TOXIC AND ALLERGIC COMPLICATIONS OF HAIR DYES* By SAMUEL M. PECK, M.D. New York, N.Y. ]'HERE ARE THREE classes of hair dyes: the metallic dyes, the vegetable dyes, and the synthetic organic dyes. In approximately 95 per cent of the hair dyeing operations, both professionally carried out in beauty parlors as well as in the home, there is used a paraphenylenediamine dye or some modification of para. The remaining 5 per cent are either carried out with natural products or with the compound henna dyes. Many of the compound henna dyes contain small amounts of paraphenylenedia- mine and metallic salts to obtain variations in shades required. The active principle in henna dyes is 2-hydroxy-l,4-naphthaquinone. It is recognized that henna is practically blameless as a local or systemic toxic agent. It has verv rarely, if at all, been incriminated as a sensi- tizer. Henna hair dyes have not become popular because there is an in- sufficient range of colors produced with this dyeing material and the color is practically limited to an auburn with a reddish tone. In addition, henna has the distinct disadvantage after repeated applications of giving a rather brassy, unnatural looking color to the hair. The metallic hair dyes are very rarely used in modern hair dyeing. Most of the dyes are compounds of lead and rarely those of silver, copper, iron, bismuth, etc. It is believed that the color that is produced by these metal- lic compounds is due to a reaction between the sulfur in the keratin and the metallic salts so that we have a production of the sulfide of the metal. It is probable, however, that the keratin also acts as a reducing agent caus- ing a precipitation of the black metal oxide. Their use is not satisfactory because of the limitation in range of colors and because the pigment produced is deposited on the outside of the hair shaft resulting in an un- natural metallic appearance. Metallic dyes also degrade the hair and interfere with subsequent permanent waving. The discussion in this paper will be limited to the consideration of the toxicity of the para and allied dyes. * Presented at the December 10, 1953, Meeting of the American Academy of Dermatology, Chicago, Ill. 113

114 JOURNAL OF THE SOCIETY OF COSMETIC CHEMISTS Erdman patented paraphenylenediamine and the allied compounds in 1883 for dyeing hair and feathers. It was considered a great advance when it was first introduced in the dyeing of furs and human hair. In a short while nine times as many cases of dermatitis were being reported as caused by this hair dye as against any other single cosmetic. The rising tide of reports of toxicity, especially the proved cases of dermatitis, asthma, and even systemic poisoning, resulted in the prohibition of the use of para containing dyes in Germany. Soon after they were introduced in Germany the para dyes became widely used in other countries. Especially in England there was a sudden marked increase in fur dye dermatitis among the dyers and wearers of paraphen- ylenediamine dyed furs. It became such a public health problem that a special commission was appointed by the Government to investigate the irritant properties of these dyes. Its use as a hair dye has now been forbidden in several European countries. A Federal law in the United States forbids the use of para and other organic dyes on eyelashes and eye- brows because of several cases of injury, including blindness and ulcera- tive keratitis, attributed to their use. A provision of the Federal Food, Drug and Cosmetic Act, Sec. 601-A, provides as follows: A cosmetic is deemed to be adulterated if it bears or contains any poisonous or deleterious substance which may render it injurious to the user under the conditions of use prescribed in the labeling thereof, provided that this provision shall not apply to coal tar hair dye, the label of which bears the following legend conspicuously dis- played thereon: "Caution. This product contains ingredients which may cause skin irritation on certain individuals and a preliminary test according to the accompanying directions should first be made. This product must not be used for dyeing the eyelashes or eyebrows. To do so may cause blindness." According to Sollman (1) the systemic poisoning which may be observed after applications of para-containing dyes comprises vertigo, gastritis, asthenia, diplopia, lachrymation, chemosis, exophthalmus, asthma, and exfoliative dermatitis. The effects agree in principle with those of histamine that is, stimu- lation of smooth muscle, regardless of its innervation. This includes bronchial constriction which is partly responsible for the asthma and in- creased permeability of the capillaries, resulting in the inflammatory and edematous phenomena. The oral or subcutaneous administration of paraphenylenediamine (0.2 gm. per kg.) to rabbits is followed in about one and one-half hours by an intense watery edema of the entire head. This increases until the next day, and gradually disappears by the sixth day if the animal survives. Not all rabbits develop the edema. It occurs generally in cats and dogs,