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Ophthalmology of the Pharaohs: Antimicrobial Kohl Eyeliner in Ancient Egypt

Body Horrors
By Rebecca Kreston
Apr 21, 2012 3:15 AMNov 19, 2019 9:50 PM


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The bold eye makeup in the ‘60s, best exemplified by Sophia Loren’s winged ‘cat eye’ liner and Twiggy’s spidery eyelashes, had nothing on the ancient Egyptians and their gods. Their eyelids were heavily smeared with black kohl eyeliner, thick lines rimming the eyes, and the fashion was sported by everyone from peasants to pharaohs to effigies of the worshiped gods Horus and Ra. Though it may seem nothing more than a cosmetic fancy nowadays, kohl was considered to have potent magical powers and it has since turned out to possess unique pharmaceutical and antimicrobial properties. In fact, this deceptively simple beauty product may actually be one of the most ancient ophthalmological preparations known to man.

A piece of limestone pottery shows a woman nursing her child while a servant holds up a mirror and a crayon of khol. Dated from the 19th to 20th dynasty, 1285-1069 BCE, this shard is held at the Louvre, Departement des Antiquites Egyptiennes, Paris, France. Click for source.

Kohl served multiple roles in Egyptian antiquity. Egyptians of all social classes applied the eyeliner daily in veneration of the deities, satisfying both religious obligations and beautifying desires. Wearing the glossiest, highest quality kohl denoted one’s upper class status in society while the less wealthy adulterated their kohl with fire soot. Before the advent of Ray-Bans, it was applied liberally around the eyes to reduce the sun's glare, to repel flies and to provide cooling relief from the heat. It also trapped errant dust and dirt, a simple remedy to curb the desert’s regular assaults on the body. Besides lining the eyes, the substance was also used to outline the eyebrows and enhance facial tattoos. In death, pouches containing the cosmetic and applicators were buried alongside the deceased, a testament to its importance not just in day-to-day living but also in the afterlife (1).

Kohl's vast presence throughout history and across the globe testifies to its cultural, social, and hygienic purchase and evidence for its usage has been unearthed at the sites of ancient civilizations across North Africa, Central Asia, the Mediterranean and East Asia (2). It’s an incredibly old product, having been present since the Bronze Age (3500-1100 BC) and it’s usage has even been alluded to in the Old Testament, with two allusions at Kings II 9:30 and Ezekiel 23:40 to “painted eyes”.

An ancient Egyptian alabaster kohl pot dated from 1550 BC to 1070 BC. The opening was large enough to allow for a finger, feather or small stick to be dipped into the pot and then applied to the face. Image: Unknown. Click for source.

As with any product with a wide geographic distribution, it has picked up multiple labels. Arabs and modern Egyptians refer to it as “kohl”, while the Romans and Greeks named the product “kollurion”. The Iranians and those in the Indo-Pakistan region to this day call our eye-lining friend ‘surma” (2).

Kohl is predominantly composed of the mineral galena, a dark, metallic lead-based product that is also known by the chemical name lead sulfide (PbS). The mineral would be crushed and mixed with several other ingredients such as ground pearls, rubies and emeralds, silver and gold leaves, frankincense, coral, and medicinal herbs such as saffron, fennel, and neem (1)(2). These compounds were then diluted in liquids such as oil, gum, animal fats, milk, or water to solubilize the lead and assist in its eventual facial smearing. Today we use galena for less prestigious and artistic purposes, in rechargeable batteries and as lead shot to fill shotgun shells.

A sample of the mineral galena, an ancient Egyptian source of lead sulphates. Image: Creative Commons. Click for source.

In 2010, French researchers analyzed samples from 52 kohl containers residing at the Louvre museum in Paris and found that the cosmetic contained trace amounts of four uncommon lead species: galena (PbS), cerussite (PbCO3), phosgenite (Pb2Cl2CO3), and laurionite (Pb(OH)Cl) (3). These last two compounds, the lead chlorides, are not naturally found in Egypt, which points to the possibility of deliberate manufacturing using lead oxide (PbO), rock salt (NaCl), natron (Na2Co3 and NaHCo3), and water. The authors of the study reckon that “it is clear that such intentional production remains the first known example of a large scale chemical process.” (4)

When researchers exposed skin cells to the lead sulfates found in kohl, they discovered that the lead ions elicited a profound immunological response. The cultured cells released one of the most important messaging molecules in the immune system, nitric oxide gas (NO); this gaseous molecule serves an activating messenger to bacteria-eating macrophage cells and stimulates blood flow by increasing the diameter of capillaries, encouraging rapid immune cell movement within the bloodstream (3). A 240-fold increase in NO production was sparked by the presence of lead ions, a bona fide tsunami of molecules flooding surrounding cells to respond to invading bacteria. This intense biochemical interaction suggests that kohl was more than just a beautifying cosmetic and the forefather of sunglasses, but also an important antibacterial ointment.

Why does it matter that the Egyptians were smearing black antibacterial gunk around their eyes? Aside from dastardly sandy winds introducing grit and irritating the sensitive eye region, infections of the eye were a serious and widespread concern (5). The desert conditions and annual flooding of the river Nile primed the eye for inflammations and bacterial infections. Antibacterial eyeliner seeping into the conjunctiva of the eye would activate an immune response, killing off pathogenic bacteria and preventing infections before they even started. The cosmetic’s regular usage could have cut down on the prevalence of ocular scarring, cataracts and blindness, nothing for an Egyptian living in antiquity to scoff at.

The Ebers Papyrus, a sort of medical textbook in ancient Egypt. It is considered to be one of the most complete and most exquisite of the medical papyri to be found. Click for source.

Perhaps it’s not all that strange that kohl has been found to have medicinal properties: the chemists and pharmacists in Egypt were considered quite knowledgeable by their Greek and Roman counterparts and their mastery of anatomy, diseases and pharmaceuticals were widely respected throughout the Mediterranean (3). We’re fortunate enough to actually have concrete evidence of this, in the form of several medical papyri scavenged by scrappy archaeologists in the late 1800s and early 1900s.

One of these is the Ebers papyrus dating from 1550 BC, the oldest known medical texts in existence (in existence, ladies and gentlemen!), and the hieroglyphic manuscript describes a plethora of ophthalmological multisyllabic quandaries including "blepharitis, chalazion, ectropion, entropion, trichiasis, granulations, chemosis, pinguecula, pterygium, leucoma, staphyloma, iritis, cataract, hyphaema, inflammation, ophthalmoplegia and dacryocystitis" (6). It contains detailed herbal preparations for eye drops, salves, ointments and even plaster dressings for the eyelids. Some of it seems to be clearly nonsense - beetle honey, anyone? - and in some unfortunate cases the papyrus recommends prayers and magical incantations to cure an ailment, another way of saying “You’re S.O.L., pal. Speak to my falcon-god-friend Horus here.” Aside from attendant ocular dilemmas, there are also remedies for gynecological, intestinal and dermatological issues and more.

The very existence of these papyri suggests a dedicated core of physicians and pharmacists collating their experiences, observations and empirical testing to create one of mankind’s first monstrously large medical textbook. Really, we contemporary humans are so damn lucky to have captured this surviving piece of ancient medical history, thanks to several original Indiana Jones-types from a century ago.

Kohl is still used today in North Africa and Central Asia, despite its considerable toxicity. I know what you’re thinking, “Now, a warning?” Heavy metals such as lead, mercury and arsenic often contaminate today’s product leading to cases of 'saturnism' or lead poisoning. This is particularly a serious issue with young children sporting the cosmetic as protection against the evil eye, as they are more likely to engage in hand-to-mouth behavior while learning about their environment (See here).

Even today, women mimic the application of kohl to enhance and brighten eyes but, sadly, there aren’t any therapeutic side-effects to expertly drawn winged cat-eyes. This idea of “cosmetics as medicine” that is vigorously pursued by the beauty industry in the form of “plumping” lipsticks, skin foundations embedded with minerals to combat acne, anti-aging creams and so much more was originally the province of Egyptian chemists. Maybe the secret to Cleopatra’s beauty wasn’t Maybelline but lead sulfate.

Note: The title of this article is derived from this short letter in the British Medical Journal: The Ophthalmology Of The Pharaohs. (1909) Brit Med J (2): 2543: 902. View it here on JSTOR.

Resources Nothing's safe from the FDA: Kohl, Kajal, Al-Kahal, or Surma: By Any Name, a Source of Lead Poisoning

. A group at Bard College completed an "interlinear transliteration" and English translation of parts of the Ebers Papyrus that they believe covered what we now know as diabetes mellitus. Neat, huh? Go here

to check out their incredible work. For a short but captivating read on kohl's usages among women in North Africa in the early 1900s, download this pdf

from Harquus

, a website devoted to traditional women's tattoos and facial markings.

References (1) Cartwright-Jones C (2005) Introduction to Harquus: Part 2: Kohl as traditional women’s adornment in North Africa and the Middle East. Ohio: TapDancing Lizard Publications (2) Mahmood ZA (2009) Kohl (Surma): Retrospect and Prospect. Pak. J. Pharm. Sci.22(1): 107-122 (3) Tapsoba I et al (2010) Finding Out Egyptian Gods’ Secret Using Analytical Chemistry: Biomedical Properties of Egyptian Black Makeup Revealed by Amperometry at Single Cells. Anal. Chem.82(2): 457–460 (4) American Chemical Society (2010, January 11). Ancient Egyptian cosmetics: 'Magical' makeup may have been medicine for eye disease. ScienceDaily. Retrieved April 18, 2012, from here. (5) Finlaysonthe J (1893) Ancient Egyptian Medicine. Brit Med J. 1(1689): 1014-1016 (6) CN Chua. (Date unknown) A Historical Tour To Ophthalmology: The Ancient East. MRCOPTH. Accessed April 18, 2012, from here.

Tapsoba I, Arbault S, Walter P, & Amatore C (2010). Finding out egyptian gods' secret using analytical chemistry: biomedical properties of egyptian black makeup revealed by amperometry at single cells. Analytical chemistry, 82 (2), 457-60 PMID: 20030333


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