Colours of danger?

A 38-year-old woman from Keighley, West Yorkshire, UK, was in a coma recently following a suspected allergic reaction to a home hair dye. Doctors have given Julie McCabe, who coloured her hair with L'Oréal Preference colourant, an 8 per cent chance of survival with little chance of a full recovery.

McCabe's case is the latest in a series of recent news reports linking the use of hair colourant to serious anaphylactic reactions. Anaphylactic reactions can be fatal. Also recently, teenager Tabatha McCourt collapsed and died following what is believed to be an extreme reaction to a home hair-dye kit she had used just 20 minutes before.

The chemical culprit is believed to be p-Phenylenediamine (PPD), an organic compound used in more than 99 per cent of all permanent hair dyes and in a range of other applications, such as permanent make-up, black clothing and even newsprint (it is illegal in all other cosmetic products, so black eyeliners and mascaras are always PPD free). A known irritant, PPD allergies have the potential to affect 1.5 per cent of the population.

Sudden reaction

In February, I was admitted to hospital after dyeing my hair. I had begun to feel unwell minutes after leaving the hairdresser and ten minutes later was covered in large red welts, with very swollen limbs and extremities, and a great deal of difficulty breathing. An ambulance was called and paramedics spent half an hour trying to stabilise me, while I suffered a serious fit. The hospital's doctors told me they had almost certainly saved my life. Everything pointed towards PPD as the likely aggressor. I have now stopped using permanent colourant. But in Britain alone hair dye is still used 100 million times a year (60 per cent of these in the home). So why is something as potentially dangerous as PPD still so ubiquitous?

PPD is the most effective known method of covering grey hair and there are no approved alternatives. Market leading brands such as Clairol, Avon and L'Oréal seem in no rush to find replacements to the ingredient while smaller companies don't have the necessary resources without their support. Some temporary colourants (lasting for six-eight washes and not covering grey) are PPD free, but virtually all semi-permanent and permanent colourants contain the ingredient. Even those without PPD are almost certain to contain PTD, a compound so similar that those allergic to the former will almost always be allergic to that too (and which needs to be used in around double the quantities of PPD).

According to the Cosmetic, Toiletries and Perfumery Association (CTPA), only a tiny percentage of the population has the potential to develop an allergy to PPD, but an article in the British Medical Journal in 2007 called for more investigation into the safety of hair dyes after an increase in allergic reactions in recent years.

The EU has recently reduced legal PPD levels (despite some recent newspaper reports to the contrary, no European countries have a PPD ban in place, nor does the US), to a maximum of 2 per cent when the mixed dye is applied to the hair (in general, the darker the colour — in my case a deep brown, the more PPD a dye will contain).

The grey areas

Many women might assume that "natural", "organic" and "eco" hair dyes are PPD free, but this is rarely the case. There is no hair colour on the market that covers all grey without PPD or PTD (henna, though PPD free, can't achieve the same effect). There is a glimmer of hope courtesy of companies such as OCS, who make ammonia-free hair dyes, which require lower levels of PPD (an average of around 0.4 per cent rather than the more common 2 per cent) to make them work, but some PPD remains, nonetheless.

The message from the hair companies is always to do an allergy test at least 48 hours before application, as specified on the packaging. This is sound, if unsatisfactory, advice. I went to a well-respected salon where a skin test was carried out well in advance and my highly qualified colourist did everything he should. Yet I still found myself, one hour later, in an ambulance with paramedics unsure if I would even make it to the hospital. The CTPA admits that skin allergy tests are neither conclusive nor infallible.

I had been dyeing my hair for almost 20 years, with the same popular brand of colourant, and had never experienced anything more than mild itching and slight redness around the hairline. Yet one day, for no discernible reason, the same process very nearly killed me.