Allergic contact dermatitis to hair dye after sensitization from black henna tattoos

Allergic contact dermatitis to hair dye after sensitization from black henna tattoos

In the 13 February 2007 edition of the Canadian Medical Association Journal is a case series Allergic contact dermatitis to paraphenylendiamine in hair dye after sensitization from black henna tattoos: a report of 6 cases by Fara Redlick and Joel DeKoven which begins: "The cases: Over a 2-year period, 6 women have come to our dermatology clinic with an allergic contact dermatitis to paraphenylendiamine (PPD) from hair dye after being previously sensitized to PPD from black henna tattoos. These patients, 14–38 years and previously healthy, all reported similar stories of developing erythema, edema and pruritus in some combination of their scalp, hairline, eyelids or cheeks, 1–2 days after having their hair dyed. All had previously had at least 1 black henna tattoo; 4 of them also reported having a previous local allergic reaction to a black henna tattoo."

"When patch testing was performed to identify causative allergens, all 6 patients were found to have strong allergic reactions to PPD. Moreover, their skin reacted to other para-dyes, which can cross-react with PPD: specifically, paratoluenediamine, aminophenol and 2-nitro-4-phenylenediamine.

"Black henna tattoos are frequently advertised as 'temporary and harmless', and thus have become a popular and fashionable form of temporary body art for young children and teenagers, especially among travellers and holiday resort guests (Fig. 1). Once applied, they cannot simply be washed off with soap and water; they last 1–2 weeks and then fade over a few more days. Henna is derived from the leaves of the shrub Lawsonia inermis, which grows in India, North Africa and Sri Lanka; lawsone is the active dye ingredient. Henna alone is relatively safe and has been used for decades in cultural skin tattooing, especially among Hindu or Muslim women. Henna is also used as an ingredient in hair colouring, where it imparts a reddish shade. [*If earlier removal is desired, some artists suggest soaking the tattoo site in salt water, which might lighten the colour.]

"It is rare to develop an allergic reaction to pure henna. Black henna tattoos usually contain an additive, paraphenylendiamine (PPD), as well as henna. PPD intensifies the dark colour, sharpens definition, speeds up the tattooing process and makes the tattoo last longer. PPD is known to be a potent skin sensitizer and to cause allergic contact dermatitis. It can also be found as an ingredient in hair dyes, fur dyes, cosmetics, printer's inks, photographic work, textile dyes, and some latex gloves and rubber support stockings."

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CMAJ  February 13, 2007; 176 (4). © 2007 Canadian Medical Association or its licensors
Allergic contact dermatitis to paraphenylendiamine in hair dye after sensitization from black henna tattoos: a report of 6 cases, Fara Redlick and Joel DeKoven

Category S. Skin Z. Social Problems. Keywords: allergic contact dermatitis, paraphenylendiamine, hair dye, sensitization, black henna, tattoos, clinical review
Synopsis edited by Dr Jim Vause, Blenheim, New Zealand. Posted on Global Family Doctor 20 February 2007