Marking the Differences Between Natural Henna and “Black Henna” Tattoos: First With Kids - Vermont Children's Hospital, Fletcher Allen

Parents have been asking me some colorful questions about non-permanent henna tattoos and whether they are safe for children. Well, let me skin the surface of this topic and provide some information.
Henna dye is a paste produced from the dried leaves of a plant found in tropical and subtropical regions of Africa, Asia and Australia. Natural henna only stains the skin orange, red or brown, and the length of time the henna sits on the skin before it is washed off will determine how dark the tattoo is and how long it will last. It can be anywhere from a day to four weeks.

Are natural henna tattoos safe? The powder from the plant is very safe when applied to the skin of children, teens or adults since allergies to natural henna dye are extremely rare.  

So are there any problems with non-permanent tattoos?  The problem occurs when children or adults are told they can get a black or dark blue henna tattoo using what is called “black henna.” Black henna is not from the henna plant at all but is a chemical called paraphenylenediamine or PPD. PPD is approved for use as a hair dye but not for use on the skin due to serious side effects that recently resulted in the Food and Drug Administration issuing a health warning about black henna.  

What kind of side effects are we talking about? Black henna dye has been found to cause a variety of skin problems, including itching, bleeding, peeling, burns, painful blisters, and for some children and adults terrible scars. Sometimes the scars appear right away—and sometimes weeks later. Skin reactions vary in intensity from one person to another, as do the injuries that the reactions cause to the skin.    

The chemical PPD can also cause a subsequent skin reaction even if it didn’t happen the first time someone gets a black henna (which isn’t henna) tattoo.  

Hopefully tips like this will make their mark when it comes to knowing the dangers of the non-permanent black henna and the relative safety of natural henna tattoos.  

Lewis First, M.D., is chief of Pediatrics at Vermont Children's Hospital at Fletcher Allen Health Care and chair of the Department of Pediatrics at the University of Vermont College of Medicine. You can also catch "First with Kids" weekly on WOKO 98.9FM and WPTZ Channel 5, or visit the First with Kids video archives at