Hair-Color Allergy Patch-Test Form
A hair-color patch-test record — client and stylist, product and lot, test placement and method, the 48-hour observation window with reactions, and a go/no-go decision before the color service.
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Iris & Indigo Salon
HAIR-COLOR ALLERGY PATCH-TEST RECORD
CLIENT
Name: Riley Tran Client ID: CL-22988
Phone: +1 217 555 0188
Stylist: Avery Park
PRIOR REACTIONS
No prior reactions to permanent hair color (last colored 8 months ago, no issue). One mild reaction to black-henna temporary tattoo 4 years ago — itch, no blistering. Patch-testing this time as a precaution.
PRODUCT
Line / shade / developer: L'Oréal Professionnel Majirel · 6.0 Natural Dark Blonde · 20 vol developer
Lot / batch: LP-MAJ-26-0411-A
Test method: Behind-the-ear, mixed to use ratio
TEST TIMELINE
Patch placed: Tuesday, May 19, 2026 · 4:15 PM
24-hour observation (client self-report):
No itch, no redness.
48-hour read (stylist):
Read at: Thursday, May 21, 2026 · 4:15 PM
Observation: No redness, no swelling, no vesicles, no itch reported. Skin clear.
Stylist reads for: redness (erythema), swelling (edema), vesicles
(small fluid-filled bumps), papules, itch, and any spread beyond the
patch area. Any positive sign = do not proceed.
RESULT
Negative — clear to proceed
NEXT COLOR SERVICE
Saturday, May 23, 2026 · 11:00 AM (≤7 days after patch read; re-test if rescheduled beyond 7 days)
(Patch-test validity: many manufacturers require the color service to
occur within 7 days of a negative patch read; re-test if the service
is rescheduled beyond that window or if the client changes product
line, shade, or developer strength.)
CLIENT ACKNOWLEDGMENT
I confirm the patch test was placed and read above. I will report any
delayed reaction (itch, redness, swelling) that appears between the
read and the service, and I understand the salon may decline the color
service if a reaction develops at any time before the appointment.
Signature: ____________________ Date: ____________
Riley Tran
STYLIST SIGN-OFF
Avery Park Signature: ____________________ Date: ____________
(Retain this record in the client file. Salon-level liability for an
allergic reaction to PPD or other oxidative-dye components is significant;
documenting every patch test on every new product / new client is the
standard of care.)
About this template
A **hair-color allergy patch test** screens for **allergic-contact dermatitis** to **PPD (p-phenylenediamine)** and other oxidative-dye components — the most common cause of severe allergic reactions in salon services. Manufacturers (L'Oréal Professionnel, Wella, Schwarzkopf, Goldwell, Redken) **require** a 48-hour patch test before each **new client** and recommend re-testing when the client switches **product line**, **shade**, or **developer strength**, and on a **periodic cadence** for returning clients. A typical reaction profile: a mild reaction is itch and redness at the patch site; a serious reaction is **swelling around the eyes and face within hours of full service** (the dose at full service is far larger than the patch dose), and a small number of clients develop **systemic anaphylaxis** — the patch test is a **screening tool**, not a guarantee. The record documents the **client and stylist**, the **product line, shade, developer, and lot/batch number**, the **placement** (commonly behind the ear or inner elbow, mixed at the use ratio), the **placement time and 48-hour read time**, **24-hour client self-report and 48-hour stylist read**, and the **go/no-go decision**. Two operational rules. **Validity window** — most manufacturers require the color service to occur **within 7 days** of a negative patch read; a service rescheduled beyond that window requires a re-test. **Positive read** — itch, redness beyond the patch, swelling, vesicles, papules, or any spread = **do not proceed**, refer to a physician or dermatologist, and document the refusal. **PPD-free formulas** (Goldwell Elumen, Wella Color Touch demi-permanent, henna-only) may be an alternative for PPD-positive clients but require their **own patch test** because alternative dye components (e.g., para-toluenediamine, henna with additives, ortho-aminophenol) can also sensitize. Retain the form in the client file — for an adverse-event claim, the patch-test record is the single most important piece of documentation the salon owns.
When to use it
- New-client first color service.
- Switching a returning client to a new product line, shade family, or developer strength.
- Re-testing a client who has had a temporary tattoo / henna reaction.
- Re-testing on the salon's periodic cadence (annual or per-manufacturer requirement).
What to include
- Client identity and prior-reaction history.
- Product line, shade, developer, and lot/batch number.
- Patch placement method and location.
- Placement and 48-hour read times.
- 24-hour client self-report.
- 48-hour stylist read with specific observations.
- Go/no-go decision and next service scheduled (within the validity window).