Hypersensitivity reactions due to black henna tattoos and their components: Are the clinical pictures related to the immune pathomechanism?

Gianfranco Calogiuri, Elisabetta Leo, Lavjay Butani, Stefano Pizzimenti, Cristoforo Incorvaia, Luigi Macchia, Eustachio Nettis

Research output: Contribution to journalReview articlepeer-review

7 Scopus citations


Hypersensitivity to para-phenylenediamine (PPD) and related compounds induced by temporary black henna tattoos has become a serious health problem worldwide. Different patterns of sensitization with various clinical aspects are described in literature due to PPD associated to henna tattoo and these manifestations are likely correlated with the immunological and dermatological pathomechanisms involved. Henna is the Persian name of the plant Lawsonia inermis, Fam. Lythraceae. It is a woody shrub that grow in regions of North Africa, South Asia, India and Sri Lanka. Nowadays it is rather frequent to see temporary "tattoos" performed with henna. To make tattoos darker and long-lasting PPD has been associated to henna in tattoo drawings mixtures, so obtaining "black henna". In these years there has been a rise of contact sensitization to PPD and in medical literature an increased number of cases have been reported on temporary henna tattoo application. Here we review the various clinical patterns related to PPD and henna tattoo, to investigate the possible link between clinic-morphological pictures and the immunological response to PPD and henna. The literature underlines that different clinical manifestations are related to black henna containing PPD, and its derivative products may cause delayed-type as well as immediate-type reactions. Further studies are needed to investigate the relationship between clinical and morphological aspects of PPD contact dermatitis and the T cell subsets predominance.

Original languageEnglish (US)
Article number8
JournalClinical and Molecular Allergy
Issue number1
StatePublished - Apr 10 2017


  • Allergy
  • Black henna
  • Contact dermatitis
  • Henna tattoo
  • Para-phenylenediamine

ASJC Scopus subject areas

  • Immunology and Allergy
  • Immunology
  • Molecular Biology


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