Para-Phenylenediamine (PPD)

In 2000 I was diagnosed as being allergic to the chemical PPD and in the subsequent few years have been caught out a few times and had to go to hospital as an emergency case with the onset of anaphylactic shock.

When trying to find out about my allergy I was disappointed at the amount of information in layman’s language that I could find, so this page is written in an effort to give you my knowledge and experience to date. Please note that I am not a medical practitioner, just a normal person with a sometimes scary allergy! Obviously if you have any concerns about your condition you must speak to your health care provider.

What my Dermatology department told me

I have a piece of paper that I carry with me that says:

You are allergic to PARA-PHENYLENEDIAMINE (PPD) and should avoid the following:

Black dyes, including dark hair dyes and toners for bleached hair

Some furs and textiles dyed with dyes containing PPD.

People sensitive to PPD can also be sensitive to the following:

Other dyes in textiles, stocking, leather, hair dyes (in particular paratoluene diamine)

Anti-sunburn agents

Aniline dyes

Local anaesthetics (lignocaine and xylocaine are safe)

Sulphonamides (medicament)

The dye in orange peel – can eat oranges but get someone else to peel them

Black heavy duty rubbers

Printing inks eg during photocopy & lithographing

Photographic chemicals

There may be a cross reaction with some local anaesthetics or sulphonamides (an antibiotic)

There are quite a few day to day things on this list aren’t there? Suddenly your leather jacket and the newsprint coming off on your hands when you read the daily paper can be a potential worry.

What I have discovered in the last few years is that in my personal case caution is needed in handling some things otherwise I get blisters and hives. The biggest danger to me is the orange peel as when the allergy is triggered by ingesting something then that is when a trip to the hospital is called for. The good news is that I have learnt what to be careful of and haven’t had a reaction for over 18 months now.

Tips for avoiding triggering the allergic reaction

Just because you are allergic to PPD does not mean you have to avoid everything on the list above. Bearing that in mind, here are my simple tips, in no particular order that may help you:

· Be careful of sauces if orange peel can trigger your allergy. If it comes out of a bottle then check it for orange and if in doubt avoid it. If you are in a restaurant then do ask (see list below on how to ask if abroad) as having to call an ambulance to the restaurant is not good for them or you. Quite a few barbeque sauces and sweet & sour sauces have orange in them so take care at the Chinese takeaway or neighbours BBQ as well.

· Orange peel is found in obvious things like marmalade, but watch out for Christmas cakes, Christmas puddings and some rich fruit cakes that use mixed peel in their making.

· Careful of Chicken Piri Piri, that has orange peel in it.

· Chocolate orange has caught me out once. I thought the chocolate at the end of the meal in a restaurant was the usual after dinner mint in a gold wrapper…it wasn’t, it was chocolate orange and I was in hospital within the hour.

· Sadly some drinks also contain orange peel like Hoegaarden Belgium beer.

· Wear gloves when changing car tyres, windscreen wiper blades. I find I also have to be careful with the petrol pump hoses.

· Wear gloves in the gym and when cycling as handlebar grips tend to be black rubber.

· Plastic wiring (especially black) like that on telephone cords can make me sensitive. I cover them with sellotape if I can’t change them or wear cotton gloves.

· Notice that a lot of household cleaners now contain orange oil. If you go to a house and feel your hands start to prickle it’s worth asking if they are using polish or cleaners with orange and if so wash your hands and either wear gloves or remove yourself as soon as you can and don’t touch surfaces if you can avoid it.

· Fruit teas. Again some are obvious, some aren’t. My wife for instance drinks a liquorice tea which has orange peel in it….we have labelled the box and I avoid it like the plague.

· Watch out for loose olives. Some come with bits of orange peel.

Other preventative measures

Three main things to mention here.

1) Because of the risk of anaphylactic shock I have to carry round an adrenaline pen, some Piriton allergy tablets and some prednisolone tablets to treat myself should I be out of reach of a hospital (say in a small boat). I carry these along with the list describing the allergy and the restaurant translation sheet (see later) in a simple clear plastic zip up pencil case. I chose that as everything fits and it is fairly waterproof.

2) I wear a medical alert bracelet which says what I am allergic to and has a contact phone number for emergency medical information. If you are living in the UK and have this particular allergy I strongly recommend you join them. Just look up MedicAlert UK on the internet.

3) Tell your dentist at your next visit that you are allergic to PPD. This is in case they ever need to give you pain killing injections or antibiotics as there can be a cross-reaction and the dentist needs to be aware of that possibility

Going abroad ?

A couple of things to mention here. Firstly is that generally the airport staff are familiar with epipen auto injectors (the adrenaline pen) so you won’t have any trouble keeping it with you on board the plane, particularly if you have a letter from your medical practitioner stating that you must carry this at all times. Worst case get the cabin crew to take charge of it whilst you are on the plane, don’t let them tell you to put it in your checked in luggage as a) you might need it during the flight and b) the cargo hold freezes which will make the adrenaline pen useless afterwards..

I used to be very concerned about being in a country where I couldn’t speak the language to be able to ask about any orange peel in the food. I offer this translation guide that my friends at work kindly got together for me.

Translation for restaurants abroad.

English:

" I have an allergy to a chemical called PPD. The only food it is found in is orange peel, and so I have to avoid food that could have orange peel in it's preparation (like some sweet and sour sauce or cakes for instance)" . Is there any orange peel in this?"

Dutch:

"Ik ben allergisch voor de kleurstof PPD. Deze komt alleen voor in sinaasappelschil. Ik moet elk soort voedsel waarin sinaasappelschil verwerkt is, vermijden. Zoetzure saus, cake, fruitbier, etc.. Zit hier sinaasappelschil in verwerkt? "

Danish:

Jeg er allergisk for et kemikalie der hedder PPD. Det eneste foede hvori det findes er appelsinskal. Derfor er det noedvendigt for mig at undgaa mad som har sinasappelskal som ingredient. Sursod sovs, kager, frugt ol osv. Er der appelsinskal i dette?

Swedish:

Jag är allergisk mot en substans kallad PPD. Denna förekommer endast i apelsinskal, så jag måste undvika all mat som är tillagad med apelsinskal ( som t.ex. sötsur sas eller kakor ). Finns det apelsinskal i detta?

Finnish:

Mina olen allerginen PPD-lle. Tämä on aine joka esiintyy ainoastaan appelsiinikuoressa, joten minun täytyy välttää kaikkia ruokia jossa tätä on käytettty valmistukseen ( kuten esim. hapanimelät kastikkeet tai kakut ). Sisaltääkö tämä appelsiinikuoren jälkiä?

Norwegian:

French:

Je suis allergique au PPD qui est une substance chimique. La seule nourriture dans laquelle le PPD peut être trouvé est la pelure d'orange. Je dois donc éviter de consommer de la nourriture qui contient de la pelure d'orange (par exemple certaines confiseries, de la sauce aigre doux ou des gâteaux). Pouvez vous me dire si il y a de la pelure d'orange dans ceci ?

German:

Ich bin allergisch gegen Orangenschale, auch wenn diese in Gerichten enthalten sind, wie

z.B. in Sweet and Sour Saucen. Bitte um Beachtung.

Portuguese:

Eu sou alérgico a um produto químico chamado PPD. Este produto só se encontra na casca da laranja, por isso tenho de evitar comida preparada com casca de laranja (como molhos agri-doce, bolos, etc.) Esta comida tem casca de laranja?

Spanish:

Soy alérgico a un producto químico llamado PPD. Este producto se encuentra en la cáscara de naranja. Tengo que evitar todas las comidas que tengan cáscara de naranja, por ejemplo salsas, dulces/tortas, cerveza de frutas, etc. ¿Esta comida tiene cáscara de naranja?

Italian:

Ho una allergia per il colorante chemico PPD. L'unico cibo un cui si trova il PPD e' la scorza d'arancia. Percio devo evitare quel cibo.

(Per esempio dolci, salsa agrodolce etc). C'e' la scorza d'arancia qui dentro?

Other Observations

PPD allergy reactions are not progressive like say the bee sting allergy can be. Each time the allergy is triggered the reaction is dependant on what is causing it. What I am trying to say here is that the triggering time doesn’t get shorter and the reaction itself doesn’t get more intense just because you have had another one.

One thing I was warned about and have noticed in my particular case is that every time the allergy reaction is triggered it can leave your skin sensitive for up to 6 months. I have observed that I tend to need a higher factor suntan cream during this time. Michelle a biochemist from Canada recommends we should try to avoid sunscreens with parabens and PABA in them as they are similar chemicals to PPD. I also find that I am more sensitive to temperature changes and “flush up” particularly when coming into a warm room from a cooler place. Again this tends to fade as the months go by.

PPD Free Hair Dyes

The most frequent email question I get is about reactions caused by hair dyes and do I know of any safe ones that I can recommend? Try www.spiritofnature.co.uk. Sarah Burrell stocks several PPD free products from the Logona and Changes product range and will ship them worldwide. If you are not in the UK Sarah will email you the postage costs and ask you to confirm if you wish to proceed. Sarah can also get other shades for you on request. Another product recommendation comes from Georgia in Canada, it is a PPD free vegetal dye called Sanotint Light which is PPD Free (note not all Sanotint products are completely PPD Free, please check the product descriptions) and the link is www.tulipabeauty.co.uk/index.php.

Tania recommends www.natulique.com PPD free professional hair colours, but as always with all these please check the ingredients yourself and patch test before using.

Other Product Recommendations

To relieve the pain and discomfort for sores and rashes two products usually marketed for cold sores work well, Amanda tells me. They are Blitex Relief and Magicool Plus.

IKEA Furniture

Please be aware that IKEA does not use PPD in their Extorp line of living room furniture, nor do they use fabric protectant on any of their furniture. The coverings are all machine washable. Thanks to Gary for that information.

Black Henna

Please be very cautious of Henna tattoos on holiday as sometimes they are actually using Black Henna which contains PPD. If you are PPD sensitive this can give you a very nasty local reaction around the tattoo site which may need both antibiotic and topical hydrocortisone cream to get rid of the swelling, redness and itching. Thanks to Laurie for that advice.

Contact Details

If you would like to email me about your experiences or have anything you think I should add to this site then please feel free to contact me timbrooks@apricotsunset.com
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