​​Key Messages​​

• ​If healthcare providers have patients that have used this hemorrhoid ointment, urge them to stop using it and order a venous blood lead test immediately​​​.​​
  
  

​​Background

In March 2024, a woman in Sacramento developed severe lead poisoning and died after using a hemorrhoid ointment from Vietnam called, Cao Bôi Trĩ Cây Thầu Dầu (Castor Oil Hemorrhoid Extract). The woman purchased the product on Facebook and a relative in Vietnam shipped it to the U.S. Testing of the product found that it contained 4% lead (39,000 ppm), a highly dangerous amount of lead. ​Lead may be absorbed through the skin. ​

Lead poisoning symptoms can be non-specific but may include those below. While some individuals can be asymptomatic, others can experience symptoms.

• Mild symptoms: Fatigue, irritability or mood swings, difficulty concentrating, difficulty sleeping

• Moderate symptoms: Muscle and joint pain, nausea, decreased appetite, stomach cramps, constipation and diarrhea, feeling tired or sleepy, headache, tremor

• Severe symptoms: Severe stomach cramping, pins and needles sensation​​​, tingling, burning or numbness in hands, seizures, coma, death​
  

Recommendations

• If your patients have used a hemorrhoid ointment from Vietnam called, Cao Bôi Trĩ Cây Thầu Dầu, urge them to stop using the ointment immediately.

• Patients who have used this ointment should receive a venous blood lead test immediately. We also recommend blood lead testing for all household members, especially children, since they may have had contact with the ointment.
  

• Contact California Poison Control at 1-800-222-1222 for clinical guidance on lead poisoning. See Health-Based Guidelines for Blood Lead Levels in Adults (PDF) for specific recommendations based on your patient's blood lead level results.
  

Resources

CDPH: Lead Alert Ap​​ril 2024​​​​