Schoolgirl Suffers Severe Allergic Reaction to L’Oreal Hair Dye

Today the Daily Mail reported a story about Carla Harris, a 15 year old schoolgirl who suffered a potent allergic reaction to L’Oreal Recital hair dye, causing her head to swell up to twice its normal size, leaving the teenager in agony for several days. You can see an image of the damage caused on the Daily Mail website.

Despite conducting a patch test prior to using the product, Carla still had a severe reaction after using the L’Oreal hair dye and was admitted into hospital and treated with antihistamines and steroids.

Carla and her mother Lynn have called for the banning of para-phenylenediamine (PPD), the toxic chemical that doctors suggested caused the problem.

Two-thirds of hair dyes contain PPD, which was banned from use in hair-dyes in the 20th century in Germany, France and Sweden, because concerns arose about its harmful effects.

I can sympathise, when I was 16 years old after a number of years using hair dyes without adverse reactions, I applied a semi-permanent hair dye which caused over a third of my hair to fall out. Unfortunately it never grew back and in subsequent years more of hair fell out. I just put it down to me being sensitive but my mother told a woman at her workplace about my unfortunate incident with the hair dye and she explained that her daughter had used the very same hair dye and all of her hair had fallen out. It wasn’t until many years later that I began to reseach the toxicity of ingredients used in cosmetics and other beauty products.  

Hair Dye Today, Gone Tomorrow

Modern hair-dyes contain numerous synthetic chemical ingredients and are one of the top consumer complaint areas for the U.S. Food and Drug Administration’s Office of Cosmetics and Colours, with complaints ranging from damaged hair to symptoms necessitating a visit to the nearest emergency room. Some consumers have reported burning, redness, hair loss, irritation, swelling of the face and difficult breathing due to their use of hair-dyes. Some hair-dyes can permanently alter the physical structure of the hairshaft and cause irreversible damage to the hair.

PPD along with other related aromatic amines, have been the primary agents used in permanent hair-dyes for over 100 years. PPD is also used in textile and fur dyes, photographic developer, printing and photocopying inks, black rubber and gasoline. The properties which make it effective as a hair-dye, such as its low molecular weight, capacity to bind to protein, and ability to penetrate the hair shaft and follicle also make it among the most potent of contact allergens.¹

The National Institute for Occupational Safety and Health’s (NIOSH) Pocket Guide to Chemical Hazards warns of this substance, “prevent skin contact, prevent eye contact” and states that when PPD is inhaled respiratory support should be administered. Symptoms of exposure include respiratory irritation, bronchial asthma, sensitisation and dermatitis.² In rare cases allergy to PPD can cause death.

PPD is not approved for direct application to the skin,” ³ yet when hair-dye is applied it usually does come into contact with the scalp and very often the forehead and ears. According to Dr John P McFadden senior lecturer at St John’s Institute of Dermatology, patients with contact allergies to hair-dyes often have dermatitis around the face or hairline and sometimes facial swelling is so severe that the patients must be hospitalised. He also highlights the growing number of individuals suffering allergic reactions to PPD in patch tests. ⁴

A survey of one London contact dermatitis clinic, where eczema patients were patch tested for reactions to PPD found that allergy to the substance had almost doubled from 4.2 per cent in January 1999 to 7.1 per cent in December 2004. The study’s authors state that the “disturbing” increase in positive reactions to PPD over the six year period where research took place “may be due to subjects dyeing their hair in increasing numbers and perhaps at an earlier age. ⁵ Patch testing data from other countries such as Belgium, Portugal, Denmark, Germany and Singapore support this pattern. Dr John P McFadden writes in the British Medical Journal that more than 1 million Thai adults and 1.3 million adults in Germany may be sensitive to PPD. ⁶

Of those individuals who are allergic to PPD 10 per cent also react to semi-permanent hair-dyes. Those who have a sensitivity to PPD may also develop a cross-sensitivity to azo and aniline dyes (used in hair-dyes, ballpoint pen inks, gasoline, diesel oil and as a colourant in foods and medications), benzocaine and procaine (used in local anaesthetics), para-aminobenzoic acid (PABA – used in sunscreens and some face creams), para-aminosalicylic acid (used for tuberculosis), sulphonamides (used in pharmaceutical drugs), carbutamide (used in diabetes medication) and hydrodiuril (a diuretic medication). ⁷

According to the Scientific Committee of Consumer Products (SCCP), an expert panel of scientists which provide the EU Commission with opinions on ingredients used in consumer products, PPD sensitises 100 per cent of laboratory animals used in predictive allergenicity testing at high enough concentrations. ⁸

Occupational exposure to PPD has caused liver injury, asthma, contact dermatitis and contact urticaria. PPD has also proven to be mutagenic in cell cultures, genotoxic in human lymphocytes when combined with hydrogen peroxide, causing chromosomal abnormalities, neurotoxic at moderate to high doses in animal studies and it has also caused lung cancer in a study on mice.

Other hair colourants linked with cancer and/or other adverse effects include m-phenylenediamine, N,N-BIS(2-hydroxyethyl)-p-phenelenediamine sulphate, 2,5-toluenediamine, 2-amino-4-nitrophenol (banned for use in hair-dyes in the EU and Canada), 2-nitro-p-phenylenediamine, 4-amino-2-hydroxytoluene, 2-methyl-5-hydroxyethylaminophenol, resorcinol, 1-napthol, to name but a few.

The oxidiser hydrogen peroxide is a skin, eye and respiratory irritant and can actually burn the skin. It is strongly irritating and can be corrosive at concentrations of 10 per cent. If ingested, hydrogen peroxide can cause severe internal damage and bleeding and if splashed into the eye it can result in ulceration of the cornea. Hydrogen peroxide can also cause genetic damage in vitro by forming free radicals. Apoptosis (programmed cell death) is reported to play a role in neurodegenerative diseases such as, traumatic brain injury and strokes. One study found that hydrogen peroxide induced apoptosis in cultured cerebral vascular smooth muscle cells, in a concentration-dependent manner providing a possible association between exposure to hydrogen peroxide and neurodegenerative diseases and strokes. ⁹ Hydrogen peroxide has also been found to have a dose dependent toxic effect on immature mice neurons in vitro. ¹⁰ In Japan this substance is banned for use in hair-dyes.

There is an array of questionable ingredients used in hair products apart from the dye components, for example:

Sodium lauryl sulphate (SLS), polyethylene glycol, oleic acid and propylene glycol – are all irritants and penetration enhancers.

The oleth family of ingredients (e.g. oleth-2, oleth-10), polyethylene glycol (PEG) ethers of oleyl alcohol and nonoxynols (e.g. nonoxynol -9), which are ethoxylated alkylphenols – can be contaminated with the carcinogens ethylene oxide and 1,4-dioxane.

 Polysorbate 20 – again poses a risk of 1,4-dioxane contamination.

Diethanolamine (DEA) related ingredients such as cocamide DEA, cocamide MEA, lauramide DEA and triethanolamine (TEA) – may be contaminated with carcinogenic nitrosamines.

Chlorides are extremely irritating to the mucous membranes.

<sub>1. McFadden, J.P., Allergy to Hair-dye, British Medical Journal, 2007: 334: 220.
2. ‘National Institute for Occupational Health and Safety (NIOSH) Pocket Guide to Chemical Hazards: p-Phenylene Diamine,’ Centre for Disease Control, National Institute for Occupational Health and Safety (NIOSH), NIOSH Publication No. 2005-149, Washington, DC, September, 2005; online at www.cdc.gov/niosh.
3. ‘Temporary Tattoos and Henna/Mehndi,’ U.S. Department of Health and Human Services, U.S. Food and Drug Administration (FDA), Centre for Food Safety and Applied Nutrition (CFSAN), Office of Cosmetics and Colours, College Park, MD, April 18, 2001; Updated September 18, 2006; online at: www.cfsan.fda.gov.
4. McFadden, J.P., Allergy to Hair-dye, British Medical Journal, 2007: 334: 220.
5. Patel, S. et al, Patch Test Frequency to p-Phenylenediamine: Follow up Over the Last 6 Years, Contact Dermatitis, 2007: 56: 35-37.
6. McFadden, J.P., Allergy to Hair-dye, British Medical Journal, 2007: 334: 220.
7. ‘DermNet NZ: Allergy to Paraphenylenediamine,’ New Zealand Dermatological Society Incorporated; accessed January 4, 2008; online at: http://dermnetnz.org.
8. ‘Scientific Committee on Consumer Products (SCCP) Opinion on p-Phenylenediamine,’ European Commission, Health & Consumer Protection Directorate-General, Brussels, Belgium, Adopted by the SCCP during the 9th Plenary Meeting of October 10, 2006; online at: http://ec.europa.eu/health.
9. Jianfeng, L. et al, Hydrogen Peroxide Induces Apoptosis in Cerebral Vascular Smooth Muscle Cells: Possible Relation to Neurodegenerative Diseases and Strokes, Brain Research Bulletin, December, 2003: 62 (2): 101-106.
10. Mischel, R.E. et al, Hydrogen Peroxide is Selectively Toxic to Immature Murine Neurons in Vitro, Neuroscience Letters, August, 1997: 231 (1): 17-20.</sub>