Occupational and non‐occupational allergic contact dermatitis to hair dyes in Greece. A 10‐year retrospective study

Abstract

Background Oxidative hair dyes are an important source of chemical exposure and a major risk factor for the development of occupational and non‐occupational allergic contact dermatitis (ACD) worldwide. Objective To identify the frequency of common allergens associated with occupational and non‐occupational ACD to hair dyes during the last 10 years, in Greece. Methods We retrospectively reviewed the medical records of patients with suspected ACD to hair dyes from 2010–2019. All patients with patch‐test‐confirmed ACD to hair dyes were evaluated. Results Out of 501 patients with suspected ACD to hair dyes, 362 had at least one positive reaction to hair dye allergens (62.4% were customers and 37.6% were hairdressers). The mean age of customers and hairdressers was 43.8 years and 30.8 years, respectively. Of the customers, 58.9% were exposed to dyes for >10 years and 61% of hairdressers for <5 years. The most common site of ACD among customers was the scalp (85%) and among hairdressers the hands (90%). p‐Phenylenediamine (PPD) was the most common contact allergen (52.2%), followed by toluene‐2,5‐diamine, p‐aminophenol, m‐aminophenol, and ammonium persulfate. Conclusions Sensitization prevalences for PPD and cross‐reacting allergens have increased in Greece during the last decade, regardless of occupational or non‐occupational exposure to hair dyes.

Occupational allergic contact dermatitis: A 24‐year, retrospective cohort study from Turkey

“…The most common occupational allergens for hairdressers in our study were PPD, toluene‐2,5‐diamine sulfate (PTD), and other para‐group hair dye allergens, and ammonium persulfate in hair bleach, similar to previous reports 29,30,33,35,37‐40 . Ammonium persulfate was the predominating allergen in some studies 38 .…”

“…Hairdressers were the second most common occupational group in our series. Hairdresser apprentices were almost as frequently sensitized to hairdresser chemicals as professionals in our study, accounting for the young age and early onset of OACD, a well‐defined feature for hairdressers 29‐32 As an exception to the literature, 30‐36 male patients predominated among hairdressers in our series because men are more frequently employed as hairdressers in Turkey. Atopics were slightly more frequent among hairdresser apprentices than professionals, supporting the so‐called “healthy worker effect,” which indicated those who leave their job at an early stage of occupation due to atopy‐related morbidity 30,34 …”

“…Hair dyes seemed to be the primary sensitizer as black henna tattoos were present in the history of only a minority. Angioedema‐like periorbital edema as an often‐misdiagnosed specific pattern of ACD from PPD/hair dyes was present in a higher percentage (20%) of patients than was previously reported 33,41 …”

Occupational allergic contact dermatitis from ammonium persulfate in a hairdresser

“…Ammonium persulfate (or AP) is one of the main culprits of ACD in hairdressers; this has been demonstrated on several series in which this allergen has shown positive results in a greater proportion of hairdressers when compared with controls and customers 1‐3 . ACD in hairdressers is commonly observed as hand eczema, whereas other topographies are affected in a lower proportion of patients, which makes the use of gloves an important part of the preventive measures 4 .…”

Hair Dye Ingredients and Potential Health Risks from Exposure to Hair Dyeing

“…The presence of contact allergies is closely attributed to the potent skin sensitizers contained in hair dyes, such as aromatic amines including PPD, a prevalent hair dye ingredient. 43 However, using permanent hair dyes containing PPD at concentrations ≤0.67% is unlikely to induce skin sensitization. 44 Recently, Goebel and co-workers 45 found that a methoxymethyl side chain introduced into PPD not only reduced the sensitizing intensity and the risk of allergic induction but also resulted in excellent hair coloring performance.…”