Surma (Eye Cosmetic): The Gift that can be Dangerous

Abstract

DOI: http://dx.doi.org/10.5915/28-4-8092

Surma is a fine powder that looks like mascara but is applied to the conjunctival surface rather than to the outside of the eyelids. It has been used for medical and cosmetic purposes for many centuries. Its name derives from the Urdu word for antimony sulphide. Recently, owing to the scarcity of antimony sulphide, lead sulphide has been used.

Samples of surma have been collected from around the world, and an analysis found it contains up to 80-90% lead, usually as sulphide. Since lead sulphide is not absorbed into the body through the eye, it remained a mystery for a while as to why blood lead levels were abnormally and dangerously high in some children. The claim was revealed later: The children rub their smarting eyes, then suck their fingers as comforters. The lead passes down into the digestive system, where, after a series of complex interactions with the gastric juices, the lead is absorbed into the body.

In Oldham, United Kingdom, a child who was exposed to lead-based surma (blood lead levels greater than 80 mg/dL) died due to lead-induced encephalopathy. It is for this reason that the dangers of surma have been most widely publicized, promoting educational campaigns in many countries. In the United Kingdom, these have been in the form of leaflets and posters on surma, translated into Hindi, Punjabi, Gujerati, Bengali, and Urdu. This paper will show the importance of having continuous campaigns against surma. Despite concerted programs of information and education by the British government, the problems associated with the use of this lead-based eye cosmetic remain.