Author: Dr Ian Coulson, Dermatologist (2023)
Edited by the DermNet content department
This 15-year-old boy has just returned from a holiday in Thailand. He had a beach “tattoo” undertaken 10 days ago. Within a few days he developed persisting, itchy, red areas where the tattoo had been applied.
The likely cause of his reaction to the beach ‘henna tattoo’ is an allergic contact dermatitis to the black dye chemical paraphenylenediamine (PPD). Although the tattoo solution does contain some henna, this is much less likely to be the sensitiser.
The reaction will settle with the use of a topical steroid. However, he is now sensitised to PPD, and should he use a PPD-containing hair dye in the future, he will have a reaction to this. PPD-allergic individuals may also react to some azo clothing dyes, PABA-containing sunscreens, amine local anaesthetics (benzocaine and procaine), sulfonamides, and sulfone drugs.
