Materials added to henna can cause reactions, scarring of skin, other health problems
The Minnesota Department of Health (MDH) is warning against use of henna products that contain additives to create “temporary tattoos.”
Materials that are sometimes added to henna can cause allergic reactions in some people when applied to the skin, and cause people to develop lasting chemical sensitivities, according to MDH officials.
One of the most commonly used additives – and one that is of particular concern – is paraphenylenediamine (PPD).
PPD is used as a darkening agent to create “black henna.” PPD is approved by the U.S. Food and Drug Administration (FDA) for use in hair dye, but not in cosmetics that are applied directly to the skin. It is known to cause allergic skin reactions in some people, resulting in intense itching, redness of the skin, blistering, infections, and – in some cases – permanent scarring. In some individuals, the scarring can be accompanied by light or dark patches on the skin.
In addition, an allergic reaction to PPD in a henna product used on the skin can set the stage for allergic responses to similar chemicals later on, including ingredients in hair dye, sunscreen and medications.
Pure henna is a red or brown dye derived from the dried leaves of the henna shrub, and commonly used as a hair coloring agent. Although not approved by FDA for direct application to the skin, henna is commonly used for temporary tattoos. Allergic reactions from use of pure henna on the skin have rarely been reported.
However, MDH advises against getting henna tattoos for infants or young children – even if pure henna is used – and the agency is also cautioning people about getting tattoos with henna preparations that may contain other ingredients.
MDH has been investigating reports of allergic skin reactions in a group of 35 Twin Cities eighthgraders who had been given temporary tattoos using a dark-colored material. About half of the children had skin reactions, which included blistering and weeping lesions. In most cases, the lesions appeared within 20 days of getting the tattoo, and half occurred within 7 days.
The children were treated with creams, including steroid containing creams, and three children were given oral antibiotics. Although the material used for the tattoos was described as black in color, MDH has not determined as yet whether it contained PPD or other additives. However, MDH officials say this episode underscores the need for caution before getting a henna tattoo.
Consumers purchasing henna to create their own tattoos should check product labels to see if these products contain PPD or other additives before applying them to the skin. They should be especially leery of any products that appear to be black in color. By law, ingredients must be listed on the label of all retail cosmetics.
Henna tattoos are frequently offered by vendors at salons, or at venues like public celebrations, fairs or festivals. People who consider getting a henna tattoo – for themselves or their children – should make sure the vendors are not using products that contain PPD or other additives. Vendors are urged to check with suppliers, and verify that they are only using additive-free henna. PPD-containing henna products can cause a reaction in as little as 24-48 hours if an individual has previously been exposed to PPD. Reactions to “black henna” more commonly occur 4-10 days after the product is applied, but can occur up to three weeks later.
People who believe they are having a reaction to PPD should contact their health care provider. PPD reactions can also be reported to the Minneapolis office of FDA at (612)758-7221.
Questions and Answers
Additives Used in Henna Tattoo Materials – Potential Health Concerns
What is henna?
Henna is red or brown dye that is typically derived from the dried leaves of the henna shrub (Lawsonia inermis). In the United States, according to the U.S. Food and Drug Administration (FDA), henna is approved for hair dye only. Henna is used in direct application to the skin for temporary tattoos, in particular for decorating hands and feet. Dried leaves are ground into a fine powder and mixed with oil or water to make a paste which is applied to the skin. Allergic reactions from pure henna are rarely reported. It is not advised that henna be used with infants or young children.
What is black henna? What is PPD?
Other ingredients can be added to henna to darken the color and lengthen the time that the tattoo is visible. This is referred to as “black henna.” One of the additives frequently used to make a darker color, is para-phenylenediamine, an ingredient in hair dye. Para-phenylenediamine or PPD (this is not the PPD or purified protein derivative used in tuberculosis testing) is not approved for direct use on the skin. PPD in cosmetics directly applied to the skin can cause allergic reactions that can result in intense itching, redness of the skin, blistering and in some cases scarring. (Reactions can also occur from hair dye, although the concentration in hair dye may differ from what is used in “black henna” and dye is usually washed out within 30 minutes, so it does not have prolonged contact with skin). Some individuals with skin reactions develop scars with lighter or darker patches of skin. Scars can last months or be permanent in some cases. Individuals who have sensitivity to PPD may have allergic reactions later on to substances that are similar chemically which may be in a variety of products including hair dyes, sunscreens and medications.
What about other additives to henna?
Allergic reactions from the use of pure henna products on the skin have rarely been reported. A variety of other additives may be in a henna product and may cause an allergic reaction.
How do I know what is in a temporary tattoo product?
Retail cosmetics must list ingredients on the label. The requirement for listing ingredients does not apply to products used exclusively by professionals for application at a salon, booth or fair. Consumers are advised to inquire what is in a henna product. Artists and vendors are advised to check with suppliers regarding the ingredients in a product.
When do reactions occur?
If someone has been sensitized (previously exposed) to PPD, and the product contains PPD, a reaction may occur in 24-48 hours. Most reactions to “black henna” occur 4-10 days after the application, but reactions can occur up to 3 weeks later. Allergic reactions to other compounds may also occur quickly if there was a prior exposure or develop later (often within 10-14 days).
What can be done?
If a reaction is suspected, please see your healthcare provider promptly. Consultation with a dermatologist may be helpful. In addition to a possible reaction to the product, it is important to check that there is not also an infection.
How do I report an adverse reaction to a temporary tattoo?
You can contact the Minneapolis FDA district office at (612)758-7221.
See the FDA Website for more information.