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Abstract: The epidemic of Para-phenylenediamine Sensitization

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Clients and stylists are generally aware that a person can develop an allergy to chemical hair dye. Most people and most stylists expect the number of allergic reactions to be very small, and the allergies to be mild. This has been the case for the decades because hair dyes were limited to a maximum of 6% para-phenylenediamine content. At 6%, a person can dye their hair with oxidative hair dye for a number of years with little problem, particularly if a stylist is careful to keep dye off the scalp. The diamine-based dyes pass quickly through the scalp skin into the blood stream, and circulate through the body on their way through to excretion.

What is the risk to the home user of, and to the stylist who applies chemical hair dye? In day to day practice, few people and few home users do a patch test before proceeding to dye hair. Patch tests may require 8 days to show reaction. One or two days wait after a patch test is simply not long enough; para-phenylenediamine causes a delayed hypersensitivity reaction, similar to poison ivy. A patch test, itself, may initiate sensitization. Sensitizations may gradually build up over exposures; a person who has used hair dye for years may have a sudden onset of sensitization. Pauley Perette, a blonde actress who dyed her hair black, gradually developed an allergy to chemical hair dye that hospitalized her. Her case is typical of long-time users of oxidative hair dye. She tweeted to her fans after she had a severe reaction,

“Wasn’t sure if I should tweet about this, but it’s important. Did my head look a big puffy on the red carpet last night? Turns out I was having a dangerous allergic reaction to hair dye. Been battling this for a year now, but it gets worse every time. It’s an acquired allergy for people that dye their hair for years (Y’all know I’m blonde) Was in ER. Just got home from hospital. Awful. My head swelled up huge like a melon. If you or someone you know dyes their hair, especially black, please google “hair dye allergy”. Know the symptoms. It can be fatal. People have died. For real.”

Before you mix and apply hair dye, ask every client should be asked whether they have ever had a temporary tattoo. If the client responds, “yes,” ask if the stain was black in less than two hours after the paste was removed. If the client responds, “Yes, the stain was black when I removed the paste,” do NOT apply oxidative hair dye to that person. The likelihood of a severe reaction requiring hospitalization is too high to risk. Do not even patch test that client; a patch test could cause an extremely painful allergic reaction. Simply formulate Ancient Sunrise® henna, indigo, and cassia to the color the person wishes. Dye their hair without chemicals. You can use Ancient Sunrise® a sensitized client without harm.

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