European Journal of Dermatology

, Volume 28, Issue 5, pp 644–648 | Cite as

Acquired diffuse slate-grey facial dyspigmentation due to henna: an unrecognized cause of pigment contact dermatitis in Korean patients

  • Yu Ri Woo
  • Jong Sic Kim
  • Ji Hong Lim
  • Jin Young Choi
  • Miri Kim
  • Dong Soo Yu
  • Young Min Park
  • Hyun Jeong ParkEmail author
Clinical report



Henna is a vegetable hair dye that can be used by individuals who are sensitized to oxidative dyes due to low allergenicity. The reported incidence of slate-grey facial dyspigmentation following the use of henna hair dye is extremely rare.


This study aimed to identify the clinical, dermoscopic, and histopathological features of slate-grey facial dyspigmentation following the use of henna hair dye in Korean patients.

Materials & methods

We identified all patients who presented with slate-grey facial dyspigmentation following usage of henna hair dye. Patients were further evaluated for clinical, dermoscopic, and histopathological findings along with their patch test results.


All 11 patients were females with Fitzpatrick’s skin phototype III or IV. Prominent slate-grey-coloured dyspigmentation on the lateral side of the face and neck was most common in eight (72%) patients. Under dermoscopic examination, a pseudo-network with grey dots was observed in all patients. Histopathological examination revealed liquefaction degeneration of the epidermal basal layer and pigmentary incontinence in the papillary dermis in all patients. The diagnosis of pigmented contact dermatitis following usage of henna was made based on the clinical, dermoscopic, and histopathological findings in all patients.


Pigmented contact dermatitis associated with henna occurs mostly in middle-aged women and requires long-term treatment. Therefore, careful attention should be paid when henna is used to dye hair in this age group.

Key words

pigmented contact dermatitis henna hair dye dermoscopy Riehl’s melanosis dyspigmentation 


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  1. 1.
    Belhadjali H, Ghannouchi N, Amri C, Youssef M, Amri M, Zili J. Contact dermatitis to henna used as a hair dye. Contact Dermatitis 2008; 58: 182.CrossRefGoogle Scholar
  2. 2.
    Polat M, Dikilitaş M, Öztaş P, Allı N. Allergic contact dermatitis to pure henna. Dermatol Online J 2009; 15: 15.Google Scholar
  3. 3.
    Alagappan U, Tay Y–K, Lim S–PR. Pigmented contact dermatitis secondary to benzyl salicylate. Acta Derm Venereol 2013; 93: 590.CrossRefGoogle Scholar
  4. 4.
    Trattner A, Hodak E, David M. Screening patch tests for pigmented contact dermatitis in Israel. Contact Dermatitis 1999; 40: 155–7.CrossRefGoogle Scholar
  5. 5.
    Jo SJ, Shin H, Paik SH, et al. The pattern of hair dyeing in Koreans with gray hair. Ann Dermatol 2013; 25: 401–4.CrossRefGoogle Scholar
  6. 6.
    Wang L, Xu AE. Four views of Riehl’s melanosis: clinical appearance, dermoscopy, confocal microscopy and histopathology. J Eur Acad Dermatol Venereol 2014; 28: 1199–206.CrossRefGoogle Scholar
  7. 7.
    Nakayama H. Pigmented contact dermatitis and chemical depigmentation. In: Johansen J, Frosch P, Lepoittevin JP, eds. Contact Dermatitis. 5th edn. Springer, 2011: 377–93.Google Scholar
  8. 8.
    Kazandjieva J, Grozdev I, Tsankov N. Temporary henna tattoos. Clin Dermatol 2007; 25: 383–7.CrossRefGoogle Scholar
  9. 9.
    Chung W–H, Chang Y–C, Yang L–J, et al. Clinicopathologic features of skin reactions to temporary tattoos and analysis of possible causes. Arch Dermatol 2002; 138: 88–91.Google Scholar
  10. 10.
    Bolhaar S, Mulder M, Van Ginkel C. IgE–mediated allergy to henna. Allergy 2001; 56: 248.CrossRefGoogle Scholar
  11. 11.
    Lee YB, Park SM, Kim J–W, Yu DS. Combination treatment of lowfluence Q–switched Nd: YAG laser and oral tranexamic acid for postinflammatory hyperpigmentation due to allergic contact dermatitis to henna hair dye. J Cosmet Laser Ther 2016; 18: 95–7.CrossRefGoogle Scholar
  12. 12.
    Wantke F, Gotz M, Jarisch R. Contact dermatitis due to henna, solvent red 1 and solvent red 3. A case report. Contact Dermatitis 1992; 27: 346–7.CrossRefGoogle Scholar
  13. 13.
    Garcia Ortiz JG, Terron M, Bellido J. Contact allergy to henna. Int Arch Allergy Immunol 1997; 114: 298–9.CrossRefGoogle Scholar
  14. 14.
    Akyüz M, Ata Ş. Determination of aromatic amines in hair dye and henna samples by ion–pair extraction and gas chromatography–mass spectrometry. J Pharm Biomed Anal 2008; 47: 68–80.CrossRefGoogle Scholar
  15. 15.
    Serrano G, Pujol C, Cuadra J, Gallo S, Aliaga A. Riehl’s melanosis: pigmented contact dermatitis caused by fragrances. J Am Acad Dermatol 1989; 21: 1057–60.CrossRefGoogle Scholar
  16. 16.
    Perez–Bernal A, Mu˜noz–Pérez MA, Camacho F. Management of facial hyperpigmentation. Am J Clin Dermatol 2000; 1: 261–8.CrossRefGoogle Scholar
  17. 17.
    Li YH, Liu J, Chen JZ, et al. A pilot study of intense pulsed light in the treatment of Riehl’s melanosis. Dermatol Surg 2011; 37: 119–22.CrossRefGoogle Scholar
  18. 18.
    On HR, Hong WJ, Roh MR. Low–pulse energy Q–switched Nd: YAG laser treatment for hair–dye–induced Riehl’s melanosis. J Cosmet Laser Ther 2015; 17: 135–8.CrossRefGoogle Scholar
  19. 19.
    Kim JE, Jung HD, Kang H. A survey of the awareness, knowledge and behavior of hair dye use in a Korean population with gray hair. Ann Dermatol 2012; 24: 274–9.CrossRefGoogle Scholar
  20. 20.
    Søsted H, Hesse U, Menné T, Andersen KE, Johansen J. Contact dermatitis to hair dyes in a Danish adult population: an interview–based study. Br J Dermatol 2005; 153: 132–5.CrossRefGoogle Scholar

Copyright information

© John Libbey Eurotext 2018

Authors and Affiliations

  • Yu Ri Woo
    • 1
  • Jong Sic Kim
    • 1
  • Ji Hong Lim
    • 1
  • Jin Young Choi
    • 2
    • 3
  • Miri Kim
    • 1
  • Dong Soo Yu
    • 3
  • Young Min Park
    • 2
  • Hyun Jeong Park
    • 1
    Email author
  1. 1.Department of Dermatology, Yeouido St. Mary’s Hospital, College of MedicineThe Catholic University of KoreaSeoulKorea
  2. 2.Department of Dermatology, Seoul St. Mary’s Hospital, College of MedicineThe Catholic University of KoreaSeoulKorea
  3. 3.Department of Dermatology, Uijeongbu St. Mary’s Hospital, College of MedicineThe Catholic University of KoreaSeoulKorea

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