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

Andrew Scheman; Christina Cha; Manpreet Bhinder

Disclosures

Dermatitis. 2011;22(4) 

In This Article

Conclusion

The vast majority of reactions to hair-dye products are caused by PPD.[4–6] In past years, PPD was used in permanent hair dyes but not in semipermanent dyes. More recently, PPD has been used in most permanent, demipermanent, and semipermanent hair-dye products.[1,2] Some manufacturers have recently started to produce permanent and demipermanent dyes using PTDS instead of PPD (Table 4). These newer products are cosmetically elegant and could potentially provide an excellent alternative for PPD-allergic patients who are not allergic to PTDS. The PPD-free PTDS-based hair dyes were recommended to all 13 subjects of this study who were seen since January 2008. Ten of these 13 subjects used the recommended dyes, and none of these subjects experienced any adverse reaction.

Based on this series of patients, we estimate that about 57% of patients allergic to PPD will tolerate the newer permanent and demipermanent hair coloring products based on PTDS. Although these products do contain other coloring agents, patch testing indicated that most individuals who do not demonstrate an allergy to PTDS will also have negative reactions to the other dye substances in the hair dye series. In our study, only 1 of 27 individuals who tested negative for allergy to PTDS had positive reactions to any of the other substances in the hair dye series.

One limitation of our study is that most hair dyes contain other potentially allergenic ingredients that are not included in the current hair dye series. (These potential allergens were listed in a recent review article on this subject.)[7] It is possible that patients who test negative to PTDS will be allergic to one of these ingredients. We recommend that the hair dye series be expanded to include these potential allergens.

Another limitation of this study is that it is possible that individuals who initially tolerate the new PTDS-based hair-dye products will eventually have cross-reactions to PPD since PTDS and PPD are closely related chemicals. However, five of this study's subjects have been regularly coloring their hair for at least 1.5 years with the PTDSbased hair dyes without any adverse reactions.

We recommend that individuals who demonstrate contact allergy to PPD be tested with a complete hair dye series. If that series is unavailable, these individuals should at least be tested for allergy to PTDS. Patients who are allergic to PPD but test negative for allergy to PTDS will very likely tolerate the newer permanent and demipermanent PPD-free hair-dye products based on PTDS. Although patients who are patch test negative to PTDS will likely tolerate the new PTDS-based hair-dye products, we strongly caution that a negative patch-test reaction to any proposed PTDS-based hair dye should be obtained before the patient actually uses any of these products.

These PTDS-based products represent the first cosmetically elegant alternative hair-dye products for individuals allergic to PPD. Although approximately 43% of the patients in this study will not be able to tolerate them, a substantial number of individuals allergic to PPD will benefit from the availability of these new products.

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