What Black women should know about hair relaxers and their health

The damage chemical hair relaxers can have on Black women is coming under intense scrutiny. 

Several landmark studies have been published in the last year highlighting the link between chemical hair relaxers — which break down proteins in hair to straighten it — and increased rates of uterine cancer. And last week, after pressure from Democratic Reps. Ayanna Pressley of Massachusetts and Shontel Brown of Ohio, the Food and Drug Administration said it would propose a ban on hair-smoothing and hair-straightening products containing formaldehyde, an ingredient known to cause cancer. 

As more research continues to reveal potential dangers, hundreds of Black people have filed lawsuits against big-name beauty and cosmetic retailers like L’Oreal and Revlon, blaming their chemical hair straighteners as causes of uterine cancer, fibroid tumors and infertility

The latest research on the effects of hair relaxers was published Oct. 10 by Boston University. According to the Black Women’s Health Study, or BWHS, postmenopausal Black women who have used chemical hair relaxers more than twice a year or for more than five years have an increased risk of developing uterine cancer.  

In following 44,798 Black women for up to 22 years, researchers found a higher rate of uterine cancer among postmenopausal Black women who reported having used chemical hair relaxers for at least 10 years, regardless of frequency. 

Better grasping Black health and the factors that contribute to racial disparities in cancer was the intent behind the 22-year study. 

“The idea here is that a renewed emphasis or attention to the potential dangers of these products, I hope, will spur policies, and that will sort of help reduce exposure in this population or even help us identify potentially safer alternatives to straighten hair,” said the lead author of the study, Kimberly Bertrand, an associate professor of medicine at Boston University Chobanian & Avedisian School of Medicine. Revealing the potential risks of hair relaxers, she said, can help spread awareness and encourage making safer choices.

NBC News spoke to Bertrand and other researchers to answer some questions Black people may have about chemical hair straighteners and the potential risks to their health

What has the research said about chemical hair relaxers and women’s health so far?

Several studies have found that chemical hair straighteners have harmful effects on the body. Last year, the National Institutes of Health published a major study linking chemical hair straighteners to a higher risk of uterine cancer. The study analyzed data from 33,497 U.S. women ages 35 to 74 who were followed for nearly 11 years. During that period, 378 cases of uterine cancer were diagnosed.

According to this month’s BWHS, women who reported using hair relaxers more than twice a year or who used them for more than five years had a greater than 50% risk of developing uterine cancer compared to those who rarely or never used relaxers, additional data from the study shows. 

In 2021, the BWHS found that Black women who used hair products containing lye, an ingredient typically found in salon relaxers, at least seven times a year for more than 15 years had a 30% increased risk of developing breast cancer. Among the 50,543 women who participated in the 25-year study, 2,311 participants had developed breast cancer, including 1,843 who developed invasive breast cancers, meaning the cancers spread into surrounding breast tissue. While Black women have a 4% lower incidence rate of breast cancer than white women, Black women have a 40% higher breast cancer death rate, according to the American Cancer Society.

Other studies have shown that hair relaxers can cause fibroids and an early onset of puberty in girls, Bertrand said. Early puberty can increase the risk for metabolic syndromes such as obesity, Type 2 diabetes and cardiovascular disease in adulthood.

Why are hair relaxers so harmful? 

Chemical hair relaxers contain endocrine-disrupting chemicals, which can disrupt the functions of the endocrine system (which includes the thyroid, ovaries, pancreas and adrenal glands) and affect hormone levels. These chemicals include phthalates and parabens, which can be found in relaxers. People can be exposed to them by absorption through the skin or inhaling them in the air. 

Black women are often exposed to endocrine disruptors by using relaxers, which are applied on the scalp, said Jasmine Abrams, a research scientist at the Yale University School of Public Health.

“If you have ever gotten a relaxer, you know it usually sits on for a little bit, and most people sort of alert their hair stylist that it needs to be washed out once it starts tingling or burning — and at that point, you are running the risk of burns,” said Abrams, one of the authors of a study this year linking chemical hair straighteners to issues with fertility. “And if you’re running the risk of burns or any sort of injury with that type of chemical, then you’re definitely increasing your risk for absorption. If you do that over time for many, many years, then it can, of course, become continuously problematic.”

Endocrine-disrupting chemicals can also be found in some beauty products like lotions, body washes and perfumes, she added. 

Are all chemical hair relaxers dangerous, or are there safer alternatives?

Parabens, phthalates and other chemicals that are often found in chemical hair straighteners pose a greater risk than other products because of scalp exposure, Bertrand said. Even other chemical hair straighteners marketed as safer to use, including no-lye relaxers, still pose potential risks.

“In our study, women who reported using non-lye relaxers were pretty much just as likely to report scalp burns as those who use lye relaxer,” she said. 

Hair-straightening products are “very poorly regulated” by the federal government, Bertrand said, and many mask harmful chemicals under names such as “fragrance and preservatives, so women don’t really know what they’re being exposed to.”

U.S. law does not require the Food and Drug Administration to approve cosmetic products and ingredients, other than color additives, before they go on the market, according to the FDA website. However, the FDA announced last week that it would propose a ban on hair-straightening and hair-smoothing products containing formaldehyde. The FDA did not immediately respond to a request for comment.

Stricter regulations of ingredients in cosmetic products and using alternative methods like heat straightening may help reduce exposure to harmful chemicals, Bertrand said.

Am I still at risk if I stopped using chemical hair straighteners years ago?

Researchers are not entirely sure. 

“We can’t definitively say that occasional use is entirely safe,” said Abrams, an author of the 2023 study about hair relaxers and infertility. “Our data essentially suggests that less frequent use is associated with lower risks when compared to regular prolonged use.”

In Abrams’ study — which included women of different races ages 21 to 45 — Black women accounted for the greatest population of people who had started using relaxers at age 10 or younger. More than 50% of the Black participants in the study also had used hair relaxers before they reached age 10.

Bertrand’s study found that postmenopausal Black women had a greater risk of developing uterine cancer if they used hair relaxers more than twice a year or consistently for more than five years. 

Other factors put Black women at risk for developing uterine cancer, including age, obesity and family and reproductive history, Bertrand added.

What can I do if I suspect my health has been put at risk by using chemical hair straighteners?

There are no proven screening mechanisms to detect uterine cancer in the general population, as there are with other diseases like breast cancer, Bertrand said. 

Women should visit their doctors if they have any symptoms of pain in the pelvic area or abnormal vaginal bleeding. Those with family histories of uterine cancer can also speak to their doctors about genetic testing to identify potential higher risks for certain cancers. 

In terms of monitoring reproductive health, Abrams said, women can monitor their hormone levels — either by visiting endocrinologists or mailing in their biospecimens to labs — and speak with gynecologists about their concerns and ask about taking fertility assessments. In working on an upcoming study on Black women and infertility, she said, many of her participants have described challenges in getting treatment or being heard by their health providers.

“One of our participants said, ‘I felt like the goal among providers has always been to figure out how to keep Black women from getting pregnant, not to help them figure out how to get pregnant,’” Abrams said. “So she felt like, when she expressed these concerns about her fertility to her provider, she wasn’t taken seriously.”

Many Black women have consulted with attorneys to sue Revlon, Just for Me and other cosmetics companies, alleging their hair straighteners cause cancer, fibroids and other health problems. Strength of Nature, LLC, which owns Just for Me, declined to comment.

Larry Taylor Jr., an attorney at The Cochran Firm in Dallas, said thousands of women from their 20s to their 50s have filed suits alleging they developed ovarian, cervical and endometrial cancers from using hair relaxers. 

Revlon declined to comment. Robert Britton, an attorney for the company, said earlier this year that Revlon “disputes any link between cancer and its hair relaxer products.”

Thousands of Black women have also claimed that hair relaxers from L’Oreal were harmful to their health, including a group of Black women who sued L’Oreal and other companies last year. One woman, Bernadette Gordon, who used hair relaxers from 1983 to 2015, experienced uterine and breast cancer resulting in a double mastectomy and a hysterectomy, she previously told NBC News.

In July, L’Oreal asked a federal court to dismiss the dozens of consolidated lawsuits against the company, arguing that the plaintiffs’ claims were “vague” and based on “unsupported conclusions.” The company did not respond to a request for comment for this article.

Many Black women straighten their hair to keep their jobs or advance to higher positions, which puts them at risk, Taylor said.

“This is not a hoax,” he said. “This is something that is actually harmful and could potentially cost them their lives.”

Still, there are many unknowns researchers are trying to uncover, including whether the products on the shelves today are going to lead to cases of uterine cancer in the future, Bertrand said. It is also not entirely clear why Black women are at an increased risk of developing and dying from uterine cancer

“We continue to explore those factors — everything from environment to racism to genetics,” she said. 

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