Synthetic hair extensions causing irritant contact dermatitis in patients with a history of atopy: A report of 10 cases

Abstract

BackgroundWe present a case series of 10, atopic, African women who developed irritant contact dermatitis (ICD) from synthetic hair extensions.MethodsTen consecutive African female patients who presented with a pruritic cutaneous eruption on the neck over a period of 2 years are described. Patients underwent skin patch testing using both standard and hair commercial patch test panels and samples of their own hair extensions. Hair care products were not tested.ResultsAll 10 patients used synthetic hair extensions. A strong history of atopy was documented for all the patients and examination was significant for eczematous, lichenified plaques at the location of contact with the free end of the hair extension. Patch test results yielded no relevant reactivity and a diagnosis of ICD was made for all patients. The lesions resolved completely on removal of the hair extensions and the use of topical steroids and emollients, dependent on eczema severity.ConclusionsArtificial hair extensions should be considered as a potential irritant, resulting in ICD. Patients with a history of atopy are at risk of developing ICD from synthetic hair extensions.

Review of hair prosthetic options for patients with alopecia

“…Patients presenting with sudden eruption of a rash restricted to areas of glue adhesive application should raise concern for allergic contact dermatitis. Synthetic hair fibers have also been linked to allergic dermatitis 16 . This can manifest as a pruritic eczematous rash localized to areas of contact such as the nape or any location with contact to the free end of the hair fibers.…”

“…Synthetic hair fibers have also been linked to allergic dermatitis. 16 This can manifest as a pruritic eczematous rash localized to areas of contact such as the nape or any location with contact to the free end of the hair fibers. If a prosthesis must be applied via glue, a water-soluble glue would be a safer option.…”

Considerations and recommendations on camouflage in alopecia in Black women

“… 5 Additionally, some patients may develop contact dermatitis to the material composition of synthetic weaves. 12 …”

“… 32 Patients should be made aware of the potential for irritant contact dermatitis with synthetic hair. 12 Studies have shown Black patients are significantly more sensitized to para-phenylenediamine (PPD), a chemical found in hair dyes, compared to White patients. 12 PPD is the most common allergen in hair dye, with darker-colored dyes containing higher levels of PPD.…”

“… 12 Studies have shown Black patients are significantly more sensitized to para-phenylenediamine (PPD), a chemical found in hair dyes, compared to White patients. 12 PPD is the most common allergen in hair dye, with darker-colored dyes containing higher levels of PPD. It is hypothesized that Black individuals are more sensitized to PPD given their propensity to select darker shades of hair dye compared to White individuals.…”