Snow White's tale in nephrology: the emerging threat of skin-whitening creams on kidney health.

Abstract

The timeless tale of Snow White, with its emphasis on fair skin as a beauty ideal, mirrors a contemporary issue in nephrology: the harmful impact of skin-whitening creams on kidney health. Fairness creams have deeply embedded themselves in global society, driven by a pervasive obsession with lighter skin tones as a symbol of beauty. This widespread use reflects deeply rooted cultural beliefs and social norms, despite the significant health risks associated with these products. Despite regulatory bans, these creams often contain hazardous substances such as hydroquinone, mercury, and arsenic, posing serious health risks. Mercury, a frequent component of these cosmetics, disrupts melanin synthesis by inhibiting tyrosinase, leading to serious health risks, including nephrotoxicity. Chronic exposure to mercury from cosmetics can harm the liver, kidneys, nervous system, and eyes, with the kidneys being particularly vulnerable. This review discusses the link between fairness creams and the occurrence of glomerular diseases. It delves into the mechanisms by which skin-whitening agents cause kidney damage. Mercury can induce kidney damage through direct cellular toxicity and immune-mediated mechanisms. We present evidence from case studies and published studies connecting mercury-containing creams to nephrotic syndrome. Minimal change disease and membranous nephropathy are the most frequently reported glomerular diseases due to these products. Treatment typically involves stopping the use of the creams and chelation therapy, with glucocorticoids and immunosuppressants for non-responsive cases. The prognosis is generally favourable, with high remission rates, and relapses are seldom reported. By highlighting the nephrotoxic effects of skin-whitening creams, this manuscript emphasizes the urgent need for stringent regulatory oversight and increased public awareness to prevent further health complications.