Hair Dye Allergy - Symptoms, Causes, and Treatments

Phenylenediamine (PPD) Allergy

Hair Dye Allergy
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The use of hair dye has been on the increase over the past 20 years in many parts of the world. In the United States, women are using hair dye earlier and more frequently in an attempt to maintain a more youthful appearance. The same can be said of men in the U.S., who have seen a 25% increase in the use of hair dye in recent years. A similar pattern is seen in many other areas around the world, including the Far East and Europe.

Causes of Hair Dye Allergy

Along with the increased use of hair dye has come an increased rate of allergic reactions to hair dye. The chemical in hair dye most likely to cause allergic reactions is para-phenylenediamine (PPD). PPD is found in more than two-thirds of permanent hair dyes, and is very effective at penetrating the hair shaft and follicle, as well as binding to proteins in the skin. These characteristics make PPD a potent contact antigen able to induce allergic reactions. For this reason, some European countries, including Germany, France and Sweden, have banned PPD.

Other chemicals found in hair dye known to cause allergic reactions include cobalt, which is found in some brown hair dyes, and glyceryl thioglycolate, found in permanent wave solutions that may be used in conjunction with hair dye.

Symptoms of Hair Dye Allergy

Common symptoms of hair dye allergy include contact dermatitis (an itchy, flaky red rash) that most often occurs on the face, eyelids, ears and neck.

Rashes on the scalp are less common due to the thickness of the skin on this area of the body. It is not uncommon for severe facial swelling to also occur with contact dermatitis to hair dye, which may be mistaken for angioedema. Angioedema, however, unlike contact dermatitis, is not red, does not itch, usually only occurs on one side of the face at a time, and does not peel or flake.

Symptoms of a hair dye reaction most often occur within 2 to 3 days after a person colors his or her hair. However, symptoms may last for days to weeks after the last time a person dyed their hair.

Diagnosis of Hair Dye Allergy

The diagnosis of hair dye allergy is made with the use of a patch test, using a standard panel that includes para-phenylenediamine. A patch test involves the placement of antigens onto the skin, held in place with paper tape. The patch is left in place typically for 48 hours, with the results being interpreted both at the time the patch test is removed, as well as either 24 or 48 additional hours later. A positive patch test result is found when small, red bumps or blisters are present at the site of the test.

Treatment of Hair Dye Allergy

The main treatment of hair dye allergy is avoidance of the chemical responsible for the allergic reaction. If the antigen can be identified, it can be avoided, and a person may be able to continue to use hair dye that does not contain that antigen.

Once an allergic reaction to hair dye has occurred, the main treatment involves the use of corticosteroids. If the reaction is mild and limited to a small area of the body, topical corticosteroid creams can be used. Topical corticosteroids should be used with caution on the face, given the concern for serious side effects with long-term use. Treatment of facial rashes is better treated with safer topical medicines, such as Elidel and Protopic. More severe rashes caused by hair dye allergy are best treated with systemic corticosteroids, either given in pill form or as an injection.

Learn more about the causes of cosmetic allergy.


McFadden JP, White IR, Frosch PJ, et al. Allergy to Hair Dye. BMJ. 2007;334:220.

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