Kajal (Kohl) - Dangerous cosmetics
The use of 'Kajal' (also known as kohl or surma) is a common practice in Indian families. Although concerns about its safety have been raised, its use in pediatrics is very common. The beliefs and practices associated with the use of 'Kajal' in children studying at a nursing hospital in a north Indian state have been described.
One hundred consecutive children under the age of 12 were both male and female and all religions (65% Hindu, 30% Muslim, and 5% other religions) were tested for use of 'Kajal'. Eighty-six children were used 'Kajal'. Of these, 48 were girls and 38 were boys. Most children were under the age of five. In the discussion, the following details were selected.
64% of mothers have been taught to attend classes 12 and above;
90% of mothers use 'Kajal' for advice from their elders;
Over 50% of parents were unaware of the benefits of using 'Kajal'. Other reasons cited included the fact that i) increase eye size; b) improves visual perception; and c) protects the eyes from infections.
No mother who used 'Kajal' would admit any discomfort with using Kajal.
Approximately 80% of respondents used 'Kajal' made at home. The most common is that the smoke from the oil-based flame is mixed with some oil or eye. Some parents have used 'Kajal' for advertising.
Of the mothers who did not use 'Kajal', most had no reason not to use it while others said it was harmful to the eyes.
'Kajal' (Kohl) is a popular eye care product and its use has been reported since ancient times. Kohl (surma) has been described as preparing the eye with a special eye for the special "Kohl Stone" (galena) supplemented with other effective therapeutic ingredients.  It is said to have kept the eye cool and clean, enhancing vision and strengthening the eye. It is also used for the prevention and treatment of eye diseases such as blepharitis, cataract, conjunctivitis etc.  It is also said to block 'the evil eye'.
The most commercially produced 'kajal' contains high levels of lead. Studies have revealed that 'Kajal' contains galena (PbS), minium (Pb3O4), amorphous carbon, magnetite (Fe3O4), and zincite (ZnO).  Prolonged exercise can lead to excessive retention in the body, affect the brain and ***** marrow, and cause scarring and anemia. Dirty, sharp and uneven fingers of caregivers are very dangerous in a child's eyes.  However, some studies have questioned the validity of such reports and stated that 'Kajal' is safe to use.  The US FDA does not endorse its use in cosmetic or any other FDA-regulated product. 
Apart from the compliments associated with using 'Kajal', it is frequently used in children. It is imperative that healthcare providers educate parents about the use of Kajal. The steps that different agencies can take can be
Pediatric bodies, pediatricians and pediatric surgeons should work with social leaders on community education.
Parent education by children, health care providers and other health care providers.
Display of educational materials in health care facilities such as hospitals and clinics.
Regulatory guidelines to manufacturers regarding compulsory 'Kajal' inspection of lead levels and other metals and certification.