2 people hospitalised after using underarm whitening cream, weight loss product

SINGAPORE: Three people experienced adverse effects after using adulterated health products, with two of them hospitalised, the Health Sciences Authority (HSA) said on Friday (Jun 28).

Members of the public are advised not buy or use 88 Total White Underarm Cream, Sausando Cellulite Pills and Pelangsing Double Strong, HSA added. 

Listings for all three products were found on local e-commerce platforms such as Shopee and Lazada. The underarm whitening cream was also sold on Carousell as well as by a retail shop in Lucky Plaza.

HSA has seized all stocks of the cream from the Lucky Plaza shop and investigations are ongoing, said the agency.

The affected listings have been removed from the e-commerce platforms with the help of adminstrators and enforcement action will be taken against online sellers.  

SEVERE SKIN REACTION

A woman in her 30s was hospitalised after using 88 Total White Underarm cream for a month, HSA said.

She developed a severe rash on most parts of her body, as well as liver impairment and jaundice from the cream she purchased at the Lucky Plaza shop.

“The product was touted to provide whitening effect and smooth skin, and reduce body odour,” the agency said.

However, HSA found that the product contained a high level of mercury and two other potent medicinal ingredients - betamethasone, which is a potent steroid, and salicylic acid.

Mercury is a toxic heavy metal and is prohibited for use in cosmetic products, the agency said, adding that it can cause rashes and skin irritation. 

If absorbed through the skin, it can cause numbness, dizziness and headaches, and long-term exposure "can cause serious health consequences".

As a result of mercury exposure, the woman was diagnosed with Drug Rash with Eosinophilia and Systemic Symptoms (DRESS syndrome), which is characterised by skin rash, blood abnormalities and injury to the liver that can be life threatening.

It is "extremely rare" for a topical cream to cause DRESS syndrome, Associate Professor Peter Goon from the Department of Medicine's dermatology division at the National University Hospital (NUH) told CNA on Friday.

The condition "has a mortality rate of eight to 10 per cent in the medical literature", Assoc Prof Goon, who is treating a patient that used the 88 Total White Underarm cream, said.

As mercury can be highly toxic, he noted that "strict controls are in place banning imports of consumer products containing mercury". 

"The fact that this skin-lightening cream was openly sold in a popular mall frequented by the public is, therefore, of grave concern," he added.

Betamethasone is a potent steroid which should only be used under medical supervision as inappropriate use can cause serious adverse effects. Salicylic acid is used to treat common skin conditions such as acne and dandruff, but it can lead to dry, irritated skin and rashes, if used in high amounts. 

Consumers who have used 88 Total White Underarm cream are advised to see a doctor as soon as possible.

Underlying skin conditions like eczema might worsen and result in other serious withdrawal symptoms such as fatigue, confusion and low blood pressure if the use of products containing steroids is suddenly stopped without medical supervision, HSA said.

BANNED SUBSTANCE

Both Sausando Cellulite Pills and Pelangsing Double Strong were found to contain sibutramine, a prescription-only weight loss medicine that is banned in Singapore. 

The substance has been banned in Singapore since 2010 due to an increased risk of heart attack and stroke. Other adverse effects include seizures, psychosis and hallucinations.

A man in his 50s was hospitalised after experiencing seizures, low blood sodium and vomiting. He had been taking Sausando Cellulite Pills for five months. Another woman reported experiencing insomnia and heart palpitations after consuming the product.

The pills were advertised online as a weight loss medication with claims such as “lose weight fast in seven days”. They were also marketed as a “natural health food”, according to HSA. 

The cellulite pills also contained phenolphthalein, an "obsolete" laxative that has not been registered in Singapore since 2011. Phenolphthalein may cause issues like kidney disorders, rashes, abdominal cramps and breathing difficulties. 

HSA was alerted to the online sale of Pelangsing Double Strong by a member of the public. The product claimed to help consumers “lose weight and to maintain the ideal body weight”.

Testing by HSA found that the slimming supplement also contained sibutramine and another similar chemical.

The public are advised to stop taking Sausando Cellulite Pills and Pelangsing Double Strong immediately and to consult a doctor if unwell.

“There is no quick and easy way to lose weight,” the agency said. 

“Be wary of products that make exaggerated claims such as ‘lose weight fast in seven days’ while claiming to be ‘natural’. They may contain potent ingredients that can seriously harm your health.” 

Assoc Prof Goon also warned consumers to "be wary of cosmetic products promising fantastic results", adding that if it sounds too good to be true, it probably is.

HSA reminded consumers to exercise caution when buying from unknown or unfamiliar sources, even from friends or relatives. Instead, they should only purchase health products from reputable pharmacies or retailers' websites as well as those with an established retail presence in Singapore.

"HSA will not hesitate to take stern enforcement actions against anyone who sells and supplies products found to be adulterated with banned substances, potent ingredients or toxic heavy metals beyond the allowable limits," said the authority.

If convicted, sellers and suppliers may be jailed for up to two years, fined up to S$50,000 (US$36,808), or both.