Ophthalmology of the Pharaohs: Antimicrobial Kohl Eyeliner in Ancient Egypt

By Rebecca Kreston | April 20, 2012 6:15 pm

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.


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.

(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.
This post was chosen as an Editor's Selection for ResearchBlogging.org

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


CATEGORIZED UNDER: Bacteria, History, Religion & Rituals
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  • http://jdm314.livejournal.com Mad Latinist

    Just a linguistic note:

    Collyrium is Latin, not Egyptian. This is derived from Greek ?????????, and kollurion is just another way to spell that in our letters. Furthermore, I don’t know that collyrium and kohl are the same thing: collyrium seems to be some sort of salve for which complicated recipes are attested… the name also refers to a type of bread. When kohl is referred to in the Bible, the Greek version uses stimmi or stibion. I honestly don’t know the Egyptian word for kohl, but I really should look into it.

    I don’t know about beetle honey, but bee honey was common in eye treatments, and my understanding from people with more medical knowledge than I was that this has some scientific merit… I guess because the sugar concentration is so high that it’s bacteriostatic?

    • http://blogs.discovermagazine.com/bodyhorrors/ bodyhorrors

      Hey Mad Latinist, thanks for the heads up! I’ve since corrected it but I would love to know what you find out about the ancient Egyptian’s name for kohl.

      A lot of the ancient terms I used in this article were derived from the scientific literature I referened, in particular Mahmood’s 2009 article “Kohl (Surma): Retrospect and Prospect”. From what I’ve found, having another search, the literature attests that collyrium means an eye salve or unguent and that collyrium and kohl were virtually interchangeable and served the same purpose. They both required extensive recipes with complicated chemistry as was mentioned in the article. Check out this link for more.

      Indeed you’re right about bee honey – it has both antibacterial and antiviral properties. If you’re interested, you can visit this link here about it’s use as a topical agent for infected wounds. Adding sugar usually makes microbes quite happy, as opposed to being bacteriostatic. This is why dentists dislike our consumption of sugary sweets, as it fuels the microbiome in your mouth and causes cavities.

      Thanks again, hope you continue to visit!

      • http://jdm314.livejournal.com Mad Latinist

        Hmm, this certainly isn’t my area of expertise, but a while back, when I was trying to understand the connexion between the salve and the bread (as well as what appears to be a pasta), I found the following note in W.G. Spencer’s 1938 translation of Celsus:

        A tent, or collyrium (Low Latin tenta, Greek ?????????) was material made up with a glutinous paste which was rolled and formed into sticks shaped like vermicelli (collyra). These were used to dilate a fistula, or the uterus (??? ?????? ?????????. Hippocrates, Diseases of Women, I.51); or else pieces were broken off the stick and dissolved for use (e.g. as eye salves, VI. 6) As lately as thirty or forty years ago such sticks were still prepared and pieces broken off and used in this way.
        —(pp. 154—5, note a)

        Now, of course if I can’t research this myself (and frankly I cannot), and I’m forced to take the word of other scholars, I’m more inclined to trust modern medical historians than early twentieth century classicists… but his explanation is pretty interesting.

        Anyway, as long as you’re making corrections: I would write either collyrium or kollurion (but, that is, not kollurium). Well, that, and Horus has a falcon head, not an owl head 😉 Kollyrion ends up borrowed into a number of ancient languages by the way, including Coptic, and Hebrew. In fact, I believe there are discussions of making the stuff in the Talmud.

        But the Hebrew word in Ezekiel 23:40 that means “you have painted”, by the way, is ?????????? kå?alt? (modern pronunciation is kakhált, which will be easier for you to say), which is a direct cognate to the Arabic word kohl! Cool, eh? For some reason, at some point the Hebrew word for “blue” used in the bible fell out of common use, and was replaced by kakhól, which literally means “kohl colored”!

        As for sugar, I know that even microbes have their limits: this is, for instance, why pure honey doesn’t go bad, but diluted honey ferments into mead. If I remember correctly this has to do with diffusion: if the concentration of sugar is way higher outside the cell than inside the cell, bad things can happen.

        • http://blogs.discovermagazine.com/bodyhorrors/ bodyhorrors

          You had me at Egyptian pasta! I love how you went research hunting and went from kohl –> bread recipes –> gynecological health “sticks”. Love it. In the article that I read and mentioned below, collyrium could refer to eye salves or gynecological treatments so I think we’re in agreement there! It’s just a shame that the two refer to both as they’re so morphologically dissimilar!

          Falcon head, thank you! When I was traipsing around Luxur a few years back, I was convinced they were owl heads. Alas, I was incorrect. Falcon it is.

          So here’s my two-cent worth of insight. The Egyptians were rocking kohl long before it became trendy in the ancient world. These original hipsters had their own term for it, whatever it may be, and so the Roman/Latin term “kollurium” was clearly derived from the Egyptians. As such, I think the two should be quite similar phonetically. I feel like we’re in sticky territory when we venture into linguists or historians tackling the exact etymology and history of a word and then asking a scientist, “well, what exactly is this biological function of this THING”.

          That’s super neat that the Talmud has kohl recipes in it. It just goes to show how important this cosmetic was. Eye infections were a big deal back then!

          Also, I like your take on osmosis: “if the concentration of sugar is way higher outside the cell than inside the cell, bad things can happen.” Have you ever thought of going into the sciences, Mad Latinist? :) You’re correct – we get imbalances in the homeostasis of the system. I think you ought to go into the sciences!

  • http://jdm314.livejournal.com Mad Latinist

    Argh, formatting on this blog is difficult, because you can’t preview :/

    • http://jdm314.livejournal.com Mad Latinist

      This is just how my mind works. If you mentioned this chain of associations to a friend of mind, they would probably ask if you’d heard it from me.

      And, oh right, THAT was it: “osmotic pressure.”

      I doubt collyrium is borrowed from Egyptian. I doubt it’s even borrowed from the Semitic ko?l, though you’re right they do sound plausibly similar. The thing is if ko?l were the source, it would probably be spelled with a ? (ch) in Greek, rather than a ? (c/k)… that’s pretty regular in words of Semitic origin.

      I’m still having a surprising amount of trouble figuring out the Egyptian word. Do you maybe have a reference from the Ebers papyrus? I can look that up pretty easily if you do.

      • http://jdm314.livejournal.com Mad Latinist

        OK, this last comment was obviously meant to go in the other thread. Don’t know why I’m having so much trouble with this particular blog interface.

        Anyway, I was looking in the wrong places for the Egyptian word. In Coptic (a form of the Egyptian language spoken after the Egyptians converted to Christianity, and written in a modified form of the Greek alphabet) the word for kohl is ???? (st?m), which would be the origin of the Greek/Latin stimmi and stibium.* St?m in turn comes from Demotic Egyptian st?m (which my dictionary defines as “eye paint”) and that from late Hieroglyphic Egyptian sdm (the Egyptians didn’t write vowels. For our purposes you can pronounce that “sedem,” also defined “eye-paint.”) The ultimate origin appears to be Hieroglyphic mstm (“mestem”–again, not the real pronunciation, just convenient for our purposes), defined as “a black mineral.”

        Perhaps stibium is a subcategory of collyrium that refers specifically to kohl and/or antimony? I don’t know if there’s a more general (or earlier) term in Egyptian.

        * Notice that the chemical symbol for Antimony, Sb, derives from stibium!

        • http://blogs.discovermagazine.com/bodyhorrors/ bodyhorrors

          So my main Ebers papyrus source that detailed ophthalmological ailments was Chua’s ‘A Historical Tour To Ophthalmology: The Ancient East’ available here but I also hunted through a bunch of poorly scanned old Jstor papers from the 1800s including
          – F. Ll. Griffith (Aug. 26, 1893) Some Notes On The Ebers Papyrus quick view. The British Medical Journal, Vol. 2, No. 1704, pp. 477-478
          – (Dec. 13, 1930) The Ebers Papyrus. The British Medical Journal, Vol. 2, No. 3649 , p. 1014
          There were other papers but I don’t have their citations. I know, bad academic! In any case, they were more for my personal confirmatory purposes than anything else.

          But I see you’ve come up with ‘mstm’! Cool! When I get a spare second, I’ll make the necessary changes in the article and attribute them to your hard work! Thanks so much, Mad Latinist!

  • http://jdm314.livejournal.com Mad Latinist

    Well, what I mean is did any of your sources cite a specific recipe in the Ebers papyrus, so I can go look at the Egyptian text and see what it says?

  • http://goo.gl/JGvgx Traci

    Although cosmetics were definitely used for the purpose of beautification, in ancient Egypt, eye makeup did more than paint a pretty face. As we have seen to be typical of the ancient Egyptians, they took a truly holistic approach to the notion of eye makeup. Not only was it decorative and ornamental, the practice also served medicinal, magic and spiritual practices.

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Body Horrors

Body Horrors looks at the history, anthropology and geography of infectious diseases and parasites.

About Rebecca Kreston

Rebecca Kreston is an infectious disease scholar trained in microbiology and epidemiology. She obtained her Biology degree from Reed College and her Masters of Science in Tropical Medicine from Tulane University. She's lived in tropical jungles, beaches and deserts around the world and has been exposed to several of the diseases that she studies. She currently lives in New Orleans, is a fourth year medical student and regularly battles insects of the Diptera, Siphonaptera and Hymenoptera orders.

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