Clincal Briefs-With Comments from John La Puma, MD, FACP

Allergic Reaction to Henna

April 2000; Volume 3; 48

Source: Lyon MJ, et al. Allergic contact dermatitis reaction to henna. Arch Dermatol 2000;136:124-125.

"A healthy 30-year-old woman obtained a henna tattoo’ from a street vendor on a California beach. Ten days later she noted pruritus followed by multiple small papules overlying the pattern encircling her left arm. Several days later, the design appeared erythematous and raised, sparing the unpainted areas (tracing the outline of the pattern). Treatment with topical diflorasone diacetate resulted in gradual improvement with resolution in several weeks. The patient denied prior exposure to henna. She chose not to have a skin biopsy and patch testing to henna. However, the time course and clinical morphology of the dermatitis were typical of a type IV hypersensitivity reaction to henna."

COMMENT

Henna is an Old World shrub that grows both in North America and in the Middle East—most famously in Egypt. The family Lythraceae contains several different genus and species, including Henna (Lawsonia inermis). The bark of one shrub yields a yellow color; the leaves of another yield red. Henna’s leaves give a reddish brown color to skin and hair—the leaves are powdered, revitalized with water, and a cosmetic paste created and then applied.

Henna is a little like costume jewelry—beautiful designs and intricate patterns can be created for relatively little money. And like costume jewelry, henna does not last forever. In fact, a do-it-yourself kit, sold in drugstores and supermarkets across the country, will yield just 3-4 weeks of visual pleasure.

This is, the authors report, the first case of type IV hypersensitivity to henna, though contact dermatitis and type I hypersensitivity have been documented in India and reported in the medical literature. There is no skin penetration with henna tattoos, and the danger of actual systemic harm appears to be nil.

Recommendation

Know that hypersensitivity to henna exists, is rare, is treatable, and is self-limited.