Alternative Hair-dye Products for Persons Allergic to Para-phenylenediamine

Andrew Scheman; Christina Cha; Manpreet Bhinder


Dermatitis. 2011;22(4) 

In This Article


Of the 28 patients allergic to PPD who were seen from October 2006 through October 2010, 16 (57.1%) tested negative to all of the other substances on the hair dye series. Eleven of the 28 patients tested positive to PTDS. Of these 11 patients, several were also found to be allergic to other substances in the hair dye series (6 were allergic to paraaminophenol, 5 were allergic to ortho-nitro-PPD, and 4 were allergic to meta-aminophenol). None of the 28 patients in the study were allergic to resorcinol. Finally, one patient was allergic only to ortho-nitro-PPD and not to PTDS.

Seven additional PPD-allergic patients seen from January 2004 through October 2006 had similar patchtest results. Four (57.1%) of these 7 patients tested negative to PTDS. When these patients' results were combined with those of the previously mentioned 28 patients, 20 (57.1%) of the total 35 patients tested were found to have had positive reactions to PPD but negative reactions to PTDS.

Starting in January 2008, all patients with a positive patch-test reaction to PPD and negative patch-test reactions to PTDS and the rest of the hair dye series were advised to try one of the new PPD-free PTDS-based hairdye products. Thirteen of the 35 subjects in this study were seen after January 2008. Eight of these individuals had +++ reactions to PPD; the remaining five had ++ reactions to PPD (Table 2). Ten of these individuals reported having used one of the new PTDS-based hair-dye products; none of these individuals reported any adverse reactions. Of the 10 subjects who tolerated the PTDS-based hair-dye products, six had +++ reactions to PPD and the remaining four had ++ reactions to PPD. Three of the 13 subjects seen after January 2008 elected not to try the recommended hair-dye products.

We also did an analysis to further determine if subjects with strong patch-test reactions to PPD were likely to be able to tolerate the newer PPD-free PTDS hair dyes. A comparison of the intensity of reactions to PPD and PTDS is shown in Table 3. Almost half (10 of 21) of the subjects with who had +++ reactions to PPD had no reaction to PTDS.


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