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Mercury is a toxic substance that is commonly used in skin lightening products. Various effects on humans have been observed, which affect both users and non-users. Many studies reported delayed diagnosis and treatment, even after weeks of hospitalization. The possible reasons are non-specific clinical manifestation and lack of awareness and knowledge regarding chronic mercury intoxication secondary to skin lightening products. A thorough history of mercury exposure is crucial. Physical assessment and relevant supporting tests are indicated to establish a diagnosis. Blood and urine mercury levels are an essential examination for diagnosis and monitoring of the progress and response to treatment. The primary treatment is the discontinuation of the skin lightening products. Chelation therapy is not mandatory and is usually indicated for symptomatic patients. The prognosis depends on the duration of the product use, concentration of mercury in the skin product, and the severity of clinical presentation.

Objectives: To describe demographic characteristics, patterns of use, and symptoms associated with mercury poisoning among persons who used a Mexican beauty cream containing mercurous chloride and to estimate the prevalence of cream use in Texas near the Mexico border., Design: Case series and cross-sectional survey., Setting: Border communities of Arizona, California, New Mexico, and Texas., Participants: Persons who used the cream and contacted a health department in response to announcements about the cream and households that participated in the Survey of Health and Environmental Conditions in Texas Border Counties and Colonias, 1997., Main Outcome Measures: Urine mercury concentrations, self-reported symptoms, and prevalence of cream use among households., Results: Of 330 cream users who contacted their health department, 96% were women, and 95% were Hispanic. The mean urine mercury concentration was 146.7 microg/L (reference range : 0-20 microg/L). In 5% of 2,194 randomly selected Texas households near the Mexico border, at least 1 person had used "Crema de Belleza-Manning" (Laboratorios Vida Natural, S.A., Tampico, Tamaulipas, Mexico) in the previous year., Conclusions: Most cream users had increased urine mercury concentrations. Cream use was common in Texas near the Mexico border. Physicians should consider toxicity in patients with neurologic symptoms of unclear cause and use public health departments when investigating unusual illnesses.

The use of skin-lightening preparations appears to be a problem for the coloured women in Africa as well as for the Black People in general. The mercurial creams occupy a place of choice into the most useful products for the skin depigmentation. An epidemiological study from twenty senegalese women using mercurials cosmetics has permitted to determine a mean value of 155,75 +/- 75,38 ppm Hg in scalp hair while the normal level is less than 10 ppm. An experimental study was realised with monkeys (Papio papio) treated with a soap containing mercuric biiodide. This study has shown, after only three months of experimentation, a significative augmentation of mercury levels in all the organs and specially in the kidneys and the hair.