Black hair dye dermatitis is a major cause of concealed facial melanosis in patients with dark complexion
Keywords:
Black hair dye, Facial melanosis, Lichen planus actinicusAbstract
Background Hair dye dermatitis is a common problem that is localized to the head or even generalized, and in many countries, it runs as an outbreak problem. Many patients present with facial melanosis, without an obvious history of dermatitis. Objective To record patients with facial melanosis that was triggered by black hair dying and to highlight this concealed cause of facial pigmentation. Methods This is a cross-sectional descriptive study where 102 patients with black hair dye facial melanosis were seen during the period from 2014-2022. All patients with Fitzpatrick skin type III and IV. Full demographic features were clarified. History and examination were carried out, and skin biopsies for histopathological assessment were done in selected cases. All other causes of facial melanosis were excluded. The therapeutic trial used Mometasone Furoate 0.1% cream twice a day for one month. Results A total of 102 patients with facial melanosis were analyzed; their ages ranged from 30-60 years with a mean of 50 years,70 (68.6%) males and 32 (31.4%) females with a ratio of 2:1. History and examination showed that all patients were applying black hair dye from 0.5-4 years and the duration of facial pigmentation ranged from 1-5 years. Patients mentioned some itching of the face, while others mentioned a history of an erythematous rash of the face in the early course of the disease. On examination, all patients revealed deep brown to dark hyperpigmentation of the face, neck, and hands. Woods light examination gave no contrast, while histopathological assessment showed an increase in the melanin stores both in the epidermis and dermis. Topical therapy with Mometasone Furoate, 0.1% cream, gave a very satisfactory response by lightening the skin. Conclusion Black hair dye is an important cause of facial melanosis that is often overlooked and confused with other causes of facial melanosis, commonly diffuse lichen planus actinicus, as a result its therapy will be very difficult unless hair dying is prevented. Therapy with mometasone Furoate 0.1% cream showed a satisfactory result.References
Khanna N, Rasool S. Facial melanoses: Indian perspective. Indian J Dermatol Venereol Leprol. 2011;77(5):552-63;quiz 64.
Bandyopadhyay D. Topical treatment of melasma. Indian J Dermatol. 2009;54(4):303-9.
Prasad V, Mohta A, Mehta RD, Ghiya BC, Soni P, Pareek S. Clinical and dermatoscopic correlation in facial melanosis: A cross-sectional study at a tertiary hospital. Our Dermatol Online. 2023;14(2):161-9
Dharman BK, Sridhar S. Diffuse facial melanosis – An overview of etiology and dermoscopic findings. J Skin Sex Transm Dis. 2020;2(2):86-93.
Sharquie KE, Ahmad EM. Lichen planus actinicus: Clinical and histopathological study. A Diploma Dissertation in Dermatology and Venereology, College of Medicine, University of Baghdad. 1991.
Sharquie KE, Noaimi AA, Al-Ogaily SM. Acanthosis Nigricans as a Cause of Facial Melanosis (Clinical and Histopathological Study). IOSR Journal of Dental and Medical Science. IOSR J Dent Med Sci. 2015;14:84-90
Sharquie KE, Noaimi AA. Gazelle Eye like Facial Melanosis (Clinico-Histopathological Study). J Pigment Dis. 2014;1:1-2
Sharquie KE, Noaimi AA, Hasan Ra. Outbreak of Hair Dye Dermatitis with Imitating Tendency. Am J Dermatol Venereol. 2020;9(1):1-5.
Hourblin V, Nouveau S, Roy N, de Lacharrière O. Skin complexion and pigmentary disorders in facial skin of 1204 women in 4 Indian cities. Indian J Dermatol Venereol Leprol. 2014;80(5):395-401
Halder RM, Grimes PE, McLaurin CI, Kress MA, Kenney JA, Jr. Incidence of common dermatoses in a predominantly black dermatologic practice. Cutis. 1983;32(4):390.
Alexis AF, Sergay AB, Taylor SC. Common dermatologic disorders in skin of color: a comparative practice survey. Cutis. 2007;80(5):387-94.
Grimes PE. Management of hyperpigmentation in darker racial ethnic groups. Semin Cutan Med Surg. 2009;28(2):77-85.
Doddamani SH, Bhavya BM, ShubhashreeM N, Naik RM, Thakur R. Management of hair dye related contact dermatitis: A case report. Int J Res Ayurveda Pharm. 2020.
Sahoo B, Handa S, Penchallaiah K, Kumar B. Contact anaphylaxis due to hair dye. Contact Dermatitis. 2000;43(4):244.
Gupta M. Hair-Dye induced erythema multiforme like allergic contact dermatitis. Our Dermatol Online. 2017;8:177-8.
Handa S, De D, Mahajan R. Epidemiological trends in contact dermatitis to hair dye: Comparing para-phenylenediamine positivity after a decade long interval. Indian J Dermatol Venereol Leprol. 2011;77(4):511-2.
doi: 10.4103/0378-6323.82386.
On HR, Hong WJ, Roh MR. Low-pulse energy Q-switched Nd:YAG laser treatment for hair-dye-induced Riehl's melanosis. J Cosmet Laser Ther. 2015;17(3):135-8.
Woo YR, Kim JS, Lim JH, Choi JY, Kim M, Yu DS, et al. Acquired diffuse slate-grey facial dyspigmentation due to henna: an unrecognized cause of pigment contact dermatitis in Korean patients. Eur J Dermatol. 2018;28(5):644-8.
Meghana V, Gopinath H, Karthikeyan K, Venugopal V. Face and Neck Pigmentary Alterations in Hair Dye Users: A Cross-sectional Study from South India. Indian Dermatol Online J. 2020;11(5):760-5.
Rubin IM, Dabelsteen S, Nielsen MM, White IR, Johansen JD, Geisler C, et al. Repeated exposure to hair dye induces regulatory T cells in mice. Br J Dermatol. 2010;163(5):992-8.
Bonefeld CM, Geisler C, Giménez-Arnau E, Lepoittevin JP, Uter W, Johansen JD. Immunological, chemical and clinical aspects of exposure to mixtures of contact allergens. Contact Dermatitis. 2017; 77(3):133-42.
Han JH, Lee HJ, Bang CH, Lee JH, Park YM, Lee JY. P-Phenylenediamine Hair Dye Allergy and Its Clinical Characteristics. Ann Dermatol. 2018;30(3):316-21.
Patel D, Narayana S, Krishnaswamy B. Trends in use of hair dye: a cross-sectional study. Int J Trichology. 2013;5(3):140-3.
Rodrigues M, Ayala-Cortés AS. Post-inflammatory Hyperpigmentation. In: Kumarasinghe P, editor. Pigmentary Skin Disorders. Cham: Springer International Publishing; 2018. p. 197-208.
Antelmi A, Bruze M, Zimerson E, Engfeldt M, Young E, Persson L, et al. Evaluation of concordance between labelling and content of 52 hair dye products: overview of the market of oxidative hair dye. Eur J Dermatol. 2017;27(2):123-31.
