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Henna body art, unexpected reaction!

Recently we tended to a pacient with a curious lesion in her foot and arms, dued to a henna body art she made in a trip, a so-called tattoo that last for a few days and so it disappears like it never was there. Henna is a red tye prepared from the leaves of a plant that grows in Africa and Asia, and it is used since bronze age to dye hair, nails and skin.

Henna tattoo is not really a tattoo because it is made over the skin, without piercing it to inoculate any ink and it is also temporary, because it completely disappears after 5 or 15 days since its application, depending of the zone and the care that we take of it. Henna body art is made with a henna paste that must remains about 12 hours on the skin to print the typical red colour.

Normally henna si altered with different additives like Paraphenylediamine

Although traditionally this body art was made during some local ceremonies, recently it is in fashion. Since some years ago it is a typical touristic attraction in many asiatic and african countries, but now we can find it also in Spain, often in mobile stands in beaches, faires or even swimming pools.

Henna is considered to be a harmless substance for the skin and is very difficult that it causes an allergic reaction, neverthless, due to its features it is not very commercial because the colour obtained is very pale and it takes a long time to dry. To resolve these problems usually natural henna is altered with different additives such as PPD (Paraphenylediamine).

PPD is a well-known inductor of cutaneous allergies. It is very used in black hair colour, mascaras, print dyes or rubber. In henna body art it extends its duration on the skin, it also reduces the dry time and gives a dark red or black colour. Henna body art is made with plastic glued stencils and the following cover up of the painted zone, improve PPD penetration and can also expone skin to other components (latex for instance). Besides, contrary to hair colours, this PPD is not neutralized and is often found in amounts bigger than allowable (we can easily find 15% instead of 6% allowed in hair colours).

When we have a reaction to henna body art, it is normally an effect of PPD. This reaction is usually noticed some days after the application on the skin (between 5 and 14) and it does not go away even if we remove the henna ink after a few hours.

The main symptoms are itching and reddening during the making of the body art, and we can also have eczema and even blisters like the ones we have got when we burn ourselves. Contrary to what people say, these injuries are not burns even if they produce blisters, but they are an inflammatory reaction and it comes from inside the body itself: it is a response to the sensitive substance (an allergical dermatitis).

We recommend never make any henna body art in children or people who already have some skin problem.

Injuries often take some days or even weeks to heal. It is important to take off any remains of the henna ink and to use a specific topic corticoid for this type of inflammation, and in some particular cases we should also take some topic antibiotic or oral treatment.

To sum up, henna body art is very nice and normally it is totally safe, but we stongly recommend not to make it in children and never in people with previous skin problems and also always ask about the ink composition, avoiding dark or black henna, because normally it is altered.

References:

  • Actas Dermosifiliogr. 2007 Mar;98:91-5. Allergic contact dermatitis to temporary henna tattoos. Ramírez- Andreo, Hernández-Gil, Brufau, Martín et al.

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