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Public warned against use of additives in henna used to create temporary tattoos

The Minnesota Department of Health (MDH) is warning against use of henna products that contain additives to create "temporary tattoos."

Materials that are sometimes added to henna can cause allergic reactions in some people when applied to the skin, and cause people to develop lasting chemical sensitivities, according to MDH officials.

One of the most commonly used additives - and one that is of particular concern - is para-phenylenediamine (PPD).

PPD is used as a darkening agent to create "black henna." PPD is approved by the U.S. Food and Drug Administration (FDA) for use in hair dye, but not in cosmetics that are applied directly to the skin. It is known to cause allergic skin reactions in some people, resulting in intense itching, redness of the skin, blistering, infections, and - in some cases - permanent scarring. In some individuals, the scarring can be accompanied by light or dark patches on the skin.

In addition, an allergic reaction to PPD in a henna product used on the skin can set the stage for allergic responses to similar chemicals later on, including ingredients in hair dye, sunscreen and medications.

Pure henna is a red or brown dye derived from the dried leaves of the henna shrub, and commonly used as a hair coloring agent. Although not approved by FDA for direct application to the skin, henna is commonly used for temporary tattoos. Allergic reactions from use of pure henna on the skin have rarely been reported.

However, MDH advises against getting henna tattoos for infants or young children - even if pure henna is used - and the agency is also cautioning people about getting tattoos with henna preparations that may contain other ingredients.

MDH has been investigating reports of allergic skin reactions in a group of 35 Twin Cities eighth-graders who had been given temporary tattoos using a dark-colored material. About half of the children had skin reactions, which included blistering and weeping lesions. In most cases, the lesions appeared within 20 days of getting the tattoo, and half occurred within 7 days.

The children were treated with creams, including steroid containing creams, and three children were given oral antibiotics. Although the material used for the tattoos was described as black in color, MDH has not determined as yet whether it contained PPD or other additives. However, MDH officials say this episode underscores the need for caution before getting a henna tattoo.

Consumers purchasing henna to create their own tattoos should check product labels to see if these products contain PPD or other additives before applying them to the skin. They should be especially leery of any products that appear to be black in color. By law, ingredients must be listed on the label of all retail cosmetics.

Henna tattoos are frequently offered by vendors at salons, or at venues like public celebrations, fairs or festivals. People who consider getting a henna tattoo - for themselves or their children - should make sure the vendors are not using products that contain PPD or other additives. Vendors are urged to check with suppliers, and verify that they are only using additive-free henna. PPD-containing henna products can cause a reaction in as little as 24-48 hours if an individual has previously been exposed to PPD. Reactions to "black henna" more commonly occur 4-10 days after the product is applied, but can occur up to three weeks later.

People who believe they are having a reaction to PPD should contact their health care provider. PPD reactions can also be reported to the Minneapolis office of FDA at (612) 758-7221.