Dangerous skin-lightening creams available in SA

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KhumalImported skin-lightening creams laced with dangerous and illegal ingredients are readily available among informal traders in Cape Town, says a new study that raises tough questions about the government's capacity to protect consumers from dodgy cosmetics. Among the ingredients the study found in the skin lighteners were mercury, hydroquinone and topical steroids.

"The biggest problem lies with the port authorities who are supposed to ensure (imported cosmetics) comply with the law," said the study's lead author Nonhlanhla Khumalo, head of dermatology at the University of Cape Town and Groote Schuur Hospital in a Business Day report. "Some products listed illegal ingredients on the label. Someone should have stopped them," she said.

The team tested two products purchased in pharmacies and 27 from informal vendors. All 22 of the problem products came from the informal sector. A third of the problem products were from Europe, despite a EU ban on skin lighteners. "It makes one wonder whether we are the dumping ground for illegal products," said Khumalo.

The report says the study provides a detailed breakdown of the products tested. In an unusual step for the local scientific community, Khumalo and her team named and shamed the dodgy brands they identified, revealing their perilous ingredients. Many products contained a combination of banned substances.

Skin-lightening products were deceptive, because the damage they caused was not immediately apparent, Khumalo said. Mercury causes kidney and nerve damage, and can lead to psychiatric problems. It is banned in cosmetics in South Africa. Hydroquinone is permitted only in prescribed medicines, and then only in concentrations below 2%, because it can cause permanent damage to the skin. The two topical steroids identified were betamethasone and clobetasol propionate, which are classed as medicines and are, therefore, illegal in products marketed as cosmetics. They thin the skin and make it prone to infection.

The Cosmetics Toiletries and Fragrances Association's executive director Sally Gnodde said the association supported Khumalo's research and was helping to train port health authorities.

The topical steroids betamethasone (BM) and clobetasol propionate (CP) are illegal in cosmetics. Hydroquinone (HQ) and mercury (Hg) are either illegal or allowed only in limited concentrations (2% and 1 ppm, respectively).
To investigate active ingredients and countries of origin of popular skin-lightening products available in Cape Town, South Africa.
In total, 29 products were examined; of these, 22 products were purchased from informal vendors, and 2 products (out of a total of 29) were purchased over the counter. HQ, Hg2+ and steroids were quantified by high-performance liquid chromatography–ultraviolet spectrophotometry, inductively coupled plasma-mass spectrometry and liquid chromatography–mass spectrometry, respectively.
Of the 29 products, 22 (75.9%), all imported and bought from informal vendors, contained illegal or banned ingredients: 13 (44.8%) contained steroids (9 CP, 4 BM), 12 (41.4%) contained Hg (30–2300 ppm), and 11 (37.9%) contained HQ. Sequentially, the products originated from Italy (27.3%, n = 6), India (22.7%, n = 5), the Democratic Republic of Congo (DRC) (22.7%, n = 5), Cote d'Ivoire (9.1%,n = 2), USA (9.1%, n = 2), UK (4.5%, n = 1) and France (4.5%, n = 1). Two products, one from India and one from the DRC, contained all four ingredients (HQ, Hg, BM, CP). Of the 12 products containing Hg, 10 also contained HQ and/or a steroid, yet none listed Hg as an ingredient. A significant proportion of the steroid-containing products (76.9%) also contained at least one other skin-lightening agent. Not all internationally available products were tested, which is a limitation of the study.
In spite of a European Union ban on skin lighteners, a third of the products tested were from Europe. Combinations of Hg and ultrapotent steroids were prominent. International law enforcement and random testing is needed to encourage industry compliance and help protect consumers.

Full Business Day report Clinical and Experimental Dermatology abstract

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