Occupational exposure to allergens in oxidative hair dyes
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Oxidative hair dyes are the most important hair dying products. Hairdressers are exposed to the allergens found in oxidative hair dyes during the process of applying dyes to the hair, when cutting freshly dyed hair, or as a consequence of prior contamination of the working environment. pphenylenediamine, toluene-2,5-diamine and its sulphate are the most common ingredients in oxidative hair dyes that cause allergic contact dermatitis in hairdressers. Cross-reactivity of p-phenylenediamine with para-amino benzoic acid, sulphonamides, sulphonylurea, dapsone, azo dyes, benzocaine, procaine, and black henna temporary tattoos is possible. Allergic contact dermatitis is classified as delayed-type hypersensitivity, according to Coombs and Gell. Skin changes typically appear on the hands after previous sensitization to causative allergens. Combined with the patient’s overall medical and work history and clinical picture, epicutaneous testing is the basic diagnostic procedure for confirming the diagnosis and identifying the causative allergens. The simplest and most effective measure for preventing the occurrence of allergic contact dermatitis in hairdressers is prevention. Preventive measures should be applied as early as in the beginning stage of vocational guidance for this profession. It is important to include health education in the process of professional training and to implement general technical safety measures, in order to reduce sensitization to allergens in hairdressing. Here, special emphasis must be given to the correct use of protective gloves. Legislation must limit the concentration of allergenic substances in hair dyes, based on their potential hazards documented by scientific research.Keywords:
Hair dyes
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Hair dyeing is a popular practice dating back to ancient Egyptian times. Initially, hair dye use was restricted to concealing grey and white hairs of the elderly population. However, in recent times, its use is common among the younger generation as a fashion statement. Hair dye contact dermatitis is a common dermatological condition encountered by dermatologists. It is a delayed type of hypersensitivity reaction that commonly affects the scalp and the vicinity of hair line and neck. Para-phenylenediamine (PPD), a synthetic aromatic amine is the most common allergen specifically implicated in hair dye contact dermatitis. Para-phenylenediamine was announced as the allergen of the year in 2006 by the American Contact Dermatitis Society. Contact allergy to para-phenylenediamine can occur in 0.1-2.3% of the general population. Epicutaneous patch testing is the gold standard test for the diagnosis of hair dye contact dermatitis. However, para-phenylenediamine carries a risk of cross-sensitivity and co-sensitization to other allergens. Apart from contact dermatitis, hair dye use is also associated with various other cutaneous adverse effects such as pigmentary changes, hair loss, skin malignancies and autoimmune disorders. Due to the various adverse effects associated with hair dye use, it is prudent to look for safer alternatives to allergenic hair dyes. In this article, we review the epidemiology, cutaneous and systemic adverse effects associated with hair dye use, patch testing, preventive strategies to minimize the risk of hair dye contact dermatitis, and treatment aspects.
Hair dyes
p-Phenylenediamine
Contact Allergy
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Background. Occupational hand eczema is common in hairdressers, owing to excessive exposure to wet work and hairdressing chemicals. Objectives. To quantify occupational skin exposure and the use of protective gloves among hairdressers in Denmark. Methods. A register‐based study was conducted comprising all graduates from hairdressing vocational schools from 1985 to 2007 (n = 7840). The participants received a self‐administered postal questionnaire in May 2009, including questions on hairdressing tasks performed in the past week at work and the extent of glove use. A response rate of 67.9% (n = 5324) was obtained. Results. Of the respondents, 55.7% still worked as hairdressers, and they formed the basis of this study. Daily wet work was excessive; 86.6% had wet hands for ≥2 hr, and 54% for ≥ 4 hr. Glove use was fairly frequent for full head hair colouring and bleaching procedures (93–97.7%), but less frequent for highlighting/lowlighting procedures (49.7–60.5%) and permanent waving (28.3%). Gloves were rarely worn during hair washing (10%), although this was more frequently the case after hair colouring procedures (48.9%). Conclusions. Occupational skin exposure was excessive among hairdressers; the extent of wet work and chemical treatments was high, and glove use was inconsistent, especially for certain hair colouring procedures and wet work tasks.
Hand eczema
Occupational Dermatitis
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Allergic contact dermatitis involving the hands is a common occupational skin disease for hairdressers and the potent sensitizers p -phenylenediamine (PPD) and toluene-2,5-diamine (PTD) are associated with the development of occupational allergic contact dermatitis.The aim of the study was to analyze whether the use of the moderate sensitizer 2-methoxymethyl-PPD (ME-PPD) in professional hair dyes is a suitable tool to reduce the occupational contact allergy risk for hairdressers.Hand exposure of hairdressers (N = 11) to ME-PPD was analyzed under routine hair coloring conditions in commercial salons. By accounting for wet work and uneven hand exposure, the daily hand exposure was derived and compared with the occupational acceptable exposure level (AEL), that is, the sensitization induction threshold of ME-PPD adjusted for interindividual variability among workers.The daily hand exposure to ME-PPD was 1.6 μg/cm 2 , and the occupational AEL was 215 μg/cm 2 . The ratio of hand exposure to AEL was calculated as the margin of safety (MOS) against occupational sensitization. For ME-PPD, the MOS of 134 indicates a low likelihood of sensitization versus PPD and PTD with MOS values of 2.7 and 5.9, respectively.Our data predict that the use of ME-PPD in professional hair color products improves the protection of hairdressers against hair dye-related contact allergy versus the use of PPD and PTD.
Hair dyes
p-Phenylenediamine
Contact Allergy
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In this paper, the influence of oxidative dyes, dye dose, pH value of dyeing agents and packaging on oxidative hair dyes is investigated. The results show that oxidative dyes, pH value of dyeing agents and packaging have a great influence on oxidative hair dyes from the performance and quality stability.
Hair dyes
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Summary Paraphenylenediamine (PPD) is a potent skin allergen found in permanent hair dye and temporary henna tattoo ink. Several cases of adverse skin reactions to PPD have been reported in the literature. Here we present a case involving a patient who acquired a temporary tattoo while vacationing in Mexico and subsequently developed contact dermatitis at the tattoo site. He provided a history of permanent hair dye use in the past with associated cutaneous reaction. Temporary tattoos have become increasingly popular with travelers and as a result so have reports of associated allergic contact dermatitis. Of concern is cross‐reaction of PPD to related compounds, severe reactions in younger populations and sequelae including increased sensitization, permanent scarring, and persistent postinflammatory hyperpigmentation.
Hair dyes
Contact Allergy
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Hair dyes
Patch Testing
Contact Allergy
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Background. Occupational hand eczema is common in hairdressers, owing to excessive exposure to wet work and hairdressing chemicals. Objectives. To quantify occupational skin exposure and the use of protective gloves among hairdressers in Denmark. Methods. A register-based study was conducted comprising all graduates from hairdressing vocational schools from 1985 to 2007 (n = 7840). The participants received a self-administered postal questionnaire in May 2009, including questions on hairdressing tasks performed in the past week at work and the extent of glove use. A response rate of 67.9% (n = 5324) was obtained. Results. Of the respondents, 55.7% still worked as hairdressers, and they formed the basis of this study. Daily wet work was excessive; 86.6% had wet hands for ≥2 hr, and 54% for ≥ 4 hr. Glove use was fairly frequent for full head hair colouring and bleaching procedures (93–97.7%), but less frequent for highlighting/lowlighting procedures (49.7–60.5%) and permanent waving (28.3%). Gloves were rarely worn during hair washing (10%), although this was more frequently the case after hair colouring procedures (48.9%). Conclusions. Occupational skin exposure was excessive among hairdressers; the extent of wet work and chemical treatments was high, and glove use was inconsistent, especially for certain hair colouring procedures and wet work tasks.
Hair dyes
Hand eczema
Personal Protective Equipment
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406 patients were patch tested over an 18-month period (January 1998 to June 1999) at a dermatology referral centre. 33 patients (8.1%) had a positive reaction to para-phenylenediamine (PPD). 20 patients were experiencing PPD hair dye dermatitis (present relevance, 61%), 2 were using PPD hair dyes without developing dermatitis (clinical tolerance, 6%), 4 had previously used PPD hair dyes with dermatitis in the past (past relevance, 12%), 3 had previously used PPD hair dyes without dermatitis (past exposure, 9%) and 4 had no known exposure to PPD (unknown relevance, 12%). Of the 20 patients whose test results were of present relevance, 17 avoided PPD hair dyes, resulting in total clearance of the dermatitis in all except 3, who had concurrent endogenous eczema. 3 continued using PPD hair dyes: 2 had recurrent contact dermatitis and 1 avoided dermatitis with meticulous technique. The 2 patients with clinical tolerance continued using PPD hair dyes with no dermatitis.
Hair dyes
Patch test
Clinical Significance
p-Phenylenediamine
Hand dermatitis
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