Q Last month I had a severe reaction to black mehndi, but others had also used the same cone. I was treated with cortisone and now I am better but the faint trace of the design is still visible. Can I use mehndi ever again and why was only I affected?
A By itself, pure natural henna is a relatively harmless, allergy-free substance. The additives used to deepen the colour cause the most reactions. The commonest additive used especially in black henna is paraphenylene diamine or PPD. Almost 75% of the reactions occur due to its presence! Other toxic additives include acids, synthetic dyes and petrol. Women demand attractive patterns made by henna, unaware of the fact that attractive dark mehndi includes acids, chemicals and additives, which could cause rash and allergy to the skin.
A PPD reaction starts three to 10 days after the PPD black henna or black hair dye is applied. Allergic reactions cause a swelling of the henna design skin rashes, itching, blisters, oozing, open sores, scarring and other potentially harmful effects. These have to be treated immediately, but even that at times cannot prevent a permanent henna tattooing, i.e. the design is seen under the skin for years. The problem is that fake henna (made with PPD) provokes cross-allergy, making people allergic to other things that contain para substituted amino compounds.
Some people are born sensitive to PPD, Others become sensitive to PPD. If you become sensitized to PPD, that allergy will never go away and you may become cross-sensitized to many related things. Avoid hair dye and cosmetics containing the chemical para-phenylene diamine for the rest of your life because the mehndi contained PPD.
You should apply natural henna, which is safe. Herbal products like coffee or tea leaves or amla shikakai could be put in it to make it more dark but these are not totally risk free too.
Dr Badr Dhanani
OMI
Q My 18-year old son has been on antibiotics four times since March for tonsillitis. My family doctor sent him to an ENT specialist who said to wait six months and see if it gets better. Meanwhile, it came back last week and he’s on the antibiotics again. What criteria do they use before they remove his tonsils? What risks are involved?
A The infection of the tonsil is called acute tonsillitis. The patient typically presents with throat pain, fever and difficulty in swallowing. On examination, a painful swelling in the neck is usually observed and the patient may have pus points on tonsils. The diagnosis is fairly straight forward based on the symptoms and clinical findings.
The treatment of an acute attack is a course of board spectrum antibiotics, pain relievers, lots of fluid intake and rest. Other conditions of throat, like allergies and viral infections, can confuse the presentation and good clinical evaluation is important in differentiating tonsillitis from these conditions.
The criteria for surgical removal of tonsils or tonsillectomy are: recurrent attacks of acute tonsillitis (at least four attacks in a year for two years), airway obstruction due to very large size tonsils, tonsillar abscess or a suspected tumour of tonsils. The risks of operation include risk of general anaesthesia and risk of surgery like bleeding, infections and a change of voice in professional voice users, etc. In trained hands, tonsillectomy is a very safe operation.
Since your son has had only two attacks this year, there is no urgent need for a tonsillectomy. If the attacks become more frequent, you can decide in favour of surgery.
