title: Self-testing for contact sensitization to hair dyes--scientific considerations and clinical concerns of an industry-led screening programme.
abstract: The cosmetic industry producing hair dyes has, for many years, recommended that their consumers perform 'a hair dye allergy self-test' or similar prior to hair dyeing, to identify individuals who are likely to react upon subsequent hair dyeing. This review offers important information on the requirements for correct validation of screening tests, and concludes that, in its present form, the hair dye self-test has severe limitations: (i) it is not a screening test but a diagnostic test; (ii) it has not been validated according to basic criteria defined by scientists; (iii) it has been evaluated in the wrong population group; (iv) skin reactions have been read by dermatologists and not by the targeted group (consumers and hairdressers); (v) hair dyes contain strong and extreme sensitizers that are left on the skin in high concentrations, potentially resulting in active sensitization; and (vi) recommendations and instructions on how to perform the hair dye self-test vary greatly even among products from the same company, again suggesting that the basis for safe use of the test has not been determined. If the use of a hair dye self-test to predict contact sensitization becomes widespread, there is severe risk that a tool has been marketed that may cause morbidity in European consumers.
authors.affiliation: Department of Dermato-Allergology, National Allergy Research Centre, Copenhagen University Hospital Gentofte, Gentofte, Denmark. jacpth01@geh.regionh.dk
authors.forename: Jacob P
authors.initials: JP
authors.lastname: Thyssen
authors.forename: Heidi
authors.initials: H
authors.lastname: Søsted
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Uter
authors.forename: Axel
authors.initials: A
authors.lastname: Schnuch
authors.forename: Ana M
authors.initials: AM
authors.lastname: Giménez-Arnau
authors.forename: Martine
authors.initials: M
authors.lastname: Vigan
authors.forename: Thomas
authors.initials: T
authors.lastname: Rustemeyer
authors.forename: Berit
authors.initials: B
authors.lastname: Granum
authors.forename: John
authors.initials: J
authors.lastname: McFadden
authors.forename: Jonathan M
authors.initials: JM
authors.lastname: White
authors.forename: Ian R
authors.initials: IR
authors.lastname: White
authors.forename: Ann
authors.initials: A
authors.lastname: Goossens
authors.forename: Torkil
authors.initials: T
authors.lastname: Menné
authors.forename: Carola
authors.initials: C
authors.lastname: Lidén
authors.forename: Jeanne D
authors.initials: JD
authors.lastname: Johansen
mesh_terms: D017449:Dermatitis, Allergic Contact / Q000175:diagnosis*; D059026:Diagnostic Self Evaluation; D005060:Europe; D006202:Hair Dyes / Q000009:adverse effects*; D006801:Humans; D008403:Mass Screening / Q000009:adverse effects / Q000941:ethics / Q000592:standards*; D015203:Reproducibility of Results; D012882:Skin Tests / Q000009:adverse effects / Q000941:ethics / Q000592:standards
chemical_list: D006202:Hair Dyes