PPD Hair Dye Poisoning Overview

Study Notes

PPD is a key ingredient in various hair dyes, producing different shades based on concentration.
In Sudan, PPD is used to color hair and, mixed with henna, to color skin.
PPD toxicity results from skin absorption.
PPD is an allergen.
Systemic issues arise from accidental or intentional ingestion.
Toxic dose: 3-5 mg.
Symptoms of acute poisoning include severe facial and neck edema, requiring tracheostomy in some cases, a swollen tongue, and dark brown urine.
PPD intoxication can cause multisystem involvement leading to rhabdomyolysis and acute renal failure.
Other reported symptoms include flaccid paralysis, severe gastrointestinal issues, cardiotoxicity, and arrhythmias.
This form of intoxication is often fatal if not treated aggressively.
There is currently no specific antidote.

Key clinical symptoms include oedema (94%), acute respiratory insufficiency (56%), tracheal intubation (72%), tracheostomy (21%), signs of rhabdomyolysis (88%), gastrointestinal symptoms (53%), and oliguric acute renal failure (32%).

PPD intoxication is a significant health concern in Sudan, Morocco, and India.
Acute PPD poisoning is a common cause of suicide attempts needing hospitalization in Morocco.
In adult cases, 70-90% of PPD poisonings are due to suicide attempts.
Mortality rate ranges from 10.6% to 38.7%.
Statistics from a Khartoum ENT hospital (1995-2005) show 3159 cases with an average of 287.1 per year.
The affected age group is mainly 15-24 years old, accounting for 52% of cases.
80.7% of cases are females, with 87% linked to suicidal attempts.