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Increase in hair dye and fragrance allergies in children

A study due to be presented at the British Association of Dermatologists annual meeting in Manchester today has found  a substantial shift in the allergens causing skin reactions in children over the last decade, with some allergies becoming less common and with others, including to hair dye ingredients, on the rise.

The study involved 500 UK children tested for potential contact allergies (skin reactions following contact with a substance*) between 2005 and 2014, and replicated a previous study, also of 500 children, between 1995 and 2004, to see the changes that have occurred in the frequency of contact allergy and the allergens responsible over the past ten years. The study was conducted by dermatologists from Leeds Teaching Hospitals NHS Trust.

In both studies 27 per cent of the children (133 in 1995 to 2004 and 134 in 2005 to 2014) tested positive to one or more contact allergy. However, where they differed in their results most significantly was in regards to the causes of these allergies. In the 1995 to 2004 study 33 per cent of these children had a nickel allergy and 18 per cent presented with an allergy to a fragrance. Between 2005 and 2014 these two allergens remain the most common, however, there was a sharp fall in the number of nickel allergies, down to 18 per cent.

Despite the fall in nickel allergies the total percentage of children with allergies remains static because more children are becoming sensitised to other substances, some of which did not even feature in the original study, including various hair dye ingredients. It is thought this might suggest increasing use of hair dyes in children, and may also be due to black henna tattoos which contain a high concentration of para-phenylenediamine (PPD). Use of these tattoos just once can make people react to PPD in other products at a later date*.

After metals and fragrances, the next most common allergens were:

Allergen                                              Frequency         Common Uses
Para-phenylenediamine (PPD)          16 per cent         Hair dye ingredient
4-aminophenol                                    8 per cent          Hair dye ingredient
Aminoazobenzene                              7 per cent          Dye ingredient
Disperse orange 3                              7 per cent          Textile dye ingredient
Para-toluenediamine sulfate (PTDS)  7 per cent          Hair dye ingredient
Methylchloroisothiazolinone and
                                                           6 per cent          Preservative commonly used in cosmetics and many everyday household objects.

The authors of the study hypothesised that the reason for the fall in nickel allergies may be down to the European Union Nickel Directive, implemented in December 1994. The Nickel Directive limits the amount of nickel that can be used in products that come into prolonged contact with the skin. This impact of this would not be instantaneous but rather would likely show over time as new generations are less exposed to the metal, as although some people are predisposed to certain allergies others become sensitive to new substances through exposure over time.

In fact, in 2013 dermatologists raised concerns about the UK’s new five pence and ten pence coins which are nickel-plated, rather than being made of a nickel alloy, worried that people would be unnecessarily sensitised to nickel by long-term exposure through these coins.

Dr Vanessa Smith of Leeds Teaching Hospitals NHS Trust and one of the authors of the study, said: “It’s important to track the rates of allergy in children in the UK, and to recognise the underlying allergens, this can help guide policy makers and manufacturers as to potential public health risks.

“Our results suggest that efforts to curb the rates of nickel allergies have been a success and that these policies should continue. However, it’s clear that some of the highest rates of allergy amongst children are due to hair dye ingredients such as PPD. This is perhaps a sign of children using hair dyes and getting black ‘henna’ tattoos at younger ages, both of which can cause sensitivity to PPD.”

Matthew Gass of the British Association of Dermatologists, said: “Contact allergies can be very severe and can have a devastating effect on people’s lives. Nickel has been a common allergy for a long time and so it’s good to see that this study has shown that rates are falling. However, more efforts need to be made to make people aware of the sensitising properties of other common substances.”

Notes to editors:

* The study specifically looked at contact eczema, which is separate to immediate-type allergy, e.g. to foods.

Study details: Allergic contact dermatitis in children: trends in allergens, 10 years on. A retrospective study of 500 children tested between 2005 and 2014 in one U.K. centre
V. Smith, S. Clark and M. Wilkinson
Leeds Teaching Hospitals NHS Trust, Leeds, U.K.

If using this study, please ensure you mention that the study was released at the British Association of Dermatologists’ Annual Conference.
The conference will be held at Manchester Central from July 7th to 9th and is attended by approximately 1,300 UK and worldwide dermatologists.

For more information please contact:  Matthew Gass, Communications Officer, mobile 07837734620 during conference week, 0r 0207 391 6084 from Friday 10th, or email: , Website:

*‘Black henna’ temporary tattoos are generally not made from henna but high concentrations of PPD.  This use of PPD is illegal in the EU, however black henna tattoos are often available abroad.

The British Association of Dermatologists is the central association of practising UK dermatologists. Our aim is to continually improve the treatment and understanding of skin disease.

Fashions Change but Tattoos are Forever

A significant number of people regret having a tattoo, and the longer they have had one the more likely this becomes. With a tattoo parlour popping up on every high street1 and the popularity of tattoos increasing2, a study, due to be released at the British Association of Dermatologists’ Annual Conference in Birmingham this week (July 3rd to 5th), seems timely.

Author of the study Arif Aslam says, “We feel that it is important for people to know that it’s very likely that one day they will regret their tattoo. They are not that easy to remove and unwanted tattoos can affect people’s life chances and cause them upset and unhappiness”. The study used a questionnaire and took place over a six month period in a dermatology department in a large district general hospital in England. Patients (aged 16 or over) who had a visible tattoo during general skin examination were asked to complete the questionnaire which looked at age, the age at which the tattoo was acquired, whether it was done by an amateur or a professional, how long they had had it, whether they had other tattoos, the site of the tattoo, whether they still liked it and whether they would have it removed if they could.

• 580 responses were analysed (from a total sample of 615) with a split of 53 per cent men and 47 per cent women. The responses revealed:
• Most tattoos were done by a professional • Half of the patients were over 40 • 45% of the patients had their first tattoo done aged between 18 and 25 years old
• Almost half had between two and five tattoos
• Almost one third regretted their tattoo
• Men were more likely to regret their tattoo than women
• Men were three times more likely to regret their tattoo if it was done when they were under 16 years of age
• Women over the age of 21 at the time of their first tattoo were the least likely to regret it.
• Most patients who regretted getting a tattoo had them on their upper body.
• Fewer than half those who regretted their tattoos would have them removed.


Notes to editors: If using this study, please ensure you mention that the study was released at the British Association of Dermatologists’ Annual Conference. The conference will be held at ICC Birmingham, 3rd to 5th July 2012, and is attended by approximately 1,300 UK and worldwide dermatologists and dermatology nurses.

For more information please contact: Deborah Mason, British Association of Dermatologists, Communications Manager, Phone: 0207 391 6355 or 07957 145992 (mobile during conference week only), Email:, Website:

Study details: “Fashions change but tattoos are forever: time to regret”; A Aslam and C Owen, Burnley General Hospital, Burnley UK 1. 1,500 tattoo parlours in the UK 2. A recent survey suggested that 1 in 5 British adults has a tattoo The British Association of Dermatologists is the central association of practising UK dermatologists. Our aim is to continually improve the treatment and understanding of skin disease.

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