With an increase in the usage of chemicals in the manufacturing of the colours used in Holi, the incidence of skin allergies, dermatitis and other ocular illnesses have risen. Discussed here are some issues that patients present with around this festival of the year.

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The flipside of Holi

As an aftermath of Holi, a large number of patients consult clinicians for various skin problems arising out of celebration with these colours. A large number of cutaneous reaction patterns result from:

1. The various forms of colours (pastes, powders and watercolours).
2. The various methods adopted for removal of the colours from the skin after the celebration is over.

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Dermatological manifestations of Holi

The chemical infused colours available have high amounts of heavy metal compounds:

• Copper sulphate: Known to cause allergies and even temporary blindness
• Mercury sulphite: Known to cause skin cancer and Minamata disease
• Chromium iodide: Known to cause Bronchial asthma
• Aluminium bromide: May cause cancer
• Lead oxide: May cause renal failure
• Mica granules: May cause skin rashes
• Industrial dyes: May cause skin allergies and temporary blindness

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Various forms of problems which are presented to physicians/dermatologists 

• Pruritus
• Burning sensation on the skin
• Pain
• Oozing lesions
• Dryness and scaling
• Eczematous lesions (most common reactions)
• Erosions, xerosis and scaling, erythema, urticaria, acute nail fold inflammation, and abrasions
• Exacerbation of pre-existing dermatoses like acne, eczema, and paronychia
• Pre-existing lesions complicated with secondary pyoderma

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Most affected sites on the body

The face is the most common site affected, followed by other areas of the exposed skin. Sometimes severe eczematous reactions may be seen at the sites of undergarments where the dry and liquid colours tend to accumulate. Many of these cutaneous manifestations are thought to be either allergic or irritant contact dermatitis exacerbated in some due to the mechanoabrasive properties of the dry colours. Some of the cases may also be a result of photosensitivity.

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The worsened fate of acne

1. Acne is one of the most common dermatoses amongst youngsters, which is also affected secondarily.
2. Most topical drugs for acne such as benzoyl peroxide and isotretinoin render the facial skin dry.
3. The dryness is worsened by the vigorous and rough forms of cleansing employed to rid the skin of the stubborn colours, a mechanoabrasive phenomenon.

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Playing with coloured water

Holi is considered incomplete without playing with coloured water. However, it has the following consequences:

1. People tend to use stagnant water and even muddy water to play in Holi which can lead to dermatological problems.
2. Water itself can harbour microorganisms and the colours add to the chemicals.
3. People tend to stay in the sun after having played Holi which adds to the tanning and dermatitis

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Other manifestations

Mild to serious ocular involvements

• Redness in the eyes
• Watering, and grittiness
• Conjunctivitis
• Corneal abrasions
• Periorbital necrotizing fasciitis

Holi has also been associated with some allergic manifestations like:

• Allergic rhinitis
• Exacerbation of Asthama
• Pneumonitis

Life-threatening systemic complications may also arise in rare cases like:

• Methemoglobinemia
• Urticarial Vasculitis

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Awareness and consultation

1. Patient education in regard to the use of more herbal colours.
2. Awareness about skin and eye care before and after playing Holi.
3. General physicians may refer the patients to consulting dermatologists or ophthalmologists in case of severe manifestations of Holi colours on skin or in the eyes.

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Tips for patients

1. Use herbal colours instead of playing with chemical colours.
2. Apply coconut oil to hair and enough moisturiser or sunscreen on skin.
3. Wear clothes that cover most of the body parts.
4. Do not stand in the sun for long.
5. Avoid letting the colours stay on for a long time.
6. Dust off dry colours while cleaning yourself, and then wash off the rest.
7. Do not overuse shampoo or soap to clean the skin as it may cause unnecessary dryness and scalding.
8. It may take 2 or 3 days for the colours to completely wash off.

Disclaimer- This article was previously published on 18th March 2022. The views and opinions expressed in this article are those of the author and do not necessarily reflect the official policy or position of M3 India.