Mercury is ranked one of the most hazardous and toxic chemicals by the World Health Organization. One of the major culprits contributing to this toxin’s amplification in the environment is the cosmetics industry. From anti-ageing creams and eye makeup to skin whitening products and some coloured cosmetics, mercury has found its way into a wide range of beauty products. Pakistan has especially become a thriving market for mercury-added skin whitening products (soaps and creams) and their widespread use is now raising concerns about mercury’s impact on both health and the environment. Mercury is not only harmful to the user of such products but also to the people around the consumer. This can occur through direct contact with the person, inhalation of mercury vapours released by these products, contamination of shared spaces or handling of packaging/containers. Prolonged exposure, even to low-level mercury, can cause it to gradually build up in the body, leading to serious health issues such as kidney damage, skin conditions (dermatitis, rosacea, melanosis, eczema rash, skin thinning, skin sensitivity, hyperpigmentation, melasma) and even a compromised immune system. Long-term use may result in Central Nervous System complications such as headache, insomnia and possible mood swings. Excessive usage can also cause pregnant women to have children with neurodevelopmental delays. As a party to the UN multilateral treaty Minamata Convention, Pakistan is legally bound to limit mercury emissions and prohibit its use in consumer products, including cosmetics where inorganic mercury is added to inhibit the production of melanin. According to the latest mandate in 2023, the manufacture and trade of all cosmetics, even with traces of mercury, will be banned by 2025, except eye area cosmetics where organic mercury is used only as a preservative. As a party to the UN multilateral treaty Minamata Convention, Pakistan is legally bound to limit mercury emissions and prohibit its use in consumer products. In Pakistan, collaborative studies of the Ministry of Climate Change and Environmental Coordination and SDPI have revealed the seriousness of the situation. A 2018 study of 59 local and international skin whitening creams found that only three products adhered to the standard mercury limits (< 1 ppm), while the rest contained excessive mercury levels (0.74-44,292 ppm). Despite international commitments and local efforts by the Government of Pakistan, mercury-laced skin whitening products remain widely available in Pakistani markets. The increasing demand for such products is constantly being fueled by the cultural mindset that associates fair skin with beauty, success, and higher social status. Moreover, unscrutinized online trade is on the rise, advertisement campaigns promoting colourism are rotting the minds of the desperate masses, manufacturers continue to exploit loopholes in the weak regulatory system and legislation is only nominal. Although this campaign requires a multi-stakeholder approach, it is important to talk from the perspective of dermatologists and healthcare practitioners as well. Dermatologists often work at the intersection of skin health and aesthetics, which naturally ties their expertise to cosmetic products and treatments. SDPI itself has particularly involved dermatologists and health practitioners in this campaign through impactful seminars and panel discussions, addressing them as Agents of Change and hearing their insight on the scale of the problem. Nowadays, fairness is not only restricted to skin whitening creams but other treatments and products as well, such as chemical peels, laser treatments, and glutathione injections. While it has not been scientifically proven that all these treatments contain harmful chemicals, potential long-term health risks do exist such as kidney dysfunction, liver damage, and allergic reactions. Although there are many certified dermatologists involved in ethical practices and clinically proven skin treatments, there are also other con-artists posing themselves as qualified dermatologists by merely completing a short training course on dermatology. They may be performing treatments that violate health and safety laws or compromise the purity and quality of the used formulations. Dermatology is not given much importance at undergraduate level curriculum and examinations, so general practitioners sometimes even lack knowledge while prescribing products containing harmful chemicals. They prescribe these skin whitening products for their patients as a routine procedure for the complaint reported, without realizing the long-term effects of the product on the consumers as well as the coming generations. Certain patients even consult dermatologists with complaints of allergic reactions or skin disorders after using cosmetic concoctions and beauty products made from a combination of doubtful ingredients. These are often sold via beauty parlours and salons or over the counter, given appealing labels such as ‘herbal’, ‘organic’ or ‘miracle solutions.’ In actuality, these products are known to contain harmful chemicals such as mercury and hydroquinone or even steroids, something which the consumers are unaware of or bound to use due to societal pressures. The field of dermatology itself requires strict regulation, oversight and restructuring of the whole system. However, responsible and professional healthcare practitioners can play a key role in the advocacy efforts of this movement, through the provision of alternative safe products and effective counselling to consumers about the harmful impacts of mercury for the coming generations. Pakistan Association of Dermatologists has aided in bringing this topic to light through panel discussions among experts at its annual flagship event PADCON, aiming to discuss colourism, improve patient care, promote dermatology education at all levels, and partner with government authorities on relevant policies. It can target an awareness campaign about the harmful effects of mercury towards the most vulnerable population i.e. pregnant women, children and infants. It can also aid in building a counter-narrative towards the cultural mindset that is manifested in fairness-obsessed advertisement campaigns, by promoting the concept of healthy skin instead of fair skin. The issue we have in front of us is multifaceted. It requires the collaborative efforts of regulatory authorities, academia, NGOs, civil society organizations as well as healthcare practitioners. To protect the health of millions, along with advocacy, surveillance, research and regulation, targeting the issue at the cultural level is integral. Transforming our cultural norms and revitalizing the beauty standards should now be one of the main priorities, to form a more inclusive, bias-free society for the coming generations. Khadija Hasan is a Research Assistant at SDPI and can be reached at khadeeja_hassan@sdpi.orgDr. Razia Safdar is Senior Policy Advisor at SDPI and can be reached at razia@sdpi.org