# A case report of an unconventional chronic lead poisoning resulting from daily eyelid application of kohl

## TL;DR

A 63-year-old woman experienced long-term lead poisoning from using kohl, highlighting the risks of traditional cosmetics containing lead.

## Contribution

This is the first reported case of chronic lead poisoning in adults over 40 years from kohl use.

## Key findings

- Lead levels dropped significantly after discontinuing kohl use.
- Chronic exposure led to neurological symptoms but no renal or hematopoietic effects.
- The case emphasizes the need for awareness about traditional kohl's health risks.

## Abstract

Lead can be found everywhere in the environment and continues to be a public health concern. Lead exposure through kohl is a well-identified problem. In adults, the few reported cases show that this exposure is underestimated. The health consequences of chronic exposure are not well known.

a 63-year-old woman contacted the Department of Medical Pharmacology and Toxicology to report suffering from numerous neurological disorders. She mentioned having previously undergone toxicological assessments showing abnormally high levels of lead and mercury about three years ago. Several lead tests revealed active lead exposure but at levels considered subtoxic, 170–198 μg/L. Subsequently, several interviews with an internist and a toxicologist allowed the identification of the contamination source: kohl. After discontinuing the use of kohl, it took a year for lead concentrations to drop below 50 μg/L. Apart from neurological symptoms, neither renal function nor hematopoiesis was affected.

This is the first case report describing the effects of chronic lead poisoning in adults over a period of more than 40 years. It is crucial to raise awareness among populations about daily using traditional kohls and to avoid these products due to their manufacturing process using galena.