Henna and  Glucose-6-phosphate dehydrogenase deficiency:
Catherine Cartwright-Jones c 2004 
Kent State University

Henna can cause a haemolytic crisis in G6PD deficient infants.  G6PD deficiency is an inherited condition, and any infant who is diagnosed with this condition MUST NOT have henna.  Henna can cause severe anemia in G6PD deficient infants by penetrating their thin, fragile skin of infants and causing oxidative haemolysis of their blood cells.

G6PD deficiency is a recessive x-chromosome sex-linked inheritable trait. If males have that trait on their x chromosome, they will be affected.  For females have the trait on one of their x chromosomes, they will not be affected.  If both of a female's x chromosomes are G6PD deficient, they will be affected.  Therefore, in populations that have G6PD deficient individuals, males will be twice as likely to be adversely affected by henna as females.  The populations that have this trait are mostly in the Middle East and North Africa. This may be why men rarely have henna, or have henna in small applications, while women have extensive and frequent henna in those regional traditions. 

The natural red tannin dye in henna is Lawsone (2-hydroxy-1,4 napthoquinone).  This is similar in structure to 1,4 napthoquinone, a naphthalene metabolite which strongly oxidizes G6PD deficient cells. Strong oxidants, such as are found in fava beans and naphthalene fumes (most commonly encountered in mothballs) cause similar haemolytic crisis in children, and in large amounts, can endanger G6PD deficient adults. 

Pediatricians in hospitals in Kuwait, Oman, and Arabia screen newborns for hyperbilirubinemia and G6PD deficiency, and warn parents to NOT henna their children if they are G6PD deficient, or are in a family carrying the deficiency.

Many Middle Eastern and North African mothers henna their infants at 1 or 2 months of age.  They may henna their soles and palms, or even henna the full body, as a blessing and protection.  Most infants suffer no ill effects from the henna, but G6PD deficient infants become lethargic and jaundiced within 24 hours and require phototherapy and blood transfusions.  If the child is not treated promptly after onset of symptoms, the child may die.  Loving mothers also henna pre-school age children for holidays and family celebrations. For most children henna is a delight, and they enjoy henna as part of the year’s cycle of celebrations.  However, G6PD deficient children at 3 and 4 years of age have also been admitted to hospitals for jaundice, lethargy and vomiting following their henna.  After blood transfusions, the jaundice subsided, and they survived.  

It is never advisable to henna an infant, particularly if you do not know if the child is G6PD deficient. The results can be life threatening, and result in hospitalization.  A healthy G6PD deficient adult may safely have small applications of henna.  If the G6PD deficient adult is anemic, or suffering an infectious disease, henna is inadvisable. 

Some groups of people rarely have G6PD deficiency.  Indigenous people of South America and northern Europeans are rarely G6PD deficient, but 50% of Kurdish males are G6PD deficient. In the US population, about 12% of Afro-American males are G6PD deficient.  Most people are aware of this trait through anemic episodes from eating fava beans or anemia from exposure to naphthalene from mothballs.  

If you are a henna artist, do not apply henna on a child under the age of 6 unless you know for certain they DO NOT have G6PD deficiency.

If you are a henna artist, and a person wants henna that might be G6PD deficient, ask them if their physician has ever told them they are G6PD deficient.  Ask them if fava beans make them anemic. If they do not know, ask if a physician has ever strongly cautioned them against using:

· aspirin
· nonsteroidal anti-inflammatory drugs 
· fava beans
· quinine
· naphthalene fumes
· mothballs

If they respond in the affirmative, it is advisable to keep their henna to a minimum. If you are sure they do not have G6PD defiency ... have fun and henna as much as you like!

The G6PD deficiency and henna haemolysis is entirely unlike, and has nothing to do with, para-phenylendiamine "black henna"  injuries.


Henna causes life threatening haemolysis in glucose-6-phosphate dehydrogenase deficiency
P Raupp, J Ali Hassan, M VArughese, B Kristiansson
Department of Paediatrics, Tawam Hospital, Al Ain, United Arab Emirites
Buraimi Hospital, Al Buraimi, Oman
Oasis Hospital, Al Ain, United Arab Emirites
Archives of Disease in Childhood
Volume 85 Issue 5 2001
Pages 411-412

Henna: a potential cause of oxidative hemolysis and neonatal hyperbilirubinemia
Zinkham WH, Oski FA, 
Pediatrics 1996; (suppl 394) 58 - 76

Henna (Lawsonia inermis Linn.) inducing haemolysis among G6PD-deficient newborns.  A new clinical observation.
Kandil HH, Al Ghanem MM, Sarwat MA, Al-Thallab FS
Annals of Tropical Paediatrics 1996; 16; 287-91

Web resources on Glucose - 6 - Phosphate Dehydrogenase Deficiency

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*"Henna, the Joyous Body Art" 
the Encyclopedia of Henna
Catherine Cartwright-Jones c 2000 
registered with the US Library of Congress
TXu 952-968