126 JOURNAL OF THE SOCIETY OF COSMETIC CHEMISTS elbow or behind the ear, the application covering an area not less than the size of a 25 cent piece. It should be allowed to dry and to remain on the skin uncovered for 2 a, hours. If at the end of this time there is no itching or sign of irritation the dye can safely be used on the hair. This test should be repeated each time the dye is used, even for retouching the hair. The dye should not be used if there is any sign of irritation. Schwartz carried out the prophetic patch test with a new hair dye for home use as follows: He mixed the contents of the two bottles of the home use hair dye as required in the directions..He allowed the mixture to stand'for five minutes before painting it on the'cleansed skin. He chose the thin skin. of the inner fold of the elbow. The site was washed with soap and water and dried. The mixture was then painted on an area not smaller than a silver half dollar, and later was increased to a, sq. in. and allowed to dry. The subjects were instructed not to wash the site. The dye mixture was discarded after standing for 20 minutes and a fresh mixture was made. The procedu're was repeated with the same subject on the same site for three successive days. Twenty-four hours after the third application the subjects were seen again and examined for reactions and then were told to wash off the dye. To do this required several days since the skin was deeply dyed. Ten days after the last reading the contents of the two bottles were again mixed and applied as described be- fore. Twenty-four hours later the subjects were examined for reactions and then told to report if any late reactions developed. A para dye long used in beauty parlors was employed as a control patch. There were no reactions from any of the patches on any of the subjects. In every instance of true cases of allergic contact dermatitis due to hair dye which I have studied they not only gave a positive reaction to the hair dye which they used, but to a 1 or 2 per cent para solution. In order to avoid the primary irritant effect of the ammonia used in the hair dye it has been my habit after applying the test solution to allow it to dry thor- oughly on the skin for at least ten minutes before the patch is applied. An open patch test is always used at the same time. When all is said and done, one has only to discuss the problem of para sensitivity with the proprietor of any large beauty parlor to obtain a real insight into the sensitizing potency of the para dyes. There are always one or two of the operators who suffer from contact dermatitis from hair dyes and there are always one or two operators who will lose time because of this. This example may be argued against as a poor one to indicate the possible hazard of the para dyes for home use because the beauty parlor operator has much greater contact with the para dye than any person who applies it at home. I believe, however, that it is only a question of time before continuous use by any one person at home will result in increasing the number of those who are sensitive to para and allied compounds. The

TOXIC AND ALLERGIC COMPLICATIONS OF HAIR DYES 127 problem of those sensitized goes far beyond the question of being able to use a hair dye when we consider what has been said concerning cross- sensitivity. I think that Harry has given us a fine definition for the ideal hair dye and I would like to close my paper by quoting him. "The ideal hair dye should possess the following properties: "1. It should be non-injurious to the hair shaft, but should color the shaft while the natural texture and gloss of the hair should be retained. "2. It should possess no systemic toxic effect when applied to the hair or skin. "3. It should possess no primary irritant action and be free from sen- sitizing properties, i.e., it should not be a dermatitic agent. "4. It should be stable on exposure to air, sunlight and salt water and should not change color nor leach out on the application of toilet prepara- tions such as brilliantines, setting lotions, hair lacquers, soaps and/or soap- less shampoos neither should it discolor when the hair is exposed to alkalies, reducing agents, oxidizing agents or procedures such as are em- ployed in hair waving." ACKNOWLEDGEMENT I wish to express my thanks to Philip Rosmarin for technical information concerning the preparation of modern hair dyes. (1) (2) (3) (4) (5) (6) (7) (8) (9) (10) (11) (12) (13) . (14) (15) (16) BIBLIOGKAPHY Soilman, Totold, "A Manual of Pharmacology," 5th edition, Philadelphia, W. B. Saun- ders Co. (1940). Schwartz, L., and Peck, S. M., "Cosmetics and Dermatitis," New York, Paul B. Hoeber, Inc. (1946). Ingram, John T., "Dye-dermatitis in Relation to Idiosyncrasy," Brit. 5 e. Dermatol., 4, 422 (1932). Close, W. J., "A Case of Poisoning From Hair Dye," Med. 2 t. •lustralia, 1, 53 (1932). Greenbaum, Sigmund S., "Dermatoconjunctivitis Due to Lash-lure and Eyelash and Eyebrow Dye," 2 t. •lm. Med. •lssoc., 101, 363 (1933). Bourbon, Oliver P., "Severe Eye Symptoms Due to Dyeing the Eyelashes," Ibid., 101, 1560 (1933). Harner, Clyde E., "Dermato-ophthalmitis Due to the Eyelash Dye, Lash-lure," Ibid., 101, 1558 (1933). Jamieson, R. D., "Eyelash Dye (Lash-lure) Dermatitis With Conjunctivitis," Ibid., 101, 1560 (1933). Rattner, Herbert, "Dermatitis of the Eyelids," Ibid., 103, 180 (1934). Moran, Charles T., "Bilateral Necrosis of the Cornea Following the Use of Hair Dye on the Eyebrows and Lashes," Ibid., 102, 286 (1934). Forbes, S. B., and Blake, W. C., "Fatality Resulting From the Use of Lash-lure on Eye- brows and Eyelashes," Ibid., 103, 1442 (1934). Goodman, H., "Eyelash Dyes and Some Problems Evoked by Them," dlrch. Dermatol. & Syphilol., 32, 258 (1935). Block, H. M., "Chemical Conjunctivitis Following Eyelash Dyeing," ,'lm. 55 Ophthal- mology, 18, 1052 (1935). Bostroem, "Dermatitis Caused by Hair Dyes," Dermatol. Gessellsch., Stockholm, 9, 12 (1934). Aust, "Acute Dermatitis After Dyeing of The Eyebrows," I"erein Dresdner DermatoL, 2, 14 (1934). Bab, Werner, "Allergic Eye Diseases Due to Permanent Dyeing of the Eyelashes," Klin. MonatsbL f. ,'lugenh., 97, 391 (1936).