Contact dermatitis to hair dyes in a Danish adult population:: an interview-based study

Contact allergy to hair dye ingredients is a well-known entity seen both in consumers using hair dyes and among hairdressers with occupational contact dermatitis. Surveys show that consumers with even severe adverse skin reactions to hair dyes only rarely contact the healthcare services. The frequency of hair dye-induced skin reactions in the consumer population is unknown. An epidemiological investigation with the aim of establishing the proportion of hair dye-induced skin reactions was performed in a population-based sample. A representative random sample (n = 4000) was taken of the Danish adult population. Personal interview questions were asked regarding adverse skin reactions to hair dyes, either compatible with a classical allergic eczematous reaction with redness, scaling and itching or a severe allergic reaction with oedema of the forehead and face. The response rate was 65.2%. A total of 18.4% of the male respondents and 74.9% of the female respondents had at some point dyed their hair. The median age at first hair dyeing was 16 years (range 1-80). Adverse skin reactions to hair dyes compatible with an allergic reaction were reported in 5.3% of individuals who had ever used hair dye. Of these, only 15.6% had been in contact with healthcare services after the hair dye reaction. Having had a temporary tattoo was not a significant risk factor for an adverse reaction to hair dyes. The rate of adverse allergic skin reactions to hair dyes was higher than expected from patch-test studies. Only by studying the clinical types of adverse reactions to hair dyes will it be possible to gather a complete epidemiological picture of the nature and extent of the problems related to hair dye ingredients.