Unwanted skin infections, metal toxicity, and even cancer… Those are just some of the reasons we remain wary of tattoos and their health risks. One thing we can go easier on is temporary tattoos. Kids love them, they’re risk-free, and only last a few days – at least that’s what 7-year-old Madison Gulliver’s father thought.
While on vacation in Egypt, the Gulliver family was staying in a four-star hotel which had a salon that offers quite beautiful temporary black henna tattoos. After the mother, Sylvia, spent two vacation days in hospital due to a gall bladder infection, the father decided to treat his kids Madison and 9-year-old Sebastien to a pair of black henna tattoos.
With seemingly little cause for concern, the two kids got artistic designs that went from the middle of their forearms down to their fingers. To the parents’ surprise, Sebastien immediately started complaining that his skin was itching and washed off the black dye.
Shortly after, Madison had the same complaint, except her skin reaction was much more severe. The skin underneath the tattooed area broke out in blisters, so the parents rushed her to emergency.
“[Madison] is potentially scarred for life after getting a black henna tattoo,” said her father.  “The tattoo was done in the hotel’s salon and they claim it’s not the henna and that it’s my daughter’s skin. She has blisters from her finger to her elbow and is in so much pain.”
After having her wound tended to and her blisters cut away, doctors revealed that black dye used in some henna tattoos can harbor unsafe levels of toxic chemicals. In fact, after looking at the pH levels in Madison’s blisters, they reported she suffered from chemical burns. But there is one ingredient in particular you need to watch out for: paraphenylenediamine.
What Is Paraphenylenediamine (PPD)?
Known more commonly as an ingredient in hair dyes, the “skin sensitizer” paraphenylenediamine is a chemical substance which requires oxygen in order to become a dye. 
A 2012 study published in the Journal of Research in Medical Sciences even found that it’s blackening more than hair. Although PPD is allowed to used in hair dye products, it “could herald fatal complications such as rhabdomyolysis, renal failure, angioneurotic edema, and respiratory failure.” 
You can also find PPD in dark-colored cosmetics, temporary henna tattoos, and other industrial materials (e.g., printing inks, black rubber, as well as oil, greases, and gasoline). 
The Health Concerns of PPD
Everyone has varying skin sensitivities, so coming into contact with paraphenylenediamine won’t always present itself the same way. But, here are some of the most common side effects: 
- Itchy dry rash
- Reddening, blistering, and swelling
- Intense blistering reactions and potential scarring (especially with temporary tattoos)
- Post-inflammatory hyperpigmentation, hypopigmentation, or scarring
“PPD is safe and legally used in permanent hair dyes where clear instructions are given, and where the maximum level is controlled by law,” said Dr. Chris Fowler, director general of the UK’s Cosmetic, Toiletry and Perfume Association.  “But black henna often contains PPD at high levels, to give a dark color quickly… When applied to the skin in the form of a black henna temporary tattoo, PPD can cause chemical burns and lead to allergic reactions.”
What about in the United States? Henna is only approved for use in hair dye, according to the FDA. Although certain cultures use it more widely, “it is not approved for direct application on the skin… Because henna typically produces a brown, orange-brown, or reddish-brown tint, other ingredients must be added to produce other colors, such as those marketed as ‘black henna.’” 
How to Avoid Severe Skin Reactions Caused by Paraphenylenediamine?
Whether you’re at home or traveling, the best piece of advice we could give is to just not get tattoos, temporary or otherwise. (You wouldn’t want to regret any avoidable impulse decisions, would you?) However, if you really want a temporary henna tattoo, ask the artist to let you see the packaging and look out for these ingredients: 
- 1,4-phenylene diamine
If any of those are present, say no thanks and walk away. Or if you see something described as “henna,” check the actual color – it should have an orange-red color.
Henna Canada says that when looking for a good, natural henna product, seek ones that are made from 100% pure henna leaf powder (preferably from a fresh crop). Make sure it has been properly stored in a deep freezer, too, if possible.
“Powders should be vacuum sealed and in light-proof packaging. No added dyes (plant material or synthetic chemicals), preservatives, metallic salts, not irradiated. Organic is best. Well sifted.” 
We often half-jokingly say that if you can’t pronounce an ingredient, don’t put it in or on your body. Well, this is one of those cases where there’s no joking at all. Clearly, you can see the potential damage PPD can cause, so it’s best to stay away from that chemical. If you want to add a splash of color to your life, check this out instead: 4 Natural Ways to Get Gray Coverage Without Chemicals.
 P-Phenylenediamine. (n.d.). Retrieved from http://www.safecosmetics.org/get-the-facts/chemicals-of-concern/p-phenylenediamine/
 Gude, D., Bansal, D. P., Ambegaonkar, R., & Prajapati, J. (2012, June). Paraphenylenediamine: Blackening more than just hair. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3634302/
 Allergy to paraphenylenediamine. (n.d.). Retrieved from https://www.dermnetnz.org/topics/allergy-to-paraphenylenediamine/
 Dangers of black henna. (n.d.). Retrieved from https://www.nhs.uk/live-well/healthy-body/black-henna-neutral-henna-ppd-dangers/
 Center for Food Safety and Applied Nutrition. (n.d.). Products – Temporary Tattoos, Henna/Mehndi, and. Retrieved from https://www.fda.gov/cosmetics/productsingredients/products/ucm108569.htm
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