Published: 6 September 2013

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Hair-loss, a Sunsitive Issue

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Prescriber Update 34(3):3 0–31
September 2013

Medsafe has been made aware of a case of a patient who suffered a chemical burn to the forehead following the application of an oil-based scalp product.

The patient had purchased shampoo and hair tonic to combat hair loss. The products contained oils and herbal extracts, and were described as being made primarily of Himalayan herbs, 100% natural, and with no side effects.

After using these products, the patient’s scalp became irritated and dry. The hair loss clinic suggested that the oil-based product would help to calm the scalp.

Following a brief period of outdoor exposure after applying the oil, the patient experienced a weepy scaly rash along with a severe burning sensation. The reaction was of such a severity that the patient visited an after-hours medical clinic. The patient was diagnosed with a burn on the forehead together with an acute outbreak of seborrhoeic dermatitis.

Information in the Natural Medicines Comprehensive Database indicates that many of the ingredients in the three products could cause reactions such as dermatitis, hypersensitivity, and photosensitivity¹. These included Salvia officinalis (sage), Zingiber officinale (ginger), lavender oil, rosemary oil and citronella oil.

Drug-induced photosensitivity occurs when a drug or chemical is activated by ultra-violet radiation to cause a phototoxic or photoallergic reaction². These reactions can occur both with oral and topical agents, including those commonly used such as sunscreens and fragrances².

Reactions can occur relatively quickly after exposure to light, or up to three days later¹. A photoallergic reaction may present as a scaly, itchy rash, possibly spreading to areas of skin which have not been exposed². The more severe phototoxic type reactions may present as an exaggerated sunburn reaction, possibly with blisters, which is limited to the areas of exposed skin².

Healthcare professionals are reminded to ask about the use of all medicines and topically applied products, including cosmetic-type products, if a patient presents with similar symptoms to those described above.

References

1. Natural Medicines Comprehensive Database. (nd). Stockton: Therapeutic Research Faculty. URL: naturaldatabase.therapeuticresearch.com (accessed 6 August 2013).
2. New Zealand Dermatological Society Incorporated. DermNet NZ: The Dermatology Resource. URL: www.dermnet.org.nz/reactions/drug-photosensitivity.html (accessed 6 August 2013).