Kohl (surma): a toxic traditional eye cosmetic study in Saudi Arabia.

The use of kohl (surma) as eyeliner is a popular practice in Saudi Arabia and people firmly believe that it is safe to use. A total of 107 kohl samples (branded and unbranded) were collected from different regions of Saudi Arabia, and analysed for the presence of lead. In addition, aluminium and antimony levels were also determined. Lead levels up to 53% were detected in some kohl preparations, and some samples were found to contain camphor and menthol. The blood analyses of regular kohl users revealed a high lead concentration and relatively low haemoglobin levels. Due to the health risk, an official public awareness campaign is suggested to encourage the use of lead-free kohl.