henna dye

Henna Use in Humans and Its Risks for People with G6PD Deficiency

by

Henna Use in Humans and Its Risks for People with G6PD Deficiency

Introduction

Henna, derived from the leaves of the Lawsonia inermis plant, has been used for centuries across cultures as a natural dye for skin, hair, textiles, and in traditional medicine. Its reddish-brown pigment, lawsone (2-hydroxy-1,4-naphthoquinone), binds strongly to proteins and creates the familiar stain. While henna is widely considered “natural” and safe for the general population, it poses significant risks for individuals with Glucose-6-Phosphate Dehydrogenase (G6PD) deficiency.

G6PD deficiency is a genetic condition that makes red blood cells more vulnerable to oxidative stress. Exposure to certain chemicals—including those in henna—can trigger hemolysis (the rapid breakdown of red blood cells), leading to serious health complications.

Common Uses of Henna in Humans

  1. Cosmetic Applications

    • Body Art (Mehndi): Henna paste is traditionally applied to hands, feet, and body for weddings and festivals.

    • Hair Dye: Henna is marketed as a natural alternative to chemical dyes.

    • Brow/Eyelash Tinting: Henna is increasingly used in salons for semi-permanent eyebrow shading.

  2. Personal Care Products

    • Present in shampoos, conditioners, and soaps for its coloring and supposed strengthening effects.

  3. Traditional and Folk Medicine

    • Applied on wounds, burns, or skin conditions.

    • Historically ingested or brewed as teas in some regions for fever, headaches, and infections.

  4. Other Uses

    • Textile and leather dye.

    • Animal markings in cultural rituals.

Evidence of Harm in G6PD Deficiency

Scientific and clinical evidence consistently links henna exposure with hemolytic crises in G6PD-deficient individuals:

  • Case Reports in Infants and Children: Multiple studies describe severe hemolysis after topical henna application, especially in newborns. Symptoms included jaundice, dark urine, anemia, and in some cases, life-threatening complications.

  • Adult Cases: Though less common, adult G6PD-deficient individuals have also suffered hemolysis after using henna for body art or hair coloring.

  • Mechanism: The pigment lawsone acts as a strong oxidant, overwhelming red blood cells lacking sufficient G6PD enzyme protection. This oxidative stress causes red blood cells to rupture.

  • Regulatory Warnings: Some regions, such as the Middle East and South Asia, have issued advisories warning against henna use in infants or anyone with known G6PD deficiency.

Why Henna Is Risky for G6PD-Deficient People

  • Topical absorption: Even when not ingested, lawsone penetrates through the skin and enters the bloodstream.

  • Cultural practices: Application in newborns, a tradition in some regions, is particularly dangerous as infants have both immature systems and, in some cases, undiagnosed G6PD deficiency.

  • Hidden exposure: Commercial beauty products may list henna extract as a natural additive, exposing users unknowingly.

Safe vs. Risky Uses of Henna for G6PD Deficiency

  • Risky: Skin application (body art, mehndi), hair dyes, eyebrow/eyelash tinting, medicinal use on wounds, ingestion in herbal teas.

  • Possibly Low Risk but Best Avoided: Shampoos, conditioners, soaps containing small amounts of henna.

  • Safe: Indirect use in textiles, leather dyeing, or animal markings where there is no direct prolonged skin contact.

Practical Recommendations

  • Absolute Avoidance: People with G6PD deficiency (and parents of G6PD-deficient children) should avoid all cosmetic and medicinal applications of henna.

  • Check Labels: Carefully review personal care products for henna or “Lawsonia inermis” extract.

  • Inform Practitioners: Always inform hairdressers, beauticians, and healthcare providers about G6PD deficiency to avoid accidental exposure.

  • Community Awareness: In cultures where henna use is traditional for newborns and brides, public education is essential to prevent tragic outcomes.

Conclusion

While henna is cherished worldwide as a symbol of beauty and tradition, it carries a hidden danger for people with G6PD deficiency. The compound lawsone can induce severe hemolysis, leading to hospitalization or worse. For this reason, henna should be avoided entirely by G6PD-deficient individuals, regardless of whether it is used on the skin, hair, or in folk medicine. Safer cosmetic alternatives exist, and raising awareness can help protect vulnerable children and adults from preventable health crises.