“Just because a tattoo is temporary doesn’t mean that it is risk-free,” says Linda Katz, M.D., M.P.H., director of FDA’s Office of Cosmetics and Colors.

Many young people and children get temporary black henna tattoos that artists can paint on their bodies in minutes. Unfortunately, there have been many reports of these tattoos causing negative health effects that lead to doctor and hospital visits and long-term or permanent scarring.

“…his arm was weeping through his clothes and aggravating him.”

Lynn Humphreys of Wales, U.K., was vacationing in Turkey in May 2022 when she bought her son a temporary black henna arm tattoo from a street vendor. Twelve days later, his skin had “become lumpy, warm to the touch, and began irritating him.”

Humphreys removed the tattoo from his skin, but her son had already suffered an allergic reaction. An infection set in, his skin scabbed and cracked, and a rash with oozing blisters spread onto his torso and up to his chin. After three doctors’ visits, antibiotics, and two days away from school, he started improving, and he eventually made a full recovery. But the reaction had permanently scarred his skin.

What is black henna?

Henna is a reddish-brown paste extracted from a flowering plant native to tropical and subtropical regions of Asia and Africa. For thousands of years, people have used henna as a dye for the hair, skin, and fingernails, and materials such as silk and wool. Natural henna is generally safe and rarely causes allergic reactions.

Tattoo artists use black henna to make their designs look as black as real, permanent tattoos, and to make them last longer. These temporary, paint-on tattoos can last up to five weeks. Para-phenylenediamine or PPD, an organic compound, is the extra ingredient that makes black henna different from natural henna. And it’s the reason that dermatologists warn that temporary black henna tattoos are dangerous.

What makes black henna dangerous?

Hair dyes and dark clothing dyes are common culprits for allergic contact dermatitis (allergic skin reactions) because they come in contact with human skin and contain significant levels of PPD. That’s why darker hair dye instructions include warnings to apply a small amount to a patch of skin to see whether it causes an allergic reaction before dying hair.

But unlike in hair dye, PPD in black henna is used in much stronger concentrations.

The four health problems black henna tattoos can cause:

• intense itching and burning rash
• long-term temporary scars
• permanent scars
• Lifelong cross-reactions to hair dyes, compounds, and medicines

The more black henna tattoos a person gets, the more likely they are to suffer a reaction and develop sensitivity because each exposure to PPD challenges their immune system. An allergic reaction from a single black henna tattoo can lead to the development of lifelong sensitivity to PPD.  Once they are sensitized, a person will suffer reactions to many products and medications that contain certain chemicals.

People who have suffered an allergic reaction to PPD, or are sensitized to PPD, should avoid these products and chemicals:

• Medications (Sulfonamides, sulfonylureas)
• Sunscreens (Para-aminobenzoic acid)
• Hair dyes (Para-toluenediamine sulfate)
• Clothes, ballpoint pen ink, shoes (azo dyes)
• Local anesthetics (Benzocaine, tetracaine, procaine)
• Antibiotics (Para-aminosalicylic acid)

Though it’s extremely rare, poisoning from topical PPD exposure can trigger potentially deadly systemic reactions leading to acute renal failure and multiple organ failure.

What is an allergic reaction to black henna like?

Itchy, burning, and oozing blisters usually appear in the exact pattern of the tattoo. However, there are serious cases when an infection causes skin eruptions to occur in areas away from the tattoo.
The earliest indication of an allergic reaction is typically 4-14 days after exposure, but people previously sensitized to PPD will usually react within 1-3 days.

Is there permanent scarring?

The skin may recover its normal appearance, but permanent and long-term or semi-permanent keloid scarring are also common. Darkened skin (hyperpigmentation) and lightened skin (hypopigmentation) typically resolve in 6 months or remain permanently.

As with scarring due to other allergic reactions, injury, and disease, the following three factors have a significant impact on the reduction and elimination of scarring:

1. The extent of the damage to the skin.
2. The quality of the initial care of the damaged skin.
3. The quality of the care of the scarring. 

What are the chances of having an allergic reaction?

Research has found that an estimated 2.5% of people who get a black henna tattoo will experience an allergic reaction. Those who don’t have reactions may incur primary sensitization, which means they may suffer future allergic reactions when re-exposed to PPD.

Where do people get these tainted tattoos?

Most reports of allergic dermatitis from black henna tattoos have come from tourists visiting Southeast Asia or the Middle East, especially Turkey, Egypt, Bali, and Morocco. But more and more people are reporting reactions to tattoos applied by street artists in Europe and the U.S.

Henna artists do business from stands at summer carnivals, open-air malls, cruise ships, and vacation destinations, and beaches may be their most popular place of operation.

Reporting an Adverse Reaction to a Temporary Tattoo

The FDA encourages consumers to report any adverse reactions to cosmetics to the FDA’s Office of Cosmetics and Colors or the nearest FDA district office. You can find the phone number of the nearest FDA district office on the FDA website.

Trusted Black Henna Legal Assistance

If you, a friend, or a loved one has sustained ill health effects because of a black henna tattoo, there may be a strong case for personal injury compensation.

Please call McCready Law as soon as possible to get started because there are strict, court-enforced timelines to follow when filing civil claims.

For more information, please fill out our online contact form or call 773-902-0413.