Photograph shows a woman who suffered a severe infection after the application of henna.
Henna is an Old World tropical shrub of the loosestrife family that people have been using for thousands of years to color their hair and decorate their skin. For the creation of body art (also known as mehndi), henna is mixed into a paste with essential oils (or purchased in the form of ready-made henna cones) and applied to the skin in intricate patterns. When left on the skin for at least four hours, the paste produces patterns akin totattoos (albeit temporary ones). Mehndi skin decorations are particularly linked with Hindu celebrations of weddings and other festivals in countries such as India, Nepal, Pakistan, and Bangladesh.Pure henna is green but dries to a dark brown or orange hue. The desire for dark black henna designs has been satisfied through the use para-phenylenediamine (PPD) to produce a PPD-boosted synthetic version of henna that can be used to produce dramatic black patterns. As we describe in another article on this topic, although allergic reactions to pure henna are relatively rare, black henna can produce severe allergic reactions that make delicate skin erupt into blistering redness that sometimes leads to permanent scarring, and such reactions can spread, causing grotesque full-body swelling, itching, and skin sloughing.In 2006, the American Contact Dermatitis Society named PPD its 'Allergen of the Year,' and the U.S. Food and Drug Administration (FDA) states that the only legal use of PPD in cosmetics in the U.S. is as a hair dye and not for direct application to the skin:Henna, a coloring made from a plant, is approved only for use as a hair dye. It is not approved for direct application to the skin, as in the body-decorating process known as mehndi. This unapproved use of a color additive makes these products adulterated and therefore illegal. An Import Alert is in effect for henna intended for use on the skin. Because henna typically produces a brown, orange-brown, or reddish-brown tint, other ingredients must be added to produce other colors, such as those marketed as 'black henna' and 'blue henna.' Even brown shades of products marketed as henna may contain other ingredients intended to make them darker or make the stain last longer on the skin. So-called 'black henna' may contain the 'coal tar' color p-phenylenediamine, also known as PPD, which is only permitted for use as a hair dye. In some cases, the so-called 'black henna' consists only of hair dye, which the artist mixes straight from the package and applies to the customer's skin. PPD and some other hair dye ingredients may cause reactions in some individuals. That's the reason hair dyes have a caution statement and instructions to do a 'patch test' on a small area of the skin before using them. FDA has received reports of injuries to the skin from products marketed as henna and products marketed as 'black henna.'The Times of India also reported back in 2010 that the use of mehndi cones made with PPD could produce strong skin reactions and may even prove fatal with prolonged use:The colourful mehendi cones may well be the flavour of the season, what with the festive occasion of Nag Panchami round the corner. However, consumer activists and dermatologists would have you choose a mehendi cone with caution given the presence of harmful chemicals like para-phenylenediamine (PPD) in the mixture, which could lead to strong skin reactions. Founder-member of Akhil Bharatiya Grahak Panchayat, Suryakant Pathak, said that several manufacturers were now using the concoction of PPD in mehendi cones. The chemical is a common ingredient in permanent hair dye products, as well as dyes for fabrics, fur and dark makeup. PPD is also used in printing and photocopying inks. Also, the natural oils are being replaced with white oil to give a dark colour. 'Some people are very sensitive to this chemical and the prolonged use of it can prove fatal. The chemical may cause itching, body ache, restlessness, etc,' Pathak said. City doctors further affirmed the ill-effects of the ready-made mehendi cones. 'Mehendi can cause an allergy if chemicals are mixed in it. Para-phenylenediamine is a chemical that is used by manufacturers to make the imprint of mehendi darker. The presence of additional chemicals in mehendi can damage the skin and can also cause redness, itching, blistering of the skin areas,' said dermatologist Vinay Kulkarni.The item reproduced above purports to offer a photograph of the hands of a young woman who developed a serious infection through the use of a particular brand of henna ('Party Mehndi Red Cone'), with accompanying text that gruesomely describes her infection as being so severe that doctors recommended amputation of her hands and legs, but her parents instead chose to kill her through the administration of poison. While this item may be true in concept (i.e., it is a fact that the use of some types of henna for skin decoration can produce severe allergic reactions, and users have reported those symptoms), we don't yet know whether the photograph displayed above is actually connected with such a phenomenon.The original account (minus the photograph) appears to have begun at the end of 2011 in a version that attributed it to a doctor (identified in other versions as a Dr. Imran Ansari) at the Aga Khan University Hospital in Karachi, Pakistan:According to a doctor of agha khan hospital. a red cone mehandi is arrived in all over Pakistan. This cone is filled with strong chemicals. Due to which a girl was died. In his message he said, 'that girl was newly married and had applied this cone, after two to three days the red cone chemicals start burning her skin. And when the chemicals spread to the legs, she went to the agha khan hospital with her parents, the parents asked to the doctor what happened to our daughter, the doctor says, the cone mehandi she had applied contained very strong chemical and this the burning of her skin is due to the chemicals contained in the cone, so if you want to stop this chemical from spreading in her whole body then we have to cut her hands and feet. This is because we cant recover them. The parents did not agree on that. And said to doctor that instead of giving her pain by cutting her hands and feet, give her a poison injection so that she can die in peace. And the doctor gave the poison injection to the girl. After that the doctor spread this message through sms that never use this red cone mehandi.Possibly the photograph genuinely documents a real allergic reaction to henna, but the accompanying text account is unrelated, invented sensationalism. The same rumor spread widely throughout India in August 2012 and was repeatedly debunked by law enforcement and health officials:After people from the Northeast, it was the turn of Muslim women to get scared unnecessarily by rumours - that too on the day of Ramzan. Hundreds of women thronged various hospitals in Chennai, Vellore, Coimbatore and many other places in the State in the wee hours after rumours spread that mehendi, which they applied on their body on the festival day, has led to the death of persons in Bangalore. Though police tried to convince the worried people that no fatalities have been reported, it was not enough to pacify them. A miniscule number of women indeed developed allergies arising out of overexposure to chemicals in the commercially-made mehendi and were treated at various hospitals. Rumours spread thick and fast that the mehndi used was potentially fatal and some text messages claimed that a girl had died as a result. Investigation revealed that the rumour spread in Chennai, Vellore, Ranipet, Salem, Arani, Vaniyambadi, Tiruvannamalai, Dharmapuri and other places. Acting on the instructions of Director-General of Police K. Ramanujam, senior police officials intervened and convinced representatives of the Muslim community that the rumours were 'baseless and 'motivated,' the sources said. 'The message actually emanated from Facebook and spread via chain-mails and SMS. It stated that a girl who used one particular brand of cone mehndi had developed serious skin allergy, which resulted in her death. There was another SMS which said four people had died in Bangalore. This is completely baseless.' RGGH officials said four persons were admitted after they exhibited some serious symptoms. V. Kanagasabai, Dean of RGGH said, 'Patients came with burning sensation and rashes and were mostly treated in the outpatient department. They were given anti-histamine tablets to control the growing allergy.' The four patients admitted at the GH are almost cured and have been kept under observation.
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