Danger in the details; the dark side of henna art

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WALLA WALLA — Temporary tattoos have long been marketed as a way to have your cake and eat it, too.

Whether a stick-on type or one stained into the skin with henna, such tattoos offer a way to express yourself in body art that won’t leave a permanent reminder of that day you thought a giant butterfly on your hip was the perfect way to tell the world you were ready to fly.

In some cases, however, henna tattoos have indeed left reminders, and not in a happy way.

Walla Walla henna artist Annelise Amante De La Vida could not agree more. The wrong henna in the wrong hands can be devastating for some people, she said.

According to the U.S. Drug and Food Administration, some consumers report reactions that may be severe and long outlast the temporary tattoos themselves.

The FDA has received reports of serious and long-lasting consequences consumers had not bargained for after getting a henna art treatment. Problems include redness, blisters, raised red weeping lesions, loss of pigmentation, increased sensitivity to sunlight and permanent scarring.

History records extensive use of henna, a reddish-brown coloring made from a flowering plant that grows in Africa and Asia. Since the Bronze Age, people have used dried henna, ground into a paste, to dye skin, hair, fingernails, leather, silk and wool. This decoration — sometimes also known as mehndi — is still used around the world to decorate the skin in cultural festivals and celebrations.

Now, however, so-called “black henna” is often used in place of traditional henna. Inks marketed as black henna may be a mix of henna with other ingredients, or may really be hair dye alone. Other ingredients are added to darken the effect and increase longevity, but black henna is potentially harmful.

The culprit is most often a coal-tar hair dye containing p-phenylenediamine, known in the industry as PPD. The substance is mainly used as a component of engineering polymers and composites, according to Wikipedia.

It can cause dangerous reactions in some people, and there is no way to know just who until it happens, health officials say. By law, PPD is not permitted in cosmetics intended to be applied to the skin.

Some reactions have led people to seek medical care, including visits to hospital emergency rooms, the FDA said. Reactions may occur immediately after a person gets a temporary tattoo, or even up to two or three weeks later.

“Black henna is a lie. It’s really a poison,” Amante De La Vida said.

Cameron Byerley knows the pain of the not-so-temporary tattoo. The 2002 Walla Walla High School graduate joined “Teach for America” after graduating from Whitman College in 2006 and is now at Arizona State University getting a doctorate on math education.

It was while she was in Tanzania on vacation Byerley decided to get some body art, she said. “I got the tattoo from two very nice local women. One had just been married and was covered in henna and raising money for her honeymoon. I have no reason to think that the two women had any idea that adding black hair dye to the henna made it dangerous for skin.”

But the art caused red bumps and itchy reactions “in the exact shape of the tattoo,” the student noted. “I’m typically a safe person — not a huge risk taker. I really thought temporarily tattoos were safe and that I was being responsible by not getting a real tattoo.”

Byerley did research on black henna and headed to an allergist. Test showed she was exceptionally allergic to PPD after a skin test with the chemical left a large sore on her back, she said. “I later found out by reading a research journal that in people who have been exposed to black henna and had a reaction that allergists should use much smaller quantities of PPD to test them for the allergy. It took a few weeks for the mark to go away, but there was no permanent scars from the allergy test.”

Her investigation found the reaction to the culprit chemical would likely sensitize her to a wide variety of other substances, such as hair dye, rubber, printer ink and dye used in clothing dye. “And the reactions to PPD build over time so really no one can be sure if they are safe or not,” the Walla Walla native pointed out.

“I have not and will not ever dye my hair because of what I found out at the allergist about what could happen to me … I can only imagine if that one spot on my back was my entire head. It would be horrific.”

Byerley can count herself lucky by Amante De La Vida’s reckoning. There are too many places — think fairs, festivals and kiosks at the beach — manned by people who have no idea what they are doing or selling, she said. “I look at my henna through a microscope. I take a sample and it shows me the henna leaf. There should never be crystals or black dots.”

Henna solutions should contain essential oil, sugar or a sucrose, a tea and organic henna leaves, she said. Natural henna may be colored khaki, brown-green, dark brown, “but never jet black.”

Reputable henna artists should always be willing to share information about the products they use, Amante De La Vida said. “Ask what is in the mix. I feel so strongly people should never buy henna from a tube. Get it from a henna artist. Ask me.”

There are rare occurrences of reaction with the natural plant, too, she added. It is a naphthoquinone sensitivity that flares up on contact, she explained. “Within three hours of the henna application, the person will become itchy, wheezy or feel a tightness in their chest.”

If the itchy spot takes the shape of the henna design, or causes open sores and blisters, however, “that’s a sign the artist was using PPD,” she said.

Dr. Bonnie Head practices family medicine in a small hospital in North Africa, where the custom is to use pure henna and mix in custom additives. A native of Elgin, Ore., Head attended Walla Walla University and received her medical degree from the University of Guadalajara in 2000.

In the region Head lives and works, henna is used by women for any special occasion, she said. “To go to a wedding, or even when their husband who works in another town is coming for a visit. It is especially beautiful for the bride.”

The crushed leaves of the plant are mixed with water and sometimes oil, Head noted. “There is a probably petroleum additive used to make the color black. The paste is put on skin and usually wrapped in toilet paper, then a plastic bag to make the skin sweat.”

After a few hours, the chemical reaction has taken place on the skin and the paste is scraped off and cooking oil is applied, the physician said. “Can’t wash your hands until the next day. It comes off the palms of my hands about five days later, but I have to be washing my hands as I see patients … The nails keep the color and eventually grow out. I have lived here since 2009 and have never seen a rash or other complication from the henna, although there may be women that don’t do it because of a previous reaction.”

The plant mixture is also a good treatment for some symptoms of athlete’s foot, Head said.

In America laws overseeing temporary tattoos vary from state to state, increasing the possibility that no one is checking for safe practices, the FDA said. “A number of consumers have learned the risks the hard way, reporting significant bad reactions shortly after the application of black henna temporary tattoos.”

The agency cited cases including a 5-year-old girl who developed severe reddening on her forearm about two weeks after receiving a black henna temporary tattoo. Her parents thought the tattoo would be harmless fun, they told officials.

In another instance a parent reported her 17-year-old had no reaction to red henna tattoos, but looked like a burn victim, “all blistered and raw,” after a black henna tattoo was applied. A doctor has said the teen will have scarring for life.

There are things a consumer can do, Amante De La Vida said. “Look and ask. Henna should not be black. Buy it only from someone you trust.”

The natural product has a very short shelf life, she added. “A week.” Purchasing henna in a tube from a store means buying something laced with preservatives. “You should be able to eat it. Not that you would, but there should be nothing in it that could make you sick. If you can’t ingest it, you probably should not be putting it on your skin.”

People who apply henna as a hobby don’t mean to inflict harm with the additives in black henna, Amante De La Vida said, adding that she has been doing this for a decade.

“If you’re not trained, you don’t know. But I want everyone and their dog walker to know — this is a real thing.”

The FDA urges anyone experiencing a reaction to a temporary tattoo to contact his or her doctor and to contact MedWatch, the agency’s problem-reporting program, at 800-332-1088.

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