Efficient removal of black henna tattoos

Abstract Background/Objectives Para‐phenylenediamine, a dye frequently added to henna tattoos to create the black color, is a potent contact allergen. Severe contact dermatitis may arise within days even after the first application. Our objective was to develop a method for rapid and complete removal of para‐phenylenediamine‐containing black henna tattoos from the skin, an important problem many physicians are confronted with, but for which no simple method exists. Methods A database search revealed polyethylene glycol 400, described in removal of ortho‐phenylenediamine from contaminated skin. We therefore investigated its use in removal of the structurally related ortholog para‐phenylenediamine present in black henna tattoos. Results A protocol was established involving repeated cycles of rinsing of the skin with polyethylene glycol 400 solution. In 5 patients, one of whom had already developed a severe blistering contact dermatitis and another a mild erosive dermatitis, black henna tattoos were successfully removed. Removal was completed in a single session of 1 hour or less, depending on tattoo size, with a maximum of 6 rinse cycles. Conclusions We provide a simple and safe method for rapid and effective removal of black henna tattoos. This procedure requires no special equipment and can be applied in virtually any setting.