.
Ricketts P, Knight C, Gordon A, Boischio A, Voutchkov M. Mercury Exposure Associated with Use of Skin Lightening Products in Jamaica. J Health Pollut. 2020 Jun;10(26):200601.
Kain T, Weinstein J, Thompson A, Boggild AK. The "wing-heeled" traveler. Trop Dis Travel Med Vaccines. 2020 Feb 18;6(1):2.
Chan TYK, Chan APL, Tang HL. Nephrotic syndrome caused by exposures to skin-lightening cosmetic products containing inorganic mercury. Clin Toxicol. 2020 Jan 2;58(1):9–15.
Palmer RB, Godwin DA, McKinney PE. Transdermal Kinetics of A Mercurous Chloride Beauty Cream: An In Vitro Human Skin Analysis. J Toxicol Clin Toxicol. 2000 Jan;38(7):701–7.
Cullen E, Evans DS, Davidson F, Burke P, Burns D, Flanagan A, et al. Mercury exposure in Ireland: results of the DEMOCOPHES human biomonitoring study. Int J Environ Res Public Health. 2014 Sep 17;11(9):9760–75.
AlGhamdi K. The use of topical bleaching agents among women: a cross-sectional study of knowledge, attitude and practices: The use of topical bleaching agents among women. J Eur Acad Dermatol Venereol. 2010 Oct;24(10):1214–9.
Al-Saleh I. Potential health consequences of applying mercury-containing skin-lightening creams during pregnancy and lactation periods. Int J Hyg Environ Health. 2016 Jul;219(4–5):468–74.
Boyd AS, Seger D, Vannucci S, Langley M, Abraham JL, King LE. Mercury exposure and cutaneous disease. J Am Acad Dermatol. 2000 Jul;43(1):81–90.
Petit A, Cohen-Ludmann C, Clevenbergh P, Bergmann J-F, Dubertret L. Skin lightening and its complications among African people living in Paris. J Am Acad Dermatol. 2006 Nov;55(5):873–8.
US Food and Drug Administration . FDA Cosmetics Handbook. Department of Health and Human Services, Public Health Service; 1992.
Agrawal SS, Mazhar M. Adulteration of mercury in skin whitening creams – A nephrotoxic agent. Curr Med Res Pract. 2015 Jul 1;5(4):172–5.
Sin KW, Tsang HF. Large-scale mercury exposure due to a cream cosmetic: community-wide case series. Hong Kong Med J Xianggang Yi Xue Za Zhi. 2003 Oct;9(5):329–34.
Copan L, Ujihara A, Jones C, Das R, Kreutzer R, Roisman R, et al. Mercury exposure among household users and nonusers of skin-lightening creams produced in Mexico - California and Virginia, 2010. Morb Mortal Wkly Rep. 2012 Jan 20;61:33–6.
Budnik LT, Casteleyn L. Mercury pollution in modern times and its socio-medical consequences. Sci Total Environ. 2019 Mar;654:720–34.
Martinez-Finley EJ, Aschner M. Recent Advances in Mercury Research. Curr Environ Health Rep. 2014 Jun;1(2):163–71.
Asano S, Eto K, Kurisaki E, Gunji H, Hiraiwa K, Sato M, et al. Review article: acute inorganic mercury vapor inhalation poisoning. Pathol Int. 2000 Mar;50(3):169–74.
Tokumoto M, Lee J-Y, Shimada A, Tohyama C, Satoh M. Glutathione has a more important role than metallothionein-I/II against inorganic mercury-induced acute renal toxicity. J Toxicol Sci. 2018;43(4):275–80.
Al-Saleh I, Abduljabbar M, Al-Rouqi R, Eltabache C, Al-Rajudi T, Elkhatib R, et al. The extent of mercury (Hg) exposure among Saudi mothers and their respective infants. Environ Monit Assess. 2015 Nov;187(11):678.
Risher JF; World Health Association and Interantional Programme on Chemical Safety. Elemental mercury and inorganic mercury compounds: human health aspects. Available from https://apps.who.int/iris/handle/10665/42607 . Last updated 2003; cited August 9 2020.
Fernandes Azevedo B, Barros Furieri L, Peçanha FM, Wiggers GA, Frizera Vassallo P, Ronacher Simões M, et al. Toxic effects of mercury on the cardiovascular and central nervous systems. J Biomed Biotechnol. 2012:949048.
Davis BJ. Mercury Vapor and Female Reproductive Toxicity. Toxicol Sci. 2001 Feb 1;59(2):291–6.
Mahé A, Perret JL, Ly F, Fall F, Rault JP, Dumont A. The cosmetic use of skin-lightening products during pregnancy in Dakar, Senegal: a common and potentially hazardous practice. Trans R Soc Trop Med Hyg. 2007 Feb;101(2):183–7.
World Health Organization . | Children's Exposure to Mercury Compounds . WHO. World Health Organization; 2010 Available from: http://www.who.int/ceh/publications/children_exposure/en/ Last updated 2010; cited August 5 2020.
Ask Björnberg K. Mercury exposure during early human development . Institutet för miljömedicin (IMM) / Institute of Enviromental Medicine; 2005. Available from: http://openarchive.ki.se/xmlui/handle/10616/37829. Last updated April 1 2005; cited August 4 2020
Rice KM, Walker EM, Wu M, Gillette C, Blough ER. Environmental mercury and its toxic effects. J Prev Med Public Health Yebang Uihakhoe Chi. 2014 Mar;47(2):74–83.
Ask K, Akesson A, Berglund M, Vahter M. Inorganic mercury and methylmercury in placentas of Swedish women. Environ Health Perspect. 2002 May;110(5):523–6.
Oliveira CS, Joshee L, Zalups RK, Pereira ME, Bridges CC. Disposition of inorganic mercury in pregnant rats and their offspring. Toxicology. 2015 Sep 1;335:62–71.
Agency for Toxic Substances and Disease Registry?(ATSDR). Toxicological profile for mercury. Available from: https://hero.epa.gov/hero/index.cfm/reference/details/reference_id/1256999. Last updated 1999. Cited August 6 2020.
Butler Walker J, Houseman J, Seddon L, McMullen E, Tofflemire K, Mills C, et al. Maternal and umbilical cord blood levels of mercury, lead, cadmium, and essential trace elements in Arctic Canada. Environ Res. 2006 Mar;100(3):295–318.
Yoshida M. Placental to Fetal Transfer of Mercury and Fetotoxicity. Tohoku J Exp Med. 2002;196(2):79–88.
Al-Saleh I, Abduljabbar M, Al-Rouqi R, Elkhatib R, Alshabbaheen A, Shinwari N. Mercury (Hg) Exposure in Breast-Fed Infants and Their Mothers and the Evidence of Oxidative Stress. Biol Trace Elem Res. 2013 Jun;153(1–3):145–54.
Ruggieri F, Majorani C, Domanico F, Alimonti A. Mercury in Children: Current State on Exposure through Human Biomonitoring Studies. Int J Environ Res Public Health. 2017 May 12;14(5):519.
Goldman LR, Shannon MW, the Committee on Environmental Health. Technical Report: Mercury in the Environment: Implications for Pediatricians. Pediatrics. 2001 Jul 1;108(1):197–205.
Park J-D, Zheng W. Human exposure and health effects of inorganic and elemental mercury. J Prev Med Public Health Yebang Uihakhoe Chi. 2012 Nov;45(6):344–52.
Darj E, Infanti JJ, Ahlberg BM, Okumu J. "The fairer the better?" Use of potentially toxic skin bleaching products. Afr Health Sci. 2015 Dec;15(4):1074–80.
Kampalath RA, Jay JA. Sources of Mercury Exposure to Children in Low- and Middle-Income Countries. J Health Pollut. 2015 Jun;5(8):33–51.
Copan L, Fowles J, Barreau T, McGee N. Mercury Toxicity and Contamination of Households from the Use of Skin Creams Adulterated with Mercurous Chloride (Calomel). Int J Environ Res Public Health. 2015 Sep 2;12(9):10943–54.
Oz SG, Tozlu M, Yalcin SS, Sozen T, Guven GS. Mercury vapor inhalation and poisoning of a family. Inhal Toxicol. 2012 Aug;24(10):652–8.
Lai O, Parsi K, Wu D, Konia T, Younts A, Sinha N, et al. Mercury toxicity presenting as acrodynia and a papulovesicular eruption in a 5-year-old girl. Dermatol Online J . 2016 ;22(3).
Rogers HS, McCullough J, Kieszak S, Caldwell KL, Jones RL, Rubin C. Exposure assessment of young children living in Chicago communities with historic reports of ritualistic use of mercury. Clin Toxicol Phila Pa. 2007;45(3):240–7.
Dunn AM, Burns C, Sattler B. Environmental health of children. J Pediatr Health Care. 2003 Sep 1;17(5):223–31.
Ozuah PO. Mercury poisoning. Curr Probl Pediatr. 2000 Mar 1;30(3):91–9.
Feng W, Wang M, Li B, Liu J, Chai Z, Zhao J, et al. mercury and trace element distribution in organic tissues and regional brain of fetal rat after in utero and weaning exposure to low dose of inorganic mercury. Toxicol Lett. 2004 Sep;152(3):223–34.
Al-Saleh I, El-Doush I, Shinwari N, Al-Baradei R, Khogali F, Al-Amodi M. Does low mercury containing skin-lightening cream (Fair & Lovely) affect the kidney, liver, and brain of female mice? Cutan Ocul Toxicol. 2005 Jan;24(1):11–29.
Chehimi L, Roy V, Jeljeli M, Sakly M. Chronic exposure to mercuric chloride during gestation affects sensorimotor development and later behaviour in rats. Behav Brain Res. 2012 Sep 1;234(1):43–50.
Abbaslou P, Zaman T. A child with elemental mercury poisoning and unusual brain MRI findings. Clin Toxicol. 2006;44(1):85–8.
De Bont B, Lauwerys R, Govaerts H, Moulin D. Yellow mercuric oxide ointment and mercury intoxication. Eur J Pediatr. 1986 Aug;145(3):217–8.
Guzzi G, Pigatto PD. Metal Allergy: Mercury. In: Chen JK, Thyssen JP, editors. Metal Allergy: From Dermatitis to Implant and Device Failure [Internet]. Cham: Springer International Publishing; 2018 [cited 2020 Aug 6]. p. 397–421. Available from: https://doi.org/10.1007/978-3-319-58503-1_31
Szász A, Barna B, Gajda Z, Galbács G, Kirsch-Volders M, Szente M. Effects of continuous low-dose exposure to organic and inorganic mercury during development on epileptogenicity in rats. Neurotoxicology. 2002 Jul;23(2):197–206.
Organization WH, Safety IP on C. Inorganic mercury [Internet]. World Health Organization; 1991 [cited 2020 Aug 6]. Available from: https://apps.who.int/iris/handle/10665/40626
Wallace DR, Lienemann E, Hood AN. Clinical aspects of mercury neurotoxicity. In: Clinical Neurotoxicology [Internet]. Elsevier; 2009 [cited 2020 Aug 5]. p. 251–8. Available from: https://linkinghub.elsevier.com/retrieve/pii/C20090375686
Kern JK, Geier DA, Audhya T, King PG, Sykes LK, Geier MR. Evidence of parallels between mercury intoxication and the brain pathology in autism. Acta Neurobiol Exp (Warsz). 2012;72(2):113–53.
Tchounwou PB, Ayensu WK, Ninashvili N, Sutton D. Environmental exposure to mercury and its toxicopathologic implications for public health. Environ Toxicol. 2003 Jun;18(3):149–75.
Baum CR. Mercury: What's In It For Kids? Clin Pediatr Emerg Med. 2012 Dec 1;13(4):324–30.
Bose-O'Reilly S, McCarty KM, Steckling N, Lettmeier B. Mercury Exposure and Children's Health. Curr Probl Pediatr Adolesc Health Care. 2010 Sep;40(8):186–215.
Wö?mann W, Kohl M, Grüning G, Bucsky P. Mercury intoxication presenting with hypertension and tachycardia. Arch Dis Child. 1999 Jun 1;80(6):556–7.
Summers AO, Wireman J, Vimy MJ, Lorscheider FL, Marshall B, Levy SB, et al. mercury released from dental "silver" fillings provokes an increase in mercury- and antibiotic-resistant bacteria in oral and intestinal floras of primates. Antimicrob Agents Chemother. 1993 Apr;37(4):825–34.
Gardner R, Nyland J. Immunotoxic Effects of Mercury. In 2016. p. 273–302.
Laks DR. Luteinizing hormone provides a causal mechanism for mercury associated disease. Med Hypotheses. 2010 Apr 1;74(4):698–701.
Obiageli AN. Immunoglobulin levels in maternal blood, cord blood and breast milk of Nigerian pregnant women using hydroquinone and non-hydroquinone containing skin lightening creams. Our Dermatol Online. 2019 Apr 9;10(2):131–7.
Pollard KM, Cauvi DM, Toomey CB, Hultman P, Kono DH. Mercury-induced inflammation and autoimmunity. Biochim Biophys Acta Gen Subj. 2019;1863(12):129299.
How to Cite
Copyright (c) 2020 Rebecca Murerwa, Fidel Gwala, Thomas Amuti, Mary Muange
This work is licensed under a Creative Commons Attribution 4.0 International License.
Authors who publish with this journal agree to the following terms:
- The Author retains copyright in the Work, where the term “Work” shall include all digital objects that may result in subsequent electronic publication or distribution.
- Upon acceptance of the Work, the author shall grant to the Publisher the right of first publication of the Work.
- The Author shall grant to the Publisher and its agents the nonexclusive perpetual right and license to publish, archive, and make accessible the Work in whole or in part in all forms of media now or hereafter known under a Creative Commons Attribution 4.0 International License or its equivalent, which, for the avoidance of doubt, allows others to copy, distribute, and transmit the Work under the following conditions:
- Attribution—other users must attribute the Work in the manner specified by the author as indicated on the journal Web site; with the understanding that the above condition can be waived with permission from the Author and that where the Work or any of its elements is in the public domain under applicable law, that status is in no way affected by the license.
- The Author is able to enter into separate, additional contractual arrangements for the nonexclusive distribution of the journal's published version of the Work (e.g., post it to an institutional repository or publish it in a book), as long as there is provided in the document an acknowledgment of its initial publication in this journal.
- Authors are permitted and encouraged to post online a prepublication manuscript (but not the Publisher’s final formatted PDF version of the Work) in institutional repositories or on their Websites prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work. Any such posting made before acceptance and publication of the Work shall be updated upon publication to include a reference to the Publisher-assigned DOI (Digital Object Identifier) and a link to the online abstract for the final published Work in the Journal.
- Upon Publisher’s request, the Author agrees to furnish promptly to Publisher, at the Author’s own expense, written evidence of the permissions, licenses, and consents for use of third-party material included within the Work, except as determined by Publisher to be covered by the principles of Fair Use.
- The Author represents and warrants that:
- the Work is the Author’s original work;
- the Author has not transferred, and will not transfer, exclusive rights in the Work to any third party;
- the Work is not pending review or under consideration by another publisher;
- the Work has not previously been published;
- the Work contains no misrepresentation or infringement of the Work or property of other authors or third parties; and
- the Work contains no libel, invasion of privacy, or other unlawful matter.
- The Author agrees to indemnify and hold Publisher harmless from the Author’s breach of the representations and warranties contained in Paragraph 6 above, as well as any claim or proceeding relating to Publisher’s use and publication of any content contained in the Work, including third-party content.
Enforcement of copyright
The IJMS takes the protection of copyright very seriously.
If the IJMS discovers that you have used its copyright materials in contravention of the license above, the IJMS may bring legal proceedings against you seeking reparation and an injunction to stop you using those materials. You could also be ordered to pay legal costs.
If you become aware of any use of the IJMS' copyright materials that contravenes or may contravene the license above, please report this by email to email@example.com
If you become aware of any material on the website that you believe infringes your or any other person's copyright, please report this by email to firstname.lastname@example.org