Mercury pigmentation and high mercury levels from the use of a cosmetic cream.

A 42-year-old woman presented with facial mercury pigmentation, raised levels of mercury in the blood and urine and possible neuropsychiatric toxicity after the topical application of 17.5% mercuric ammonium chloride. The patient purchased a mercury-containing cream without prescription from Victorian pharmacies for many years to lighten her complexion. She was unaware of any health risk. No warning appears on the package or insert of the cream she used. Health workers, particularly pharmacists and medical practitioners, should be aware that over-the-counter mercury-containing creams may raise the concentrations of mercury in the blood and urine to potentially toxic levels. A warning on the package should be considered and use of the cream restricted.