Skincare Products & Mercury: Understanding Labels to Protect Your Baby

By Sonia Alvarado, CTIS Pregnancy Health Information Line Counselor

What do you know about the safety of the cosmetics you use on your face and body every day? I'm not talking just about foundation and lipstick, but face cream, body lotion, stretch mark cream, skin lighteners, shampoo, and conditioner? Do you read -- or understand -- the labels on all of the products that you buy? What about the skincare products that you get as gifts?

On March 6, the FDA issued a press release alerting consumers and retailers about mercury poisoning/toxicity in women and in some cases, the entire family, as a result of exposure through skin lightening creams that were sold in the U.S. but manufactured outside of the country. A search of the medical literature found reports of mercury toxicity related to creams/lotions manufactured in Mexico and China, although the FDA site reports that these products have also been sold illegally in the United States in shops found in Latino, Asian, African or Middle Eastern neighborhoods. Online shops have no borders, so the possibility of purchasing a tainted product may be higher.

Mercury is divided into three types elemental, inorganic, and organic. Organic is the kind that you find polluting streams and fish (methyl mercury).

Inorganic mercury is the type found primarily in batteries. It's also been reported in some disinfectants, health/homeopathic remedies, and skin and acne creams and lighteners (illegally). Inorganic mercury can be labeled as mercuric chloride, mercuric acetate, and mercuric sulfide. In the case of lotions containing inorganic mercury, not only is the user exposed, but the entire household may be at risk as the lotion is exposed to air, becomes a vapor, and members inhale or ingest it.

Exposure to inorganic and organic mercury is a concern for the entire family, including pregnant women. It's important to understand, however, that each type of mercury has potential risks depending on the route of exposure and the dose. Some forms are more readily available (absorbed into the body) if inhaled and some more available in the body if ingested.

Mercury crosses the placenta. High levels in the mom would be expected to produce high levels in the developing embryo or fetus. High levels of exposure in pregnancy have been associated with miscarriage. Studies of high levels of methyl mercury exposure (the kind typically found in fish) have been associated with neurologic disorders in the exposed infants/children (see http://www.otispregnancy.org/files/methylmercury.pdf). Studies of methyl mercury in pregnancy or children are more common than studies of inorganic mercury related to exposure from cosmetics or imported homeopathic remedies, which leaves a gap in our awareness and ability to treat individuals who have been exposed. This also means that it is difficult to know the levels that may be more or less harmful to the developing pregnancy.

Symptoms of mercury toxicity in the early stages include nausea, vomiting, and diarrhea. Symptoms of high acute exposure or chronic long-term exposure include kidney problems, gastroenteritis, metallic taste in the mouth, hypotension and shock, rashes, and excessive sweating, as well as others.

The FDA advisory reminds us of the importance of reading labels and understanding the potential risks with using hygiene products or cosmetics products (or supplements, herbal remedies, etc.) that are foreign-made. Per the FDA:

• Check the label of any skin lightening, anti-aging or other skin product you use. If you see the words mercurous chloride, calomel, mercuric, mercurio, or mercury, stop using the product immediately.
• If there is no label or no ingredients are listed, do not use the product. Federal law requires that ingredients be listed on the label of any cosmetic or drug.
• Don't use products labeled in languages other than English unless English labeling is also provided.
• If you suspect you have been using a product with mercury, stop using it immediately. Thoroughly wash your hands and any other parts of your body that have come in contact with the product. Contact your health care professional or a medical care clinic for advice.
• If you have questions, call your health care professional or the Poison Center at 1-800-222-1222; it is open 24 hours a day.
• Before throwing out a product that may contain mercury, seal it in a plastic bag or leak-proof container. Check with your local environmental, health or solid waste agency for disposal instructions. Some communities have special collections or other options for disposing of household hazardous waste.

Cosmetic products in the U.S.are, unfortunately, not regulated by the FDA. Furthermore, while companies are required to properly label products, the FDA does not pre-approve cosmetic product labeling either. It is illegal to sell misbranded cosmetics in the U.S., but, again, the FDA does not regulate or approve cosmetic products.

Cosmetics are commonly used during pregnancy and typically a low concern to the pregnancy due to expected low absorption into the bloodstream and therefore low exposure to the pregnancy but it can't hurt to be cautious and take a second look at the products we are using especially in light of this recent FDA warning.

For more detailed information on cosmetics, please visit the FDA website: http://www.fda.gov/Cosmetics/default.htm

References:

http://www.fda.gov/ForConsumers/ConsumerUpdates/ucm294849.htm

http://www.epa.gov/teach/chem_summ/mercury_inorg_summary.pdf

Mercury exposure among household users and nonusers of skin-lightening creams produced in Mexico - California and Virginia, 2010.

Centers for Disease Control and Prevention (CDC).

MMWR Morb Mortal Wkly Rep. 2012 Jan 20;61(2):33-6.

Sonia Alvarado is a bilingual (Spanish/English) Teratogen Information Specialist with the California Teratogen Information Service (CTIS) Pregnancy Health Information Line, a statewide service that aims to educate women about exposures during pregnancy and breastfeeding. Along with answering women's and health professionals' questions regarding exposures during pregnancy/lactation via CTIS' toll-free hotline and email service, she's provided educational talks regarding pregnancy health in community clinics and high schools over the past decade. In addition, Sonia contributes to the service's website, develops training materials for new CTIS staff, and is the supervising Teratogen Information Specialist trainer. Sonia attended San Diego State University and has worked in Tuberculosis Control for San Diego County's Public Health Department. Sonia's work has also been published through several tuberculosis studies. In her spare time, she loves to volunteer with the March of Dimes as an expert speaker on themes related to pregnancy.

CTIS Pregnancy Health Information Line is part of the Organization of Teratology Information Specialists (OTIS), a non-profit with affiliates across North America. California women with questions or concerns about pregnancy exposures can be directed to (800) 532-3749 or by visiting CTISPregnancy.org. Outside of California, please call OTIS counselors at (866) 626-OTIS (6847).