Skin Paints (Pseudo-Tattoos) with ‘Black Henna’: Hazards and Long-Term Risks

Abstract

Background: Skin paints, traditionally performed with henna, are sometimes realized with hair-dyeing preparations like ‘black henna’ containing aromatic amines. Observations: Nine patients, 7 women and 2 men aged 9–41 years, had had skin painting with ‘black henna’. Six experienced acute manifestations: flare-up (1), eczema (1) or both (1), eczema after hair dyeing (1) or chemical burn (2). Two were symptom free. In 1, a positive p-phenylenediamine (PPD) patch test was explained by previous pseudo-tattooing. Patients positive for PPD (4/4 tested) reacted to toluene-2,5-diamine (2/2), aminophenols (1/2), Disperse Orange 3 (3/3) and several azoic textile dyes (1/3). Conclusions: Some skin paint preparations contain irritant and sensitizing aromatic amines. The peculiar conditions of applications and their repetition enhance the sensitization risk. Long-term consequences of sensitivity to PPD or derivatives are allergic contact dermatitis following hair dyeing or after contact with some azoic textile dyes. Occupational consequences may be of importance.

Hairdressers with dermatitis should always be patch tested regardless of atopy status

“…A recent study from Copenhagen showed that one fifth of purchased items released nickel in concentrations that may lead to nickel allergy (20). Although PPD may not be the actual sensitizer in all cases of hair dye allergy, it is a marker for other diaminobenzenes used in hair dyes (21). Of the 23 patients positive for toluene‐2,5‐diamine, 83% ( n = 19) also tested positive for PPD.…”