A mechanistic analysis of henna in G6PD deficiency patients

Glucose-6-phosphate dehydrogenase (G6PD) deficiency is a disease in which mutations in a gene related to the G6PD enzyme lead to incomplete expression, reduction, or absence of the enzyme. Henna is a widely used product in some countries for cosmetic and therapeutic purposes. This natural hair dye doesn’t cause significant adverse effects on the body. After using Henna, there have been reports of mild contact allergic reactions and hemolytic anemia (more severe cases) in people with G6PD deficiency. In this study, we used Google Scholar, PubMed, and Scopus databases to include case reports reported in people with G6PD deficiency disease. The coloring agent in Henna is related to lawsone (2-hydroxy-1, 4-naphthoquinone) which reacts with skin creatin. The effects of Henna are systemic and much more severe and fatal than healthy people symptoms appear as hemolytic anemia, including yellowish discoloration of the sclera and dark-colored urine. Also, the temporary henna tattoo has increased dramatically in recent years in adolescents and children due to its safety and lack of pain during the tattoo. PPD (para-phenylenediamine) is added to the Henna to darken the color of Henna and reduce its red color, increase its durability on the skin, and increase the drying speed of the Henna on the skin and improve the pattern design. PPD can have toxic effects at high concentrations and have systemic or local side effects, depending on the dose taken and ingestion, inhalation, or use. It can be said that Henna can cause complications from jaundice to death for G6PD deficiency patients, depending on the degree of the disease.