Face and Neck Pigmentary Alterations in Hair Dye Users: A Cross-sectional Study from South India.

BACKGROUND: Hair dyes are commonly used for the concealment of grey hair in India. The pigmentary alterations produced by hair dyes on the face and neck have not received sufficient attention. AIMS: To study the pigmentary alterations on the face and neck in hair dye users, and identify possible risk factors associated with the face and neck hyperpigmentation. METHODS: A hospital-based descriptive cross-sectional study was done on consecutive hair dye users. A detailed history was taken, and a clinical examination was done to record the pigmentary alterations. The patterns, areas affected, the intensity of hyperpigmentation, percentage of the area involved and risk factors were noted. RESULTS: One hundred and twenty patients were included in the study. Around 118 (98.3%) patients had hyperpigmentation over face and/or neck: 16 (13.3%) barely perceivable, 40 (33.3%) mild, 44 (36.7%) moderate, and 18 (15%) severe pigmentation. The lateral forehead (106, 88.3%), the helix of the ear (106, 88.3%), central forehead (97, 80.8%), and zygomatic area (92, 76.7%) were the most frequently affected areas in our study. Fourteen patients (11.7%) had depigmented macules on the scalp and/or lips. CONCLUSION: Pigmentary alterations, particularly hyperpigmentation over the upper face and ears are common with the use of hair dyes. The skin type may play a role in the intensity of hyperpigmentation.

For the love of color: Plant colors and the dermatologist.

Humans have been anointing their skin with natural colorants since antiquity. Before the advent of modern cosmetics, tattoos and hair dyes, the spectacular colors in plants served as a palette for humanity's fascination with color. Skin, hair, nails, teeth and clothing have been altered with botanical colorants for centuries. Understanding the relevance of botanical colorants is an important part of cultural competency. Substitution or adulteration of plant colorants with synthetic colorants has played a role in varied dermatoses (eg. black henna, kumkum, and Holi dermatoses). Safety concerns over synthetic colorants have led to a resurgence of natural colorants. However, some plant colorants have produced adverse reactions. Plant colorants have also played an integral role in medicine. Ingested plant colorants are an indispensable part of our diet, playing crucial roles in the maintenance of health and prevention of disease. Excessive intake of some pigments can alter skin color (carotenoderma, lycopenemia, and the golden tan of canthaxanthin). We have relied on the colors of hematoxylin and alizarin red, derived from the logwood tree and madder roots, respectively, to study and diagnose disease in pathology. We briefly review the uses, cultural relevance, and adverse effects of the common botanical colorants on the skin, hair, and mucosa. We also describe their relevance in our diet, and in the diagnosis and description of dermatological diseases.