Hand Eczema in Hairdressers

Abstract

Among cases of occupational dermatoses, eczema in hairdressers was reported most frequently in Austria during 1981 and 1982. Analysing 247 reports, extensive data could be obtained with regard to predisposition, clinical pattern, course, contact sensitization, skin tests, prognosis, influence on occupational development, rehabilitation, and disability pension. Epicutaneous tests with standard allergens and a hairdressers' screening tray proved to be positive in 71%. Nickel (44,7%) and para-haircolors (40,2%) top the allergen list. With exception of cobalt (19,1%) and balsam of Peru (4%) all other substances tested were found to be positive in less than 4%. 65% of nickel sensitive probands reacted to their occupationally used shampoos, as compared to only 34% of nickel-negative probands. Of hairdressers allergic to para-colors, 48.1% showed positive ECT tests to their haircolors, 4/13 patients allergic to ammonium thioglycollate reacted to permanent wave liquids used at their work. Two thirds of nickel sensitive hairdressers were sensitized during apprenticeship. Alkali resistance (AR) was decreased in 35% of patients tested. AR results from the irritant dermatitis patients were worse than those from persons with contact allergy. Of the hairdressers affected, 61.8% had to discontinue their professions for medical reasons. Of those who continued a hairdresser's career only 32% of patients with allergic contact eczema and 58% of patients with irritant eczema had no skin problems (mean period of observation: 15 months). The proportion of atopics was found to be normal within the patient material, but prognosis is unfavorable once atopic hairdressers have developed hand eczema. After discontinuation of occupation, clinical resolution was slowest in patients allergic to nickel. Of those previously occupied as hairdressers 15% ended up in a wet working environment unsuitable to their skin condition.(ABSTRACT TRUNCATED AT 250 WORDS)