By Robin Roberts
So you want a tattoo, but you’re too timid to get a permanent tramp stamp. You’re considering a temp tat, such as henna, because they’re harmless, right? Not exactly. That temporary tattoo could lead to permanent health issues.
The potentially adverse effects came under renewed scrutiny late last year when actress Jaimie Alexander, who sits for over six hours while three artists apply more than 200 full-body fake tattoos for the TV series Blindspot, reportedly claimed they gave her a pulmonary infection.
Dr. Jason Rivers, board certified dermatologist and clinical professor of dermatology at UBC, has never seen such a condition in his Vancouver practice, Pacific Dermaesthetics. He does, however, see infections caused by allergic contact dermatitis. “It’s very unlikely people will develop a reaction to the tattoo,” he says. “The risk of infection is very low and generally minor. What people are reacting to is the hair dye ingredient in black henna, called paraphenylenediamine, or PPD.”
According to Canada’s Food and Drugs Act, it’s illegal to sell cosmetics, including black henna, containing PPD. The catch is, artists applying the tats, usually at fairs, festivals, markets and holiday resorts, aren’t required to disclose the ingredients in their inks, so it’s up to the buyer to beware. Health Canada says the ban is difficult to enforce, since the transgressors, like the tat, are often transient, but inspectors are constantly on the lookout for the restricted products. Ethical tattoo artists make or source their henna paste from all-natural ingredients, including premium henna powder, lemon juice, cloves, cardamom, lavender, and essential oils such as eucalyptus and tea tree.
The National Institutes of Health says that, while it’s rare in the West, PPD could cause fatal complications such as renal or respiratory failure and anaphylaxis, a tightening of your airways. Other studies suggest your new set of sleeves could have a link to various cancers. In most cases, however, any reactions range from mild to moderate.
Dr. Joel DeKoven, in the Department of Dermatology at the University of Toronto’s Sunnybrook Health Sciences Centre, says it is rare to have an allergic reaction to pure henna, and that’s where the distinction is important. Pure vegetable henna, derived from the dried leaves of the flowering shrub Lawsonia inermis, has been used to decorate skin, hair and nails for some 5,000 years in cultures throughout India, Africa and the Middle East. Its colour ranges from brown to reddish-orange and is considered generally safe. When other hues, such as blue or black dyes, are added into the mix, you have the potential for a toxic potion. Tattoo artists like the black henna because they say the PPD sharpens definition, intensifies the colour and makes the tat last longer — up to two weeks before it fades (although salt water can speed the process). But that lovely defined skin symbol today could set you up for an ugly reaction later.
In a case study, Dr. DeKoven found subjects who were sensitized to the PPD in black henna tattoos had increased hypersensitivity to hair dye. “Subsequent exposure to PPD —even in low concentrations, such as those in hair dyes — can then lead to a delayed type-IV hypersensitivity reaction manifesting as an acute contact dermatitis,” he noted in the study. “This is particularly common among women and girls who colour their hair with hair dyes containing PPD or other para-dyes after having been sensitized by PPD in a black henna tattoo.”
Other substances that can cause cross-reactions include the PABA in sunscreen, certain local anesthetics and diuretics. “If you have a sensitivity to one you may develop a reaction to the other,” explains Dr. Rivers.
Depending on the level of infection, which could manifest anywhere from one to 14 days after application of the black henna tattoo, you might experience redness, rash, blisters, weeping lesions, swelling or permanent scarring. Treatment can range from topical antibiotic cream to corticosteroids, and could take weeks to heal.
Dr. Rivers suggests, if you really want body art, to stick to decals or real henna. “Don’t go with black henna or pre-mixed henna,” he says. For kids, “The tattoos that you stick on with water have ingredients that are considered safe and not problematic to the skin and the FDA recognizes that. It provides some sense of comfort that if you’re putting a tattoo that’s not henna on a child, they’re safe to use. Reactions are very uncommon with those.”
Or try an airbrush tattoo, which is sprayed on over a stencil. These are also considered safe and can be easily removed with rubbing alcohol. Draw the line at those micro-injection machines, since they puncture the skin. Improperly cleaned machines could spread infectious diseases such as HIV and hepatitis.
Your skin is your largest and only visible organ. Protect it by making smart decisions about what you put on it, and it will return the favour.
Health Canada recommends the following tips for tats:
1) Ask the seller if PPD or hair dye was used to make their ink or paste.
2) Ask to see the ingredients list on the ink’s jar or bottle. Cosmetics sold in Canada must note their components on the product label.
3) Avoid getting a tattoo if there is no label. If you are unsure if a henna tattoo ink or paste contains PPD, look for the following tell-tale signs: a) The ink, paste or tattoo itself is a very dark black; b) The tattoo ink sets very quickly. Natural henna paste must set for many hours to completely darken; c) The ink or paste has very little or no scent. Natural henna tends to smell like soil, hay or an essential oil.
4) If you suspect someone is using black henna, report it to Health Canada or your local health department.