Health hazard: Women scarred for life by poisonous chemicals in skin-lightening creams

Gugu Mvelase* is thankful that her flirtation with skin-lightening creams was brief.

Two years ago she started using a powerful cream that “really messed up my skin”.

“I was buying them from a lady who has an office next to a doctor’s rooms in central Durban – so I was under the impression that the products were safe.

“I’m a very dark person and I also had acne. But after six months, my skin was terrible and it had turned at least two shades lighter. My friends knew something was going on and this also started to affect my confidence.”

Why did she want to make her skin lighter?

“I don’t know, really. I was 30 at the time. It’s just society, I guess. If you are lighter, you are... more beautiful. I didn’t have a specific reason. But I wanted to be more noticeable.

“Now I realise it was the biggest mistake of my life – I learnt the hard way. Thankfully, I stopped using them after receiving proper medical advice, before there was permanent damage. Now I am back to my natural dark complexion.”

Gugu was lucky. Millions of women across Africa and the world have been scarred for life or suffered very severe health damage due to a range of toxic additives such as mercury, lead and hydroquinone.

Yet the severe health risks of mercury have been known for hundreds of years. In 1687, for example, French chemist Marie Meurdrac recommended that mercury and other heavy metals be completely avoided for skin bleaching.

“In addition to destroying the beauty of the face with long use, they produce very troublesome and occasionally incurable illnesses, and it is of this that ladies must beware,” she warned. 

During the 18th century, English hat makers used mercuric nitrate to stiffen felt hats, often working in poorly ventilated rooms. Over time, many inhaled mercury vapours and developed psychosis, excitability and tremors – symptoms that became so common in hatters that the phrase “mad as a hatter” was born.

In Cato Ridge, KwaZulu-Natal, several workers died or became severely disabled in the early 1990s after being exposed to mercury fumes at the Thor Chemicals plant.

Globally, the most dramatic evidence of health damage from mercury exposure occurred in Japan, due to liquid industrial wastes that poisoned fish and shellfish in Minamata Bay between 1932 and 1968.

This led to thousands of cases of Minamata Disease, which included symptoms such as depression, insomnia, tremors, delirium, lung injuries and kidney collapse. In some cases, infants born to exposed mothers suffered brain damage and severe deformities of the limbs.

This health tragedy later gave birth to the Minamata Convention on Mercury.

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The Minamata Convention

Named after the devastating wave of mercury-related sickness that affected thousands of people around Minamata Bay, Japan, this international convention came into force in 2017 and aims to rapidly reduce global supply and demand for mercury.

It bans new mercury mines, while existing mines can continue for only 15 years after a country joins the treaty. 

The convention also aims to phase out or reduce mercury use in a number of products and processes. 

Several of these phase-outs became effective from January 2021, to ban or restrict mercury-containing products that include some batteries, compact fluorescent lamps under 30 watts, cosmetics (such as skin-lightening creams), pesticides and thermometers. Dental fillings which use mercury amalgams are also regulated under the convention to phase down their use.

The convention was a result of just three years of meetings and negotiations by delegates from nearly 140 countries and was signed in 2013.

The objective of the Minamata Convention is to protect human health and the environment from human-influenced emissions of mercury and mercury compounds. 

Every year up to 9,000 tons of mercury is released into the atmosphere, in water and on land. The largest source of mercury emissions is artisanal and small-scale gold mining, followed closely by burning coal for electricity and industrial heat, non-ferrous metal production and cement production.

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More recently, researchers have reported several cases of Kenyan women suffering kidney damage after frequent use of commercial skin-lightening creams.

Recent case studies among Mexicans living in California have emphasised the severe risks, not just for the women who use them, but also their children and other family members.

In 2014, doctors in California diagnosed mercury poisoning in a 20-month-old baby suffering from hypertension, refusal to walk, irritability, difficulty sleeping and poor appetite. The skin-lightening cream used by the mother contained 38,000 ppm of mercury. Researchers suggested the most likely exposure contamination route was through physical contact with the mother and contaminated household items. 

In a second case, a 17-year-old boy was admitted to an intensive care unit after using a non-commercial, artisanal cream from Mexico to treat acne. His symptoms progressed rapidly from weakness in his legs to involuntary muscle twitching. Later he developed severe back pain, visible muscle-twitching, unsteady gait, delirium, agitation, sleep disturbances and profuse sweating.

He had only been using the acne cream twice a day for about six weeks before the onset of symptoms. Eleven family members were found to have very high mercury levels and almost all furniture and personal belongings in the home were discarded as hazardous waste. The creams were later tested and found to contain between 96,000 ppm to 210,000 ppm of mercury.

And yet, skin-lightening creams with very high mercury levels are still on sale across South Africa.

Though local sales volumes remain unclear, there are some indications that the use of various skin-lightening products is growing – popularised in part by entertainers such as