Dr. Abdulaziz AlRashed — Consultant Dermatologist, Cosmetic & Laser
Warning: Black Henna & Hair-Dye (PPD) Allergy
A patient advice sheet — 7 practical points. Reviewed and updated by Dr. Abdulaziz AlRashed, July 2026.
Last reviewed: July 2026
The advice
- Natural henna (orange-brown) is generally safe; "black henna" contains high-concentration PPD and can cause a severe blistering reaction, permanent scarring, and lifelong allergy.
- Avoid it for children at events and festivals in particular — it is the commonest route to acquiring this allergy.
- Anyone sensitized once by black henna can later react severely to PPD-containing hair dyes (marked face and scalp swelling) — caution becomes lifelong.
- Before any hair dye: a spot test behind the ear or on the inner forearm 48 hours ahead, per the box instructions — every time, not just the first.
- Alternatives: PPD-free dyes (with possible cross-reaction to related compounds in some people) and pure, unmixed natural henna.
- If a reaction happens: wash the area immediately and see us quickly — it is treated with cortisone creams or tablets before it escalates.
- Clinic patch testing confirms PPD allergy, after which you receive a list of cross-reacting substances (certain medicines, rubber, textile dyes).
See also the full treatment page: Eczema treatment — options, evidence and expected timelines.
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