Sept. 25, 2003 -- Celebrities like Madonna and Uma Thurman have brought temporary henna "tattoos" into vogue, and now those who want the look can get henna painted onto their bodies in special booths and tattoo parlors across the country.
But even more popular are so-called black henna tattoos, which are popping up everywhere from Florida's beaches, to shopping malls, to an outdoor stand right in front of the Good Morning America studios in Times Square.
Black henna is advertised as a fun, temporary decoration that, because of its dark stain, looks like a real tattoo. It is supposed to last only one to three weeks, but some people are getting a nasty surprise after they've paid for their new look.
Joey Vitello, 6, of Newport Richey, Fla., got a black henna tattoo earlier this summer at a beach in Clearwater, Fla. At first he loved it, but soon, to his parents' shock, it became a health issue.
"I was scared. I thought maybe, you know, he had an infection or something," said his mother, Doreen Vitello. "It started stinging, but I didn't think anything of it, and he didn't make a major big deal about it. As the days went on, it just spread. It was horrible. It was all red, blisters, swollen, oozing. It was terrible."
Now Joey has a scar that his doctor says may be permanent.
Warnings in Canada, Florida
In August, Health Canada warned Canadians about the potential danger posed by black henna, which isn't pure henna at all. Much of the time, it's mixed with commercial hair dye, which includes a chemical called p-phenylenediamine, or PPD.
But in the United States, concern over the safety of black henna tattoos has been prevalent only in areas where the tattoos are readily available. Communities in Florida have tried to keep on top of tattoo artists on beaches and streets and the Florida State Department of Health even issued a warning over the summer.
Doctors at New York University School of Medicine have studied black henna and its ingredients.
"The hair dye when mixed with henna accelerates the dyeing process," said NYU's Dr. Ronald Brancaccio. "So instead of taking two to six hours to dye the skin, it only takes minutes."
PPD is one of the top 20 allergens in the country, and hair dye has warnings about it written right on the box, Brancaccio said.
Unfortunately, black henna artists rarely give the type of warnings found on hair dye packaging, or do skin tests, even though their product could be much stronger.
"The concentration of PPD in hair dye is by law less than 5 percent, and usually it's 2 to 3 percent," Brancaccio said. "In the black henna tattoo that we studied, it was almost 10 times the amount."
When the concentration increases, the rate of allergy increases, he said. When you have a higher concentration of PPD on the skin, the rate of people contracting allergies because of it will increase.
Only Legal Use of Henna Is Hair Dye
According to the U.S. Food and Drug Administration, all henna is approved for use as a hair dye, but not as a product that is applied directly to the skin, as it has not been safety tested for that purpose.
Henna is only supposed to be used as a hair dye. On its Web site, the FDA notes that "black henna" may contain the "coal tar" also known as PPD, and that some people may have allergic reactions to it.
"The only legal use of PPD in cosmetics is as a hair dye," the FDA says. "It is not approved for direct application to the skin. Even brown shades of products marketed as henna may contain other ingredients intended to make them darker or make the stain last longer."
Though the FDA does not approve of applying any type of henna to the skin, it should be noted that the skin problems seem to be associated with black henna rather than regular henna, which has been used since ancient times to ornament the hands and body as art and as a bridal tradition.
Traditional henna paste is khaki green, greenish brown, or very dark brownish green. It smells like spinach, or may smell of fragrances like pine, tea tree oil, or mentholatum from essential oils henna artists use. The PPD often found in black henna does not have a smell.
Henna artists say that if a tattooing parlor tells you to leave the paste on for less than one hour, it is using PPD. Those working with real henna tell you to leave on the paste more than an hour, as long as you can, even overnight.
Most people are unaware of the warnings about the black henna.
"I figured it was a safe thing — I even asked the lady there when he was getting it," said Joey's father, Steve Vitello. "I said, 'Is he too young?' And she says no, she says, 'It's no problem, we do it to other kids, younger kids, and even 2-year-old kids do it.' "
Reactions to black henna can cause not just scarring, but lifelong cross-sensitivities to everything from sunscreen to clothing dye, Brancaccio said.
It is all information that Doreen Vitello wishes she'd known before her son got his tattoo.
"It's very scary, very scary," she said. "I'm not only concerned about my children but everybody else's child."