HSA Alert: Child Experienced Serious Adverse Effects after Using Rash Cream Sold at a Makeshift Stall

The Health Sciences Authority (HSA) is alerting members of the public not to purchase or use ‘Tao Ju Hui Yi Mei Li Shang Kou Hu Li Ruan Gao’ (‘淘聚汇益美丽伤口护理软膏’), which led to symptoms of Cushing’s syndrome (a serious medical condition caused by prolonged use of steroids) in a child. HSA’s analysis of this product revealed that it contained four potent medicinal ingredients including two steroids.

Please refer to Annex A for photos of the product and Annex B for more information on the medicinal ingredients found in it.

Use of ‘Tao Ju Hui Yi Mei Li Shang Kou Hu Li Ruan Gao’ led to serious adverse effects in child

2        A four-year-old child was taken to the hospital to seek treatment for upper respiratory tract infection and was found to have symptoms of Cushing’s syndrome such as a “moon” face, excessive hair growth on the body and thinning of skin. The child’s parents had been using ‘Tao Ju Hui Yi Mei Li Shang Kou Hu Li Ruan Gao’ on the child regularly for rash over the past 4 months. They had purchased the product from a local peddler at a makeshift stall in Eunos.

3        HSA’s checks found that ‘Tao Ju Hui Yi Mei Li Shang Kou Hu Li Ruan Gao’ was also sold on local e-commerce platforms (Shopee, Lazada), Facebook, and a website called “Feili Health House” (feilihealthhouse.online). HSA has worked with the local e-commerce platform administrators and Facebook to remove the affected product listings. The makeshift stall in Eunos is no longer in operation. HSA is currently investigating the website “Feili Health House”.

4        The product was marketed online as a “baby cream”, and was labelled to be “used for the care of small wounds, cuts and abrasion” and “acts as a physical barrier by forming a protective layer on the wound surface”. The product was also falsely labelled to “contain ingredients that cannot be absorbed by the body” and that the “ingredients contained have no medicinal effects”. On the contrary, HSA detected chloramphenicol (antibiotic), clobetasol propionate and dexamethasone (steroids), and ketoconazole (antifungal) in the cream. These ingredients can pose serious health risks, especially in children, if used without medical supervision.

5        HSA would like to reiterate the dangers of purchasing health products from unknown sources, especially for use in babies and children as they are at higher risk of experiencing adverse effects from undeclared potent ingredients. In 2022, HSA detected potent ingredients including steroids in two other topical products marketed for young children. These are ‘Star Cream’^[1] and ‘Jolicare’^[2], with the use of ‘Star Cream’ leading to steroid toxicity in a four-month-old infant.

Advisory to parents and consumers

6    Parents and consumers are advised on the following:

• See a doctor as soon as possible if your child or other family members are using Tao Ju Hui Yi Mei Li Shang Kou Hu Li Ruan Gao’ as it contains potent medicinal ingredients, including steroids. Sudden stopping of the cream without medical supervision may result in the worsening of underlying skin conditions and other serious withdrawal symptoms such as fatigue, confusion and low blood pressure.

• Exercise caution when purchasing products for use in babies and children, as they are more vulnerable to serious adverse effects. These products include those that are applied on the skin such as creams. Potent ingredients added into the creams can be absorbed into the body and cause adverse effects. Consult a doctor if your child requires prolonged treatment to ensure that the products used are appropriate.

• When purchasing online, only buy from reputable pharmacies and retailers’ websites or those with an established retail presence in Singapore.

Advisory to sellers and suppliers

7        All sellers and suppliers must stop selling ‘Tao Ju Hui Yi Mei Li Shang Kou Hu Li Ruan Gao’ immediately. HSA will not hesitate to take stern enforcement actions against anyone who sells and/or supplies products found to be adulterated with potent medicinal ingredients. Sellers and suppliers who are selling ‘Tao Ju Hui Yi Mei Li Shang Kou Hu Li Ruan Gao’ are liable to be prosecuted and if convicted, may be imprisoned for up to 3 years and/or fined up to $100,000.

8        Members of the public who have any information on the sale and supply of ‘Tao Ju Hui Yi Mei Li Shang Kou Hu Li Ruan Gao’ may contact HSA's Enforcement Branch at Tel: 6866-3485 during office hours (Monday to Friday) or email: hsa_is@hsa.gov.sg.

HEALTH SCIENCES AUTHORITY
SINGAPORE
22 DECEMBER 2022

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^[1] https://www.hsa.gov.sg/announcements/star-cream-infant-hospitalised-for-serious-adverse-reaction/

^[2] https://www.hsa.gov.sg/announcements/press-release/hsa-alert-five-products-detected-to-contain-potent-medicinal-ingredients