Para‐phenylenediamine hair dye and dry eye symptoms: A cross‐sectional study

Abstract

Aims/Purpose: Para‐phenylenediamine is a common constituent in black hair dye which is well‐associated with irritant dermatitis. Ocular complications include blepharoconjunctivitis, dry eye disease and allergic eye disease (1), mostly reported in case studies. We conducted a cross‐sectional study to establish the prevalence of dry eye symptoms in black hair dye users, and its association with irritant dermatitis, sleeping position and frequency of hair dye use.Methods: This cross‐sectional study was conducted online among Facebook followers of an ophthalmology clinic based in Mauritius. 100 responses were gathered between November 2020 and May 2022. Participants included in the study were all users of black hair dye, over the age of 18 and of either sex. Patients with potential confounding causes of dry eye disease symptoms were not excluded from the study, but a separate analysis was conducted excluding them. Data was subsequently analysed using R statistical software.Results: Most participants were female (88%) and excluding those with confounding causes of dry eye disease, 57% of participants reported ocular symptoms, such as grittiness, blurry vision and red eyes. 34% of these patients also reported scalp dermatitis. Prevalence of ocular symptoms increased with duration of hair dye use. However, no association was found between either rates of irritant scalp dermatitis, sleeping position or frequency of hair dye use and ocular symptoms.Conclusions: We have found a high prevalence of dry eye symptoms among black hair dye users, compared to the prevalence previously described in the literature (28.2% by Golińska‐Zach et al.) (1), with a prolonged duration of hair dye use being a risk factor. Larger scale studies are needed to characterize the influence of para‐phenylenediamine hair dye on ocular surface disease, including assessment of tear film properties and meibomian gland dysfunction.Reference1. Golińska‐Zach A, Krawczyk‐Szulc P, Wiszniewska M, Nowakowska‐Świrta E, Świerczyńska‐Machura D, Tymoszuk D, et al. Sensitization to occupational allergens in hairdressing apprentices diagnosed already before entering vocational training. Med Pr [Internet]. 2016 [cited 2022 Apr 25]; 67(5): 567–75. Available from: https://pubmed.ncbi.nlm.nih.gov/27819696/