Got a PPD tattoo - now what?
July 29, 2015 4:26 PM Subscribe
My husband and I are honeymooning on Gran Canaria and, in a silly mood, got henna tattoos from a stall on the oceanside. Back at the hotel, I googled for tips on henna tattoo care and discovered that the vendor used "black henna" containing PPD, which can cause severe skin reactions and further health problems.
I am concerned and anxious now - is there any way to reduce the probability of an allergic reaction? Would scrubbing to get the color out be helpful (the tattoos are two hours old) or only irritate the skin more? Or is all we can do wait? I've searched for information, but all I can find are warnings (too late...) or tips for people who have already experienced issues, which I really want to avoid. Thanks!
I am concerned and anxious now - is there any way to reduce the probability of an allergic reaction? Would scrubbing to get the color out be helpful (the tattoos are two hours old) or only irritate the skin more? Or is all we can do wait? I've searched for information, but all I can find are warnings (too late...) or tips for people who have already experienced issues, which I really want to avoid. Thanks!
Yeah, the article says "Because the blistering reaction appears 3 to 12 days after the application, most tourists have left and do not return to show how much damage the artist has done." So I would be concerned, too. It's not my Ask, but I think it'd be great if people responding could a) not be dismissive and b) give some rationale for their responses.
posted by wintersweet at 4:52 PM on July 29, 2015 [3 favorites]
posted by wintersweet at 4:52 PM on July 29, 2015 [3 favorites]
I have actually had a class covering OSHA. CDC says wash promptly with soap.
I will do more digging, because I do not want to endanger you with half baked advice. Please wash this off promptly with soap. Right now.
posted by Michele in California at 4:59 PM on July 29, 2015 [3 favorites]
I will do more digging, because I do not want to endanger you with half baked advice. Please wash this off promptly with soap. Right now.
posted by Michele in California at 4:59 PM on July 29, 2015 [3 favorites]
If you are worried, I would just try to immediately remove it as much as possible. But I wouldn't rub it raw or anything -- I doubt breaking your skin and getting it in your bloodstream would help. Just googling around, I don't see anything you can do other than try to wash it off, and then keep an eye on it. But I'm obviously not an expert -- maybe some doctor MeFites can weigh in.
posted by AppleTurnover at 5:13 PM on July 29, 2015
posted by AppleTurnover at 5:13 PM on July 29, 2015
I notice that the wikipedia article says "can cause severe allergic reactions and permanent scarring if left on for more than 2–3 days." and later than problems show up 3-12 days after application. Therefore, it would seem logical that removing the tattoo immediately would significantly reduce your risks. Unfortunately, wikipedia doesn't cite a source specifically for that comment so no guarantees but it may give you a little reassurance.
Since PPD is used as a hair dye, suggestions for how to remove hair dye from your hands might work to get the black henna off your body. Here is one site that listed quite a few options. You can also google "remove hair dye from hands" for many more opinions.
posted by metahawk at 5:13 PM on July 29, 2015 [1 favorite]
Since PPD is used as a hair dye, suggestions for how to remove hair dye from your hands might work to get the black henna off your body. Here is one site that listed quite a few options. You can also google "remove hair dye from hands" for many more opinions.
posted by metahawk at 5:13 PM on July 29, 2015 [1 favorite]
There are hair dye removing wipes that you can buy. They are meant to clear up stray dye around ears, etc but they do a really good job. Worth a try?
posted by saradarlin at 5:17 PM on July 29, 2015 [2 favorites]
posted by saradarlin at 5:17 PM on July 29, 2015 [2 favorites]
There isn't a lot of info available for post exposure treatment.
This site suggests you can leach temporary tattoo dye out with a salt water bath if you want it gone sooner. I would totally do that to try to limit chemical exposure as much as possible.
Activated charcoal is recommended as a treatment if you have consumed it orally. You could read further on activated charcoal. I know it gets used in alternative med circles.
posted by Michele in California at 5:35 PM on July 29, 2015
This site suggests you can leach temporary tattoo dye out with a salt water bath if you want it gone sooner. I would totally do that to try to limit chemical exposure as much as possible.
Activated charcoal is recommended as a treatment if you have consumed it orally. You could read further on activated charcoal. I know it gets used in alternative med circles.
posted by Michele in California at 5:35 PM on July 29, 2015
Best answer: According to (the generally very reliable) DermNetNZ:
"Treatment of PPD dermatitis
In acute severe cases of PPD hair dye dermatitis, wash the hair and scalp thoroughly with a mild soap or soapless shampoo to remove the excess dye. Apply a 2% hydrogen peroxide solution or compresses of potassium permanganate in a 1:5000 dilution to completely oxidise the PPD. To soothe, soften the crust and alleviate the tight feeling of the scalp, a wet dressing of cold olive oil and lime may be used. Further treatment with a topical application of an emulsion of water and water-miscible corticosteroid cream, or oral corticosteroids may be indicated.
Management of PPD dermatitis on other parts of the body may be treated as for any acute dermatitis/eczema; this may include treatment with topical corticosteroids and emollients."
The above is the most reputable information, from here on out it's my opinion:
So if I were you, I'd wash it, mildly (don't scrub too hard or irritate the skin, that might exacerbate the reaction). When you are next at a pharmacy, I'd get some of the above hydrogen peroxide just to make sure it is entirely neutralised. I'd also pick up some Zyrtec (antihistamine), and sheets of tegaderm (clear plastic that acts like a second skin for grazes, burns, etc, you can usually buy it a sheet at a time), because they're both pretty cheap.
It sounds kind of like a poison ivy reaction, so while the blisters take a few days, the more time that goes by without ANY burning sensation etc, the less likely it is you are having a reaction.
Take a zyrtec each day until you're sure you aren't blistering, it's an antihistamine, won't hurt, might help. If you DO start getting blisters, slap on some tegaderm and leave it alone.
posted by Elysum at 5:36 PM on July 29, 2015 [3 favorites]
"Treatment of PPD dermatitis
In acute severe cases of PPD hair dye dermatitis, wash the hair and scalp thoroughly with a mild soap or soapless shampoo to remove the excess dye. Apply a 2% hydrogen peroxide solution or compresses of potassium permanganate in a 1:5000 dilution to completely oxidise the PPD. To soothe, soften the crust and alleviate the tight feeling of the scalp, a wet dressing of cold olive oil and lime may be used. Further treatment with a topical application of an emulsion of water and water-miscible corticosteroid cream, or oral corticosteroids may be indicated.
Management of PPD dermatitis on other parts of the body may be treated as for any acute dermatitis/eczema; this may include treatment with topical corticosteroids and emollients."
The above is the most reputable information, from here on out it's my opinion:
So if I were you, I'd wash it, mildly (don't scrub too hard or irritate the skin, that might exacerbate the reaction). When you are next at a pharmacy, I'd get some of the above hydrogen peroxide just to make sure it is entirely neutralised. I'd also pick up some Zyrtec (antihistamine), and sheets of tegaderm (clear plastic that acts like a second skin for grazes, burns, etc, you can usually buy it a sheet at a time), because they're both pretty cheap.
It sounds kind of like a poison ivy reaction, so while the blisters take a few days, the more time that goes by without ANY burning sensation etc, the less likely it is you are having a reaction.
Take a zyrtec each day until you're sure you aren't blistering, it's an antihistamine, won't hurt, might help. If you DO start getting blisters, slap on some tegaderm and leave it alone.
posted by Elysum at 5:36 PM on July 29, 2015 [3 favorites]
Best answer: Per this site on PPD sensitivity in hair dyes, PPD darkens upon oxidation (which happens with exposure to air with "black henna" tattoos); it's an intermediate that is not fully oxidized (quinodiimine, per looking up the chemistry) that is a sensitizer. Thus they suggest:
1-washing off the excess dye with mild soap or soapless shampoo
2-completing the oxidation of PPD with a 2% hydrogen peroxide solution (to minimize the amount of quinonediimine)
posted by neda at 5:40 PM on July 29, 2015 [4 favorites]
1-washing off the excess dye with mild soap or soapless shampoo
2-completing the oxidation of PPD with a 2% hydrogen peroxide solution (to minimize the amount of quinonediimine)
posted by neda at 5:40 PM on July 29, 2015 [4 favorites]
Response by poster: Thank you all! We've used some makeup remover and gentle scrubbing with a towel and the tattoos look much more faded already. The dye remover pads are a good idea, but not sure if they are available here. I do have some EpiDuo (a topical acne treatment containing adapalene and benzoyl peroxide) here right now, would that work as a substitute for hydrogen peroxide, or better get the real deal at a pharmacy tomorrow?
posted by Skybly at 5:55 PM on July 29, 2015
posted by Skybly at 5:55 PM on July 29, 2015
That 2.5% benzoyl peroxide combo you have might actually do the job very nicely. The usual hydrogen peroxide solution you buy at a drug store is 3% strength, and they are obviously both oxidizers. (Fun fact: benzoyl peroxide is a good rocket fuel.)
posted by artistic verisimilitude at 6:02 PM on July 29, 2015 [1 favorite]
posted by artistic verisimilitude at 6:02 PM on July 29, 2015 [1 favorite]
Benzoyl peroxide is an oxidizing agent that would oxidize an imine similarly to hydrogen peroxide, yes.
That said, if it were me, I'd probably not experiment on my own skin with the EpiDuo, as you've also got a retinoid in that cream as well. Some retinoids are actually reducing agents (they get oxidized by benzoyl peroxide); adalpene does not reduce/get oxidized by benzoyl peroxide (why epiduo is stable), but who knows how it will react with what you've got on your "henna" tattoo. If it were me, I'd skip it. Plus, it's your skin, not an Erlenmeyer flask, yo.
posted by neda at 6:28 PM on July 29, 2015 [8 favorites]
That said, if it were me, I'd probably not experiment on my own skin with the EpiDuo, as you've also got a retinoid in that cream as well. Some retinoids are actually reducing agents (they get oxidized by benzoyl peroxide); adalpene does not reduce/get oxidized by benzoyl peroxide (why epiduo is stable), but who knows how it will react with what you've got on your "henna" tattoo. If it were me, I'd skip it. Plus, it's your skin, not an Erlenmeyer flask, yo.
posted by neda at 6:28 PM on July 29, 2015 [8 favorites]
This fairly detailed page on it links to a medical journal article and a number of other pages discussing what to do if you do have a reaction to it.
Tegaderm's great to protect injured flesh but if it starts to itch and/or swell I would definitely see a doctor for a prescription cream ASAP. OTC hydrocortisone if that was available but good medical care was not.
posted by kmennie at 8:20 PM on July 29, 2015
Tegaderm's great to protect injured flesh but if it starts to itch and/or swell I would definitely see a doctor for a prescription cream ASAP. OTC hydrocortisone if that was available but good medical care was not.
posted by kmennie at 8:20 PM on July 29, 2015
Do you have a health care provider that you can keep in touch with? Maybe they can either call in a hydrocortisone prescription for you, have one waiting, or go ahead and book you a standing appointment for when you get home in case it gets worse?
One handy tip if it does begin going south - use the camera on your phone to monitor the area so your provider can get an accurate idea and you can monitor how fast it's progressing.
Good luck!
posted by rubster at 1:01 AM on July 31, 2015
One handy tip if it does begin going south - use the camera on your phone to monitor the area so your provider can get an accurate idea and you can monitor how fast it's progressing.
Good luck!
posted by rubster at 1:01 AM on July 31, 2015
Maybe they can either call in a hydrocortisone prescription for you
According to a thread from 2008, skybly may be able to buy low strength hydrocortisone cream from a Farmacia, without a prescription?
Or at least inquire at a Pharmacy first.
Anyway, hopefully Skybly has washed it off in time, and it's an allergic reaction that not everybody gets, so fingers crossed for a good outcome.
:)
posted by Elysum at 2:00 AM on July 31, 2015
According to a thread from 2008, skybly may be able to buy low strength hydrocortisone cream from a Farmacia, without a prescription?
Or at least inquire at a Pharmacy first.
Anyway, hopefully Skybly has washed it off in time, and it's an allergic reaction that not everybody gets, so fingers crossed for a good outcome.
:)
posted by Elysum at 2:00 AM on July 31, 2015
Response by poster: We're back home and so far, no reactions, and the tattoos are barely visible now anymore. I hope that's the end of it - thanks again!
posted by Skybly at 1:18 PM on August 3, 2015 [1 favorite]
posted by Skybly at 1:18 PM on August 3, 2015 [1 favorite]
This thread is closed to new comments.
posted by Skybly at 4:45 PM on July 29, 2015 [2 favorites]