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20 years ago, right before my wedding, I had my hands and feet adorned with these henna tattoos. After it was applied, I slept with the fresh henna paste on my skin overnight in an attempt to achieve a deeper, longer lasting color. Although this was a tradition I was familiar with, I learned very quickly on my honeymoon from all the side eyes and stares that not many people at the time were familiar with this custom. Although I didn’t mind explaining it, I found myself trying to wash it off sooner or hide it with longer sleeves!
Henna is very commonly seen in Islamic and Hindu cultures as a means to dye skin, hair and nails. Henna is derived from the plant Lawsonia inermis. The leaves are ground into a fine powder and made into a paste with water, lemon juice, and potentially stickier ingredients such as tamarind, sugar, and/or other ingredients. Henna produces an orange-red color on its own. If it is mixed with other dyes, it can produce a black color such as when mixed with para-phenylenediamine (ppd). The tattoo from henna usually lasts one to two weeks.
Henna is generally considered safe and well tolerated. Without ppd added, there are rare contact allergies reported. There are also rare reported cases of hemolytic anemia and acute renal failure in children with G6PD (glucose 6 phosphate dehydrogenase) deficiency.
Black henna, with the addition of ppd, can result in an allergic contact dermatitis. The estimates of this type of reaction range from 1.5% to 4%. It is important to understand that if this reaction occurs, these patients can also experience similar reactions to other hair dyes with ppd or textiles with ppd used as a dye. This reaction can be where the black henna is applied but can also occur in other areas when used as a hair dye. There are reports of eyelid eczema and angioedema, for example, with the use of black henna as a hair dye.
Henna is often favored by many cultures as a hair dye for several reasons. The natural red dye in henna migrates through the hair shaft and attaches to the keratin to coat the hair shaft, bind to keratin and add a natural color to hair. This process actually can result in a stronger cuticle and is more protective of the hair follicle. In some cultures, henna is used to color the nails, as well, potentially strengthening the nail plate.
The decorative designs that are customary to apply around holidays, festivals, and weddings did start to become a little more popular in the US in the past 10 to 15 years. In the summer, I started to see rashes from the henna tattoos that some young people would get when at the shore. These were usually black henna tattoos simply because the pigment could attach faster and need not set over hours or overnight as with natural henna tattoos. I also found blocks of henna dye in some natural beauty stores at the mall which had variable results. More recently, using henna to achieve ‘fake freckles’ has become popular in recent years.
I realized at this time that some patients that use henna as a hair dye do not always recognize it as a potential source of contact dermatitis. Most understand and recognize it as helpful for hair follicles in terms of protecting the hair and potentially strengthening it. However, when rashes were seen around the ears, eyelids or hairline, these patients did not think to disclose the use of henna with the assumption that it is healthy and natural. They simply do not think of it as a cause for concern.
To minimize the risk of these reactions, avoiding henna with ppd or other added dyes added is important to look out for. The henna itself is natural, however more and more henna products on the market are adding other dyes to minimize the time the henna needs to stay on to achieve its desired effect.
If you have had reactions to black dyes or ppd in the past, avoid brands that specify the color of henna. Henna as a natural product can at best promise some reddish brown hues. However, the results are widely variable.
Also, be careful of brands that specify faster results. Henna application times vary based on the location of the body, thickness of the skin, coarseness of the hair follicle. Henna products without additional dyes cannot easily guarantee faster results.
Another note is that some henna dyes will have metallic salts added such as lead, silver, cobalt, bismuth, or copper. These are usually added to enhance the color. If using a product with these metallic salts, it is important to disclose this should you plan to consider any other chemical processing of your hair with other products. These metallic salts may interfere with the results.
Here are some brands we have reviewed that do not appear to have added dyes beyond henna:
If you suspect reactions to henna or henna related products, seek out the help of your dermatologist. Consider a patch test on your upper inner arm to avoid staining the skin in an obvious area to test for reactions before using. If you feel the need to wash away your henna tattoo faster, we can talk about some things that worked for me and safe ways to help accelerate its fading!