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A Tale of La Crema de Belleza

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Bordering the Future

At first, the boy just felt fatigued. Then he reported severe headaches and tingling in his hands and feet.

For an otherwise healthy 15-year-old from Eagle Pass, the symptoms shaking through his body during September 1995 made no sense.1 A physician in bordering Piedras Negras prescribed treatment for the aches, but a week later, the boy felt worse. His worried mother gave him both a traditional Mexican herbal remedy and injections of B-complex vitamins. The boy rebounded--but only briefly.2 Then, he weakened again, rapidly losing 10 to 15 pounds.3

His condition led his mother to seek a specialist's attention in San Antonio. There, in November 1995, tests revealed the mercury level in the boy's urine to be at least 20 times the normal range for his age and weight.4 The young man, it seemed, was suffering from acute mercury poisoning.

Even after appropriate treatment, however, the mercury persisted.

An Eagle Pass nurse checked the boy a month after the San Antonio visit, only to find his mercury level had not gone down. Concerned about the source of the mercury exposure, the nurse requested an investigation from the Texas Department of Health (TDH) Office of Border Health. TDH staff soon searched the boy's house, and a mercury vapor detector device picked up a reading from pillows and sheets on the boy's bed. Next to the bed, the detector swished over a jar of acne cream prescribed for the 15-year-old. The detector's needle went off the scale.

Investigators learned that the boy had been mixing the acne cream with a popular Mexican beauty cream called Crema de Belleza-Manning to lessen skin irritation from the acne cream. The state health laboratory in Austin found the imported mixture to contain at least 6 percent mercury--enough to induce poisoning in any adult. Indeed, the Crema de Belleza's listed ingredients included calomel, otherwise known as mercurous chloride.

TDH investigators fanned along the border to find out more about the prevalence of the beauty cream by visiting pharmacies in Mexican border towns. They wanted to see how many carried the product. They also wanted to inspect flea markets and ethnic stores in Texas to determine its availability. State health officials issued warnings to physicians and beauty salon owners. They also began to work with Mexican officials to halt the product's production and sale. As Texas and U.S. health officials have no jurisdiction over Mexican laws and regulations governing health and safety, cooperation was key.

As news of the possible exposure spread, state and local health departments began to hear from dozens of individuals who had tried la crema. Some 330 individuals, mostly Hispanic women from California, Arizona, New Mexico, and Texas, contacted local and state health departments and said they had used the cream. Calls came from as far away as Chicago, where a woman said a relative regularly mailed her the cream. Women in Houston and Dallas said they, too, routinely applied the cream. Some women had been using the cream for more than 20 years. All the callers were urged to see a physician and take a urine test to check for mercury poisoning.

Investigators found the cream on sale at flea markets and ethnic grocery stores, but it was not on the U.S. Food and Drug Administration's (FDA) list of approved imports. With so much of la crema available on the open market, the only way to stem exposures would be to stop production in Mexico. Expanding its investigation, TDHjoined forces with other border state health departments in the U.S. and Mexico, the federal Centers for Disease Control and Prevention, the FDA, and Mexican federal health officials at the Secretaría de Salud (SALUD). SALUD notified TDH that the laboratories where the beauty cream was manufactured in Tampico had been shut down and the remaining product confiscated. Mexico issued an alert to all six Mexican states bordering the U.S. and asked Mexican pharmacies in the states to remove the product from their shelves.

The cream immediately disappeared. But within weeks of the Mexican efforts, spot checks of border pharmacies still found a few bottles of the cream on shelves. Other pharmacies did not have it on their shelves, but would provide it upon request. More disturbing, not long after Mexico announced its ban on the manufacture of Crema de Belleza-Manning, other beauty creams were sprouting up--all with similar-looking labels and names and all containing dangerous levels of mercury. A 1997 TDH environmental health survey of more than 2,000 households along the Texas border found 7.5 percent of respondents saying they had used Crema de Belleza-Manning within the past year.

The boy from Eagle Pass fully recovered. But the risks of poisoning from products of unknown origin have likely persisted, possibly extending well beyond the Rio Grande.

ENDNOTES

1 J.F. Villanacci, Ph.D., et al, "Mercury Poisoning Associated with Beauty Cream--Texas, New Mexico, and California, 1995-1996," Morbidity and Mortality Weekly Report, Centers for Disease Control and Prevention (May 17, 1996), Vol. 45, No. 19, p. 401.

2 The use of injections is much more common in Mexico, as it is thought that an injection brings quicker relief. Injections can be purchased and often administered over-the-counter at pharmacies throughout Mexico.

3 Texas Department of Health, "The Hottest Zone: Mercury Poisoning," Disease Prevention News, Vol. 56, No. 10, May 13, 1996, p. 9.

4 The mercury level in his urine was 178 grams/liter where the normal range for someone of his age and weight should be 0-20 grams/liter.

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Bordering the Future