QoM Archives -

Does she have a hair dye allergy?

Does My Mom Have a Hair Dye Allergy?

Doc,

My mom has been dyeing her grey hair for many years. Recently she went to the salon for her usual touch-up and she developed a rash along her hair line. The next time she went, the rash got worse. Has she developed a hair dye allergy?

21224010 - hands of a female hairdresser tinting the hair of a client in a hairstyling salon applying the paste with a brush

Hi K.,

You are correct! It seems as if your mother has developed an allergy to her hair dye. The most likely culprit is Paraphenyldiamine aka PPD. It is the most reliable hair dye ingredient that makes the hair dark brown or black. However, it is widely known to be a sensitiser, i.e. it triggers the body to remember it so that each time it comes into contact with it a reaction occurs. There are instances of persons who used henna mixtures for mehandi (black henna tattoo) only once who later on developed rashes when they started to dye their hair. The henna used for mehandi usually contains very high amounts of PPD.

The problem is that there are very little substitutes out there that do the job as well. There are many natural hair dyes however, they tend to be messier and/or take longer for the dye to set. The most famous of which is natural henna. Ensure that the henna that you purchase is not a henna/chemical dye mash up. Henna dyes the hair red-brown. To get a deep black colour, indigo is usually added.

There are other chemical dyes that use similar ingredients to PPD that do not have the same sensitising profile as PPD. Interestingly, with the advent of the active protein based cosmeceuticals, there are products containing melitane (a protein) that helps the hair follicle to naturally restore its pigment production. Hopefully, we will see more of this on the market soon.

What do if you have a hair dye allergy?

Once the rash develops, you will need to get an antihistamine such as Chlorpheniramine e.g. Benadryl to help with the itching. A Cortisone (steroid) cream will help to minimise the symptoms pretty quickly. If you continue to use PPD containing dyes the rash or reaction will continue to worsen and can take up the entire body. Please read below what happened to NCIS star who had a PPD allergy: http://ow.ly/gOyq307n1rg

It is best that anyone who suspects he/she has a dye allergy should go to a dermatologist or allergist to do what is called a patch test. This involves the placement of small amounts of known allergens on her back and doing readings after day 3 and day 5 to see which one she has developed a reaction to. This will help her determine the exact cause of her rash and then she can avoid products containing that particular ingredient(s).

February QoM

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I heard that if I have Male Pattern Hair Loss and if I start using Rogaine (Minoxidil), I will have to use it forever? Is that true, and why?

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Yes this is true. The main reason for this is that there is no cure for Pattern Hair Loss. The underlying cause is a genetic disorder, and as such would require gene therapy, which does not exist. The medical therapies that exist, including Minoxidil, only reverse the effects of the genes and not the gene itself. Therefore, if you do not continue using the Minoxidil, you will lose the benefits of keeping the regrown hair.

January QoM: Is Brazilian Keratin Treatment safe?

Every now and then someone asks me this question: Is the Brazilian Keratin Treatment (BKT) safe?

What is Brazilian Keratin Treatment?

The Brazilian Keratin Treatment has been been a hot topic for several years now. The concept behind it is however not new. Brazilian Keratin Treatment is based off of a now defunct method of permanent press technology used in the ’70s to create wrinkle free clothing. It involved the use of formaldehyde which was found to keep textiles straight for quite extended periods. The problem was that the amount of formaldehyde used resulted in high amounts of formaldehyde being released over time from the clothing and people were not comfortable with that. Newer agents have been used since.

Fast forward several decades later, Brazilians considered using the same method to keep hair straighter for longer. The result was a new straightening method that used formaldehyde to essentially stun the hair straight.

Mechanism of Action

Unlike chemical relaxers and permanent waves, the formaldehyde does not break the disulphide bonds which are the backbone of the hair fibre. Instead, it forms reversible cross-links with the side chains of the keratin protein of hair. These bonds are stable for 3-4 months. This is what keeps the hair in the new formation, NOT the keratin amino acids in the product as claimed by most companies. The added keratin is just for conditioning purposes. Most products use about 2%-5% of formaldehyde in their products.

Method of Application

The hair has to be free of all product. A stripping, chelating, and clarifying shampoo is used to wash the hair.
The hair is then towel dried and the product is sprayed in after which the hair is blow dried straight.
The hair is then flatironed straight.
The product is left in for at least 2 hours. The original products required a 72 hour wait period with explicit instructions to not get the hair bent or kinked in any way.
After the marination period has passed, the hair is then washed again with a salt and sulphate free shampoo which would not strip the product out. The hair is then blown straight and flatironed.
The client goes home with maintenance products that will help to prolong the style.

The end result is hair that stays straight for up to 3- 4 months. However, there are numerous problems with the method of straightening:

A lot of companies were not declaring the correct percentage of formaldehyde in their products exposing both cosmetologists and clients to higher than what is accepted in most products. The FDA sent out warnings about this.
Cosmetologists were developing respiratory problems and other concerning growths in their nose and respiratory system due to the release of high amounts of formaldehyde when flatironing the hair. This occurred especially in places where there was poor ventilation thus exposing the stylist to a lot of formaldehyde on a daily basis.
Companies would state that they were using formaldehyde free products when all they simply did was switch from formaldehyde to glutaraldehyde or other ingredients that form formaldehyde when broken down. Higher amounts of these ingredients are used to get the same effect as formaldehyde has the best efficacy.
In the hands of poor stylists, great damage could occur due to the high heat used to flatiron the hair, and how many passes of the flatiron it would take to straighten the hair.

So is it safe?

For the consumer, it is relatively safe because the amount of formaldehyde that is released from the hair on a daily basis at home is not significantly higher than what you would normally be exposed to anyway. Just a side note: Formaldehyde is present in surprising places, like food, and in furniture and building material. It naturally occurs in several foods that we eat, see a list of those here: http://www.cfs.gov.hk/english/whatsnew/whatsnew_fa/files/formaldehyde.pdf. Also read what the CDC says about formaldehyde in our regular environment: http://www.cdc.gov/nceh/drywall/docs/whatyoushouldknowaboutformaldehyde.pdf

For the stylist who has to do several clients a day, that is where the problem lies. The stylist would have to ensure that the product she/he uses is safe for use as well as make sure that she/he wears a mask when applying the product and the procedure should be done in a well ventilated room. See the FDA’s advice: http://www.fda.gov/Cosmetics/ProductsIngredients/Products/ucm228898.htm

Read what the American Occupational and Safety & Health Administration have to say about it:

https://www.osha.gov/SLTC/hairsalons/

October’s QOM- What causes sores or cysts on the scalp?

Greetings hair Doctor,. I recently shaved my hair bald due to hair loss. I’m experiencing painful sores or cysts on the scalp and they are tough to regrow patches. What should I do? I really want healthy hair.

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Hi there,

It sounds like you could be having Dissecting Cellulitis, a very stressful and painful scarring type hairloss with recurrent sores or cysts on the scalp. Sometimes these sores or cysts on the scalp can ooze when they form sinuses or tracts. When they heal, they form scars which prevents regrowth of hair. Hence why you say it is tough to regrow hair in the affected areas.

You may have to be on long term antibiotics or other medications to help stop the progress of the condition. The best thing to do is to go to a dermatologist in order to be examined and have tests done including a scalp biopsy so that you can find out what is wrong with your scalp. A fungal infection of the scalp can present in a similar manner, which can be easily cured with a course of antifungal medication. Once you have determined the exact cause of your #hairloss, then hopefully you can get the best treatment for your condition.

Here’s a link showing what Dissecting Cellulitis looks like:

http://dermnetnz.org/acne/scalp-folliculitis.html

Here’s an article by the British Association of Dermatologists detailing the management of the condition:

http://ow.ly/Tiaj4

September’s QOM- What is Aminexil?

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Hi Doc,

Could you give me some information on Aminexil Force R capsules? What is aminexil?

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Hiya!

Aminexil Force R is a relatively new topical hair loss product produced under the L’Oreal group. Aminexil,, 2,4-Diamino pyrimidine-3-oxide, is a derivative of Minoxidil.

Minoxidil

minoxidil

Amenixil

kopexil

It has been marketed as having the same positive effects as Minoxidil, i.e. hair growth, without the side effects. It is also claimed to help prevent fibrosis or scarring around the hair follicles which can be seen in late stage Androgenetic Alopecia. There has only been a few studies done on the efficacy of this molecule. Therefore, it has not been rigorously examined when compared to Minoxidil.

Is it worth trying? Only if you have already exhausted available topical and oral options.