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Hairdressing: occupational respiratory allergies and dermatitis
Hands, skin, nose, eyes and airways: recognise the role of work and act early
In hairdressing, wet work and repeated exposure to certain products may cause irritant dermatitis, contact allergy, hives, rhinitis or asthma. Persulphates in bleaching products have a particular role in respiratory disease. Identifying the link with work early helps protect health and, where possible, supports continuation in the occupation.
In this sheet
Three essential points
1. Hand eczema is not necessarily an allergy
Water, shampoos, detergents, repeated washing and prolonged glove use may irritate the skin. Allergic contact dermatitis may occur as well: irritation and allergy can coexist.
2. Bleaching plus nose, eye or airway symptoms: consider persulphates
Ammonium, potassium and sodium persulphates are the best-documented agents in occupational rhinitis and asthma among hairdressers.
3. The earlier the work link is investigated, the better
Symptoms that appear or worsen in the salon and improve on days off are suggestive. Rhinitis may precede occupational asthma.
Why does hairdressing involve so much exposure?
- Common exposure
- Wet work
- Exemples
- Shampoos, wet hands, rinsing and repeated cleaning.
- Common exposure
- Hair colouring
- Exemples
- Oxidative dyes, particularly PPD and related molecules.
- Common exposure
- Bleaching
- Exemples
- Persulphates, particularly during product preparation and use.
- Common exposure
- Perming / straightening / other products
- Exemples
- Thioglycolates, preservatives, fragrances, irritants or volatile substances depending on the products.
| Common exposure | Exemples |
|---|---|
| Wet work | Shampoos, wet hands, rinsing and repeated cleaning. |
| Hair colouring | Oxidative dyes, particularly PPD and related molecules. |
| Bleaching | Persulphates, particularly during product preparation and use. |
| Perming / straightening / other products | Thioglycolates, preservatives, fragrances, irritants or volatile substances depending on the products. |
Skin: irritation, contact allergy or hives?
- Problem
- Irritant dermatitis
- General appearance
- Dryness, redness, cracks, burning or itching.
- What to remember
- Promoted by wet work, shampoos, detergents and chemicals.
- Problem
- Allergic contact dermatitis
- General appearance
- Delayed eczema after sensitisation.
- What to remember
- Hair dyes, persulphates, biocides, fragrances, thioglycolates or some glove components may be involved.
- Problem
- Contact hives
- General appearance
- Rapid wheals or swelling.
- What to remember
- Alkaline persulphates are an important cause; systemic reactions remain possible.
| Problem | General appearance | What to remember |
|---|---|---|
| Irritant dermatitis | Dryness, redness, cracks, burning or itching. | Promoted by wet work, shampoos, detergents and chemicals. |
| Allergic contact dermatitis | Delayed eczema after sensitisation. | Hair dyes, persulphates, biocides, fragrances, thioglycolates or some glove components may be involved. |
| Contact hives | Rapid wheals or swelling. | Alkaline persulphates are an important cause; systemic reactions remain possible. |
Products to know
Persulphates: an essential product to know
Found mainly in bleaching products, persulphates may cause skin irritation, allergic dermatitis, contact hives, rhinitis, conjunctivitis or asthma. The respiratory mechanism is not always a classic IgE allergy, so a negative allergy blood test is not enough to rule out persulphate-related occupational respiratory disease.
Hair dyes: PPD and related molecules
p-Phenylenediamine (PPD) is an oxidative dye found particularly in some dark permanent hair colours. In hairdressers it is mainly associated with allergic contact dermatitis. Simply changing brand is not enough: the responsible allergen must be identified and the composition of replacement products checked.
Other exposures to know about
- Product / exposure
- Thioglycolates
- Why consider it?
- Found in some perming or straightening products; contact allergy is possible.
- Product / exposure
- Preservatives / biocides / fragrances
- Why consider it?
- Possible causes of occupational eczema.
- Product / exposure
- Gloves
- Why consider it?
- Some rubber accelerators may themselves cause contact allergy.
- Product / exposure
- Nickel
- Why consider it?
- Some metal tools may be a source of exposure.
- Product / exposure
- Hair-straightening products
- Why consider it?
- Depending on their composition, some techniques may expose users to irritants or formaldehyde.
| Product / exposure | Why consider it? |
|---|---|
| Thioglycolates | Found in some perming or straightening products; contact allergy is possible. |
| Preservatives / biocides / fragrances | Possible causes of occupational eczema. |
| Gloves | Some rubber accelerators may themselves cause contact allergy. |
| Nickel | Some metal tools may be a source of exposure. |
| Hair-straightening products | Depending on their composition, some techniques may expose users to irritants or formaldehyde. |
Nose, eyes and airways: which symptoms?
Sneezing · runny or blocked nose · red or watery eyes · cough · wheezing · chest tightness · breathlessness.
Symptoms may appear during work or sometimes several hours later. Improvement during weekends or holidays is a useful clue, but does not prove an occupational cause.
How can we tell whether work is responsible?
Diagnosis begins by reconstructing a precise timeline:
Which skin assessment?
For delayed eczema, assessment may include patch tests with a baseline series and, according to exposure, an occupational hairdressing series or some products actually used. A positive patch test shows sensitisation; it is still necessary to confirm that the allergen is present at work and explains the symptoms.
Which assessment for rhinitis or asthma?
There is no single blood test that says ‘you are allergic to hairdressing products’. Depending on the situation, assessment may include spirometry, investigation of bronchial variability and sometimes repeated breathing or peak-flow measurements during periods at and away from work. Allergy tests may help for some agents, but are less effective or unavailable for several small chemical molecules.
In complex situations
Specialist investigations, including specific challenge tests, may be discussed in some centres. They are not performed routinely.
The occupational physician: an important partner
Do not leave your job on the basis of suspicion alone. The allergist or dermatologist, general practitioner and occupational physician have complementary roles in identifying the responsible product and task, assessing substitution or workstation adjustment and, when necessary, discussing occupational disease procedures.
- Before a major decision
- Responsible product
- What to discuss
- Composition, safety data sheet and possible alternatives.
- Before a major decision
- Responsible task
- What to discuss
- Bleaching, colouring, shampooing, straightening, perming, cleaning, etc.
- Before a major decision
- Prevention
- What to discuss
- Ventilation, work organisation, reduced wet work and suitable gloves.
- Before a major decision
- Remaining in the occupation
- What to discuss
- Possible in some situations; this depends on the agent, condition and available adjustments.
| Before a major decision | What to discuss |
|---|---|
| Responsible product | Composition, safety data sheet and possible alternatives. |
| Responsible task | Bleaching, colouring, shampooing, straightening, perming, cleaning, etc. |
| Prevention | Ventilation, work organisation, reduced wet work and suitable gloves. |
| Remaining in the occupation | Possible in some situations; this depends on the agent, condition and available adjustments. |
Can I continue working?
The answer is neither ‘gloves are all you need’ nor ‘you must stop hairdressing’. Some allergies require genuine avoidance of the responsible agent; in other cases, prevention or workplace adjustments may allow the person to continue working.
Prevention measures that really matter
- Reduce exposure at source and, where possible, choose products that are less sensitising or release less material into the air.
- Limit the dispersal of bleaching powders and use ventilation or extraction suited to the preparation area.
- Reduce repetitive wet work as far as possible.
- Use gloves suited to the task and product, change them if contaminated and protect the skin regularly.
- Do not treat a mask as a substitute for good collective prevention and effective ventilation.
Emergency
Generalised hives, swelling of the face or throat, significant breathing difficulty, feeling faint or loss of consciousness during or after using a product is a medical emergency. Do not deliberately reuse the product to ‘see whether it happens again’.
Common myths
- Myth
- ‘I have hand eczema, so I must be allergic.’
- SOS Allergo message
- No. Irritation from wet work is very common.
- Myth
- ‘If my patch tests are negative, work cannot be involved.’
- SOS Allergo message
- False: they do not investigate every occupational disease.
- Myth
- ‘Bleaching agents can only irritate the skin.’
- SOS Allergo message
- False: persulphates are also an important cause of occupational rhinitis and asthma.
- Myth
- ‘Any gloves will do.’
- SOS Allergo message
- No. The material, task, duration and glove contamination all matter.
- Myth
- ‘My symptoms disappear on holiday, so that proves it.’
- SOS Allergo message
- This is a useful clue, but the diagnosis must be documented.
- Myth
- ‘If it is occupational, I must leave hairdressing immediately.’
- SOS Allergo message
- Not automatically: the agent and possible adjustments must first be identified.
| Myth | SOS Allergo message |
|---|---|
| ‘I have hand eczema, so I must be allergic.’ | No. Irritation from wet work is very common. |
| ‘If my patch tests are negative, work cannot be involved.’ | False: they do not investigate every occupational disease. |
| ‘Bleaching agents can only irritate the skin.’ | False: persulphates are also an important cause of occupational rhinitis and asthma. |
| ‘Any gloves will do.’ | No. The material, task, duration and glove contamination all matter. |
| ‘My symptoms disappear on holiday, so that proves it.’ | This is a useful clue, but the diagnosis must be documented. |
| ‘If it is occupational, I must leave hairdressing immediately.’ | Not automatically: the agent and possible adjustments must first be identified. |
Before my appointment
If possible, bring: product names · photographs of labels and compositions · safety data sheets if available · tasks performed · glove type · symptom date and delay · photographs of lesions · changes at weekends or on holiday · treatments tried · previous patch tests or PFTs.
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Asthma · Rhinitis and rhinoconjunctivitis · Eczema and contact dermatitis · Skin prick tests / patch tests · Laboratory tests in allergology · Occupational allergy · Anaphylaxis
References and resources
- Uter W, Johansen JD, Macan J, et al. Diagnostics and Prevention of Occupational Allergy in Hairdressers. Curr Allergy Asthma Rep. 2023;23:267-275.
- Macan J, Babić Ž, Hallmann S, et al. Respiratory toxicity of persulphate salts and their adverse effects on airways in hairdressers: a systematic review. Int Arch Occup Environ Health. 2022;95:1679-1702.
- Havmose MS, Kezic S, Uter W, et al. Prevalence and incidence of hand eczema in hairdressers: a systematic review and meta-analysis. Contact Dermatitis. 2022;86:254-265.
- Uter W, Strahwald J, Hallmann S, et al. Systematic review on skin adverse effects of important hazardous hair cosmetic ingredients with a focus on hairdressers. Contact Dermatitis. 2023;88:93-108.
- Crépy MN. Dermatites de contact professionnelles des coiffeurs. Références en santé au travail. INRS, TA 105, 2022.
- INRS. Tableau RG 66 - Rhinites et asthmes professionnels ; ressources de prévention des agents sensibilisants.
This information sheet does not replace medical consultation or assessment by the occupational physician. Preventive measures and occupational decisions must be tailored to the individual situation.
Scientific review: September 2026 · sosallergo.fr
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