SummaryThe cosmetic industry producing hair dyes has, for many years, recommended that their consumers perform 'a hair dye allergy self-test' or similar prior to hair dyeing, to identify individuals who are likely to react upon subsequent hair dyeing. This review offers important information on the requirements for correct validation of screening tests, and concludes that, in its present form, the hair dye self-test has severe limitations: (i) it is not a screening test but a diagnostic test; (ii) it has not been validated according to basic criteria defined by scientists; (iii) it has been evaluated in the wrong population group; (iv) skin reactions have been read by dermatologists and not by the targeted group (consumers and hairdressers); (v) hair dyes contain strong and extreme sensitizers that are left on the skin in high concentrations, potentially resulting in active sensitization; and (vi) recommendations and instructions on how to perform the hair dye self-test vary greatly even among products from the same company, again suggesting that the basis for safe use of the test has not been determined. If the use of a hair dye self-test to predict contact sensitization becomes widespread, there is severe risk that a tool has been marketed that may cause morbidity in European consumers.Key words: allergy alert test; diagnostics; hair dyes; nickel; p-phenylenediamine; screening; self-test; skin alert test.Contact allergy, defined as positive patch test reactions to common haptens, is frequent in general populations, affecting up to 20% of people (1-3). It is Correspondence: Jacob P. Thyssen, Department of Dermatolo-Allergology Gentofte Hospital, National Allergy Research Centre, University of Copenhagen, 2900 Hellerup, Denmark. Tel: +45 3977 3977; Fax: +45 3977 7118. E-mail: jacpth01@geh.regionh.dk Accepted for publication 15 February 2012 caused by repeated or prolonged cutaneous exposure to contact allergens, including metals such as nickel, cobalt, and chromium; preservatives, such as isothiazolinones, methyldibromo glutaronitrile, formaldehyde, and formaldehyde-releasers; fragrance substances, such as Myroxylon pereirae, Evernia prunastri, limonene, and isoeugenol; and finally, a wide range of very different chemicals, such as those present in topical drugs, plants, and hair dyes. Contact allergy is considered to be the latent