hair dye contact dermatitis y

Hair dye contact dermatitisy

Dr Akiva TrattnerDepartment of Dermatology

Rabin Medical Center

Hair dye contact dermatitisHair dye contact dermatitis

Hair dye contact dermatitis


Prevalence among Asian patch test population


Prevalence among European patch test population


Prevalence among American patch test population

Hair dye contact dermatitisHair dye contact dermatitisIncidence of positivity to PPD:NACDG1994-1996 6.8%1996-1998 6.0%1998 2000 4 9%1998-2000 4.9%2001-2002 4.8%Mayo Clinic1998-2000 4.9%

Hair dye contact dermatitisyPrevalence in Europe

21,515 patients – 4.6% PPD sensitivity

Relevance – 53.6% current, 20.3% past

Consumer hair dyeing 41.8% ,occupational hair dye exposure 10.6% ,textile dyes 12.6%

More prevalent in central and southern European centers than in Scandinavian

Contact Dermatitis 2009,June ,60:314-319, ,


Population using hair dyes:

2/5 American women 20% Danish male

p-Phenylenediamine (PPD)p y ( )

PPD – contact allergen of the year 2006

Dermatitis ,2006,17:53-55

p-Phenylenediamine (PPD)p y ( )1.PPD –colourless compoundp2.Acts as a primary intermediate in hair dyes3 O idi d b h d id d th3.Oxidized by hydrogen peroxide and then

polymerized to a colour within the hair by a coupler

4 Once it polymerized it is not allergenic4.Once it polymerized it is not allergenic5.In most dyed hair there is unpolymerized hair dye

p-Phenylenediamine (PPD)p y ( )1.Allergic contact dermatitisg2.Contact urticaria3 Systemic contact dermatitis (drugs of the para group)3.Systemic contact dermatitis (drugs of the para group)4.Purpuric allergic contact dermatitis5.Erythema multiforme –like reaction 6.Vitiligo g7.Rosacea –like eruptions8 Photo contact dermatitis8.Photo contact dermatitis9.Burning mouth syndrome


S t i id ff tSystemic side effectsIn Sudan – mix of “black powder” with henna p20 patients with toxicity – some fatal

Suicidal intent by ingestiony g


Systemic side effects1 Angioneurotic edema edema of the face lips1.Angioneurotic edema-edema of the face ,lips,

glottis,pharynx and bronchi-within hours2.Anuria and acute renal failure – second day3 Death – third day3.Death – third day

Oxidative dye componentsrelated to PPD

p-Phenyleneamine diaminep-Toluenediaminepp-Aminodiphenylamine2 4 Di i i l2,4-Diaminoanisoleo-Amino-phenol1,4-Benzenediaminep-Aminoanilinep-Aminoaniline

PPD freeColoro does not contain para-phenylenediamine (PPD), which is one of the most important oxidation intermediaries used in permanent hair colors.

It has been substituted with para toluenediamine (PTD)para-toluenediamine (PTD).This intermediary means that cases of product intollerance can be greatly reducedintollerance can be greatly reduced.

Redlick, F. et al. CMAJ 2007;176:445-446, ;

Hair dye contact dermatitisHair dye contact dermatitisChemicals that may cross-react with PPD:1.Sunscreens PABA and padimate O2.Antiinfectives Sulfonamides and p-aminosalicylic acid3.Diuretics Thiazides4.Anesthetics Benzocaine and related “caines”5.Textile dyes Azo dyes6.Antidiabetics Sulfonylureas7.COX-2 inhibitors Celecoxib8.Rubber accelerators N-isopropyl-N-phenyl-p-phenylenediamine9.Black rubber mix

p-Phenylenediamine (PPD)p y ( )Sources of exposure540 ti t t t d i B il540 patients tested in Brazil23 (4.2%) positive to PPD

Hair dye – 48% yRubber – 17%Black shoes – 17%Black shoes 17%Elastic – 9%Makeup 9%Makeup -9%

Dermatitis 2008,19 :342

p-Phenylenediamine (PPD)p y ( )Sources of exposure83030 patients tested in UK p e s es ed U3307 (3.9%) positive to PPD

Hair dyes in clients -22% (0.2% general population)Occupational exposure- hairdressers, paint and rubber exposure –

23% (0 22% general population)23% (0.22% general population)Clothing and shoes -12% ( 0.12% general population)

Could not identified -44%

Br J Dermatol 2008 159:379 386Br J Dermatol 2008,159:379-386

p-Phenylenediamine (PPD)p y ( )Chemical leukoderma864 patients in India74% contact area 26% spread to remote areas41% face, 6% scalp Etiologic agents :

hair dyes 27%perfume 22%detrgents 15%rubber 9%black socks and shoes 9%

Br J Dermatol 2009,160:40-47

p-Phenylenediamine (PPD)p y ( )Patch test kit for use by hairdressers Colourstart kit3/7 patients allergic to PPD detected by kit3/7 patients allergic to PPD detected by kit1 patient allergic to toluene-2,5-diamine was not

detected

Br J Dermatol 2007, 157:1017-1020


U d d l f f i f Unconsumed precursors and couplers after formation of oxidative hair dyes. Contact Dermatitis 2006,55:95-100

“ The consumers are thus exposed to precursors and couplers of oxidative hair dyes , both during and after hair dyeing , when the hair is washed .”y g

Diagnosis of hair dye dermatitisg y

Standard patch test : 4-phenylenediamine base

Hairdressing patch testHairdressing patch test

Hairdressing series

1. 4-Phenylenediamine base* 1.0 pet P0062. 2,5-Diaminotoluene sulfate 1.0 pet D0023. 2-Nitro-4-phenylenediamine 1.0 pet N0044. Ammonium thioglycolate 2.5 aq A0125. Ammonium persulfate 2.5 pet A0116. Formaldehyde* 1.0 aq F002A7. Nickel sulfate* 5.0 pet N002A8 C b lt hl id * 1 0 t C017A8. Cobalt chloride* 1.0 pet C017A9. Resorcinol 1.0 pet R00110. 3-Aminophenol 1.0 pet A00811 4 A i h l 1 0 t A00911. 4-Aminophenol 1.0 pet A00912. Hydrogen peroxide 3.0 aq H00613. Hydroquinone 1.0 pet H00714 Balsam Peru** 25 0 pet B00114. Balsam Peru 25.0 pet B00115. Chloroacetamide 0.2 pet C00616. Glyceryl monothioglycolate (GMTG) 1 0 pet G0041.0 pet G00417. Cocamidopropylbetaine 1.0 aq C01818. Cl+Me-isothiazolinone

Hairdressing series cont’

19. 2-Bromo-2-nitropropane-1,3-diol(Bronopol) 0.25 pet B015A( )20. Captan 0.5 pet C02521. 4-Chloro-3-cresol (PCMC) 1.0 pet C00822. 4-Chloro-3,5-xylenol (PCMX) 0.5 pet C010A23. Imidazolidinyl urea (Germall 115) 2.0

t 001Apet 001A24. Quaternium 15 (Dowicil 200)* 1.0 pet C007A25 Zi ithi (Zi di ) 1 0 t25. Zinc pyrithione (Zinc omadine) 1.0 pet Z00626. 2,5-Diazolidinylurea (Germall II) 2.0 pet D044AD044A27. Lauryl glucoside 3.0 pet L-004

Genetics in PPD sensitivity

PPD sensitivity in identical twinsDermatitis 2007 ,18:56-57

Rapid acetylation -53% PPD positive vs. 37% controlInt J Dermatol 2006,45:323-326,

TNFA-308 genetic polymorphism more common in PPD positive patients than controlp p

Allergy 2009 ,64:279-283

Prevention

Do not use temporary tattooing with black hennahenna

Test oxidative dyes before usePPD-sensitive patients have to use non-

oxidative hair dyesyBe careful with cross- reacting chemicals or

drugsdrugs

Occupational dermatosis in h i dhairdressers

Germany – 242/10,000 in hairdressers11 9/10 000 i l k11.9/10,000 in metal workers

Netherlands -32.8/100 person-years in hairdressers14 5/100 person ears in n rses14.5/100 person-years in nurses

Hair dye contact dermatitis

Occupational dermatosis in hairdressershairdressers

Prevalence of CD in hairdressers

16.9% - 83%16.9% 83%

Arch Dermatol 2006, 142 :362-364

O ti l d t i iOccupational dermatosis in hairdressershairdressers

Safe hairdressing practice Safe hairdressing practice1.skin care of the hands

wash the hands as little as possibledrying with a dry towel ,not with hot-air drieruse a water-resistant skin cream every morninguse the cream several times a dayy

2.protection of the hands during workuse gloves for: hair washing using hair bleachuse gloves for: hair washing ,using hair bleach,

using hair dyes ,setting a perm

Occupational dermatosis in hairdressers

Safe hairdressing practice 3 wearing a jewellery3.wearing a jewellery

use earrings made of synthetic materials, stainless steel silver or goldstainless steel ,silver or goldget rid of nickel containing parts of clothing ,watches or jewellery

4.cleaning of instruments and materials

Temporary tattoo and PPD ysensitization

Henna:Henna: Lawsonia Inermis

• Henna is a small tree that grows in many countries.

• There are henna traditions in North and East Africa, the Middle East, and South Asiaand South Asia.

• There are many words for henna: mehandi mehndi camphire andmehandi, mehndi, camphire, and kopher.

• The word for the art form is theThe word for the art form is the same as the word for the plant.

http://www.hennapage.com © 2005

Henna is used on brides for their weddings in India, the Middl E t d Af iMiddle East and Africa.

• The “Night of the Henna” is the oldest and most famous henna celebration.• Both men and women have a “Night of the Henna” just before their

marriage.• Henna is supposed to be lucky for a bride, and to make her beautiful.• Hindu, Sikh, Muslim and Jewish brides have a “Night of the Henna”.


NEVER make a temporary tattoo with black hair dye!

• Henna is NOT black!Henna is NOT black!• Some people use para-

phenylenediamine to make “black henna” This can cause severe allergichenna . This can cause severe allergic reactions, with blistering and permanent scarring.

• Do not ever get a “black henna” tattoo!Do not ever get a black henna tattoo! Use only safe, natural, red-brown henna.Learn more about the dangers of “black henna” at: http://www.hennapage.com/henna/ppd/index.html


Textile dermatitis and PPD sensitizationsensitization

Self reported textile related skin problems: Self –reported textile-related skin problems: CD to PPD – 2.1 ORCD to textile dye mix – 1.9 0R

Br J Dermatol 2009 ,160:107-115

PPD sensitive patients :46% reacted to Disperse Orange 322% reacted to Disperse Yellow 3% eacted to spe se e ow 3

Contact Dermatitis 2003,48:248-250

Future תאי הנבט של זקיק השערה מאותתים לתאי הנבט

באמצעותהמלנוציטריים השערה בבסיס מלנין ולהפריש לפעול לפעול ולהפריש מלנין בבסיס השערה באמצעות המלנוציטריים. Wntחלבון

את מחדש אינו השיער מתקיימת אינה האינטראקציה אם אם האינטראקציה אינה מתקיימת השיער אינו מחדש את.צבעו

החלבון פעולת את שיחזק עתידי טפול Wיתכן tלכל ויאפשר יתכן טפול עתידי שיחזק את פעולת החלבוןWnt ויאפשר לכל.שיער שחור לנצחהמעוניין להישאר עם

cell 2011;145:911.

hair dye contact dermatitis y

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