Household Hazards

How everyday products make us sick.

Is Black the True Color of Your Love’s Hair?

The potential problems of a common hair dye

Everyday household items may not be completely hazard-free. But there is a general perception (or misperception) that gratuitously toxic products are more or less kept in check. We presume that this is accomplished through market restrictions that protect us from misadventure: we can’t hurt ourselves with something we can’t buy in the first place. We count on watchdog governmental agencies to guard us or, failing that, bet that a healthy fear of legal liability keeps at bay would-be purveyors of unhealthy goods. Not the best of all possible worlds, maybe, but a system that works. Here is a cautionary tale of a toxic hair product countering that Panglossian view: not a parable of a pricey Brazilian blow-out, but rather a humbler narrative about a basic black dye called paraphenylenediamine.         

First, a personal disclaimer on the substance or appearance of a conflict of interest: I don’t color my hair, but I did once get a temporary henna tattoo on a beach in Brazil. Lest this seem to carry personal disclosures too far, a temporary tattoo on the forearm is not merely emblematic of too much cachaça in the tropical sun, it is directly relevant to the hazard at hand.  Paraphenylenediamine, which also goes by the initials “PPD,” is a relatively inexpensive chemical with longstanding and widespread use as a black dyestuff. PPD has many industrial applications but it is its common cosmetic use, both in hair dyes and in “black-henna” temporary tattoos, that is critical here.

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For nigh on a hundred years, PPD has been infamous for its allergy-causing potential. Due to expanding markets, by the early 1930s this had become a huge consumer problem. The most disastrous effects were linked to PPD-laced mascara (Lash-Lure was the brand of choice). Despite the severe illnesses, including blindness, that that product caused, the U.S. Food and Drug Administration (FDA) remained powerless to step in until its legislative authority to do so was finally established after years of Congressional debate (AboutFDA/WhatWeDo/History/Origin). Not only did new labeling rules require recommendations for skin allergic testing before use (albeit but not by a doctor), eye lash dyes with PPD were banned outright (although not, of course, PPD in hair dyes). 

The main allergic problem from PPD is called contact dermatitis. In 2006, nearly four decades after FDA controls, the American Contact Dermatitis Society still felt this was a persisting issue of sufficient scope to name PPD its “contact allergen of the year” (contactderm.org). Contact dermatitis is condition causing the skin to erupt in a red, itchy, and painful rash. Poison oak, which contains a natural and potent chemical sensitizer, induces a classic form of contact dermatitis. Paraphenylenediamine, a wholly manmade substance, is no less a powerful sensitizer, a classic in its own right.  Metaphorically, if pastoral poison oak is the Beethoven of contact dermatitis, PPD is its Wagner, a la Götterdämmerung.                  

The walls have come crashing down a lot with PPD. It’s one thing if you get it on your skin once you have become allergic to it, that’s not new. What’s changed over time is that drinking the hair dye chemical has emerged as a popular method of attempted suicide in various parts of Africa and Asia. The victims of such ingestion are severely ill: complications include kidney failure, muscle breakdown, and interference with the blood’s ability to carry oxygen.  The most acutely life-threatening manifestation, however, is called angioedema. This leads to a rapid and profound allergic swelling of the face and neck that chokes off breathing.

Why has this become such a problem? There was no medical notice suicide by PPD at all until 1982; one year later, the Lancet carried a medical report of 24 cases out of the Sudan. The authors noted that it was the widespread availability of the dyestuff, sold in markets as a powder or in lumps, that contributed to suicidal use.  The same theme continues to be echoed in all too frequent medical case reports of this type of poisoning that continue to appear. The main change is that the market for PPD has morphed from powder and lumps into colorfully packaged but still relatively cheap consumer goods. In India, the brand of choice for suicide seems to be Super Vasmol (sometimes vasomol in medical reports).  One internet marketing huckster boasts: “Super Vasmol Aamla Herbal based Powder is a unique herbal combination that darkens your hair naturally to give it natural black colour…. enriched with the goodness of herbal ingredients like Aamla and Bhringraj that helps to revitalise, darken hair and prevent hairfall. Super Vasmol Aamla Herbal based Powder also has Mehendi, Jatamansi and Jasund which nourish and condition your hair to make it look shiny and lustrous.”  By the way, mehendi, jatamansi and jasund (henna, spikenard, and hibiscus) may be ok, but this “herbal-based” snake-oil also carries a hefty wallop of PPD.

Don’t take too much comfort in the fact that Super Vasmol marketed is so far away. It doesn’t take much time surfing on the web to find internet sites to order for U.S. delivery.  Nor is there a lack of homegrown products if you are committed to toxins made-in-the-USA. On the net it’s not always so easy to figure out which cosmetic products contain PPD (as opposed to more exotic sounding components such as “bamboo extract”), but the FDA-mandated warnings (fda.gov/Cosmetics/ProductandIngredientSafety) are a dead giveaway. This one takes me back to my beach disclosure,  “BLACK HENNA TATTOO: IF YOU HAVE EVER HAD A BLACK HENNA TATTOO, even a long time ago, you are very likely to have become allergic without realizing it. Take no risk. Never use this product unless you have done the skin allergy test, 48 hours before use.”

Paul D. Blanc, M.D., M.S.P.H., is Professor of Medicine and Endowed Chair in Occupational and Environmental Medicine at the University of California San Francisco.

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