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The (FDA) is expected to as an ingredient in chemical hair straighteners, also known as relaxers. Theresa Werner, MD, deputy director of Huntsman Cancer Institute and a professor of oncology at the (the U), and , investigator at Huntsman Cancer Institute and associate professor at the U, discuss some things you need to know.
鈥淚 think this is an important step based on scientific research and data showing increased health risks, including cancer,鈥 says Werner. 鈥淭his ban emphasizes that we are always learning about risk and should be adaptable, using information to improve health and safety for our patients.鈥
What is formaldehyde?
Formaldehyde is a colorless, flammable, and strong-smelling chemical, most widely known for its use as embalming fluid. The as a known human carcinogen, or substance that causes cancer, in 2011. According to the , exposure to formaldehyde has been linked to cancer in both lab studies in animals and people.
But in that time, formaldehyde has remained a common ingredient in relaxers.
This is the first time the FDA has moved to ban the chemical in hair straighteners鈥攂ut it has been on regulators鈥 radar for some time. The agency started advising users of about possible exposure to formaldehyde in 2010. The that formaldehyde in the straightener can be released into the air as a gas鈥攚hich can cause health problems if inhaled or touched. Recent studies have also identified chemical straighteners as having possible long-term effects鈥攑articularly in cases of uterine cancer.
In 2022, the found that women who used chemical straighteners had a higher rate of uterine cancer than those who did not. that 1.64% of women who had never used hair straighteners would develop uterine cancer by the age of 70. For women who frequently used relaxers, that number increased to 4.05%.
鈥淚t鈥檚 over double, right? You may say, 鈥榦h my gosh鈥, the risk increases by more than 100%. But again, you have to take into account that the risk of uterine cancer is so low in general, and they had fewer than 400 cases in that study,鈥 says Werner. 鈥淪o, looking at the absolute number, it鈥檚 not that big of an increase, but we鈥檙e always looking for things that potentially increase risk.鈥
Black Women, Relaxers, and Uterine Cancer
Uterine cancer makes up only 3% of new cancer cases. But that rates are on the rise, particularly for Black women鈥攚ho have twice the rate of deaths from uterine cancer compared with other racial groups.
鈥淲e know that there are a lot of health disparities based on race and ethnicity with cancer, and a lot of Black Americans use chemical straighteners,鈥 says Werner. 鈥淢aybe it鈥檚 not just genetics, maybe there are other environmental factors for Black women because they鈥檙e using these relaxers that may increase the risk of cancer.鈥
Chemical straighteners are marketed to Black women to straighten their natural hair. According to the , 60% of Black women choose to chemically straighten their hair. This practice typically begins at a young age鈥 46% of respondents said they had their hair first chemically straightened between the ages of four and eight. Women may spend decades chemically relaxing their hair, making multiple visits to their stylist per year.
鈥淭his ban emphasizes that we are always learning about risk and should be adaptable, using information to improve health and safety for our patients.鈥
鈥擳heresa Werner, MD
鈥淚t would make sense that something like an environmental exposure would take a long time to actually cause the cancer,鈥 says Werner. 鈥淭hese women are older, and they鈥檝e lived longer. And the incidence of uterine cancer goes up the older you get.鈥
Which may be why another longitudinal project, the Black Women鈥檚 Health Study, also among postmenopausal women.
Werner says the scalp is a very vascular region鈥攚ith vessels that carry blood and lymph fluid throughout the body. 鈥淔or whatever reason, the uterus cells tend to be a little more sensitive to whatever compound is in there that could be carcinogenic,鈥 says Werner.
NIH researchers identified formaldehyde as just one ingredient that could be contributing to the increased cancer risk.
Hair and Culture
For Black women, the decision to use chemical relaxers is culturally sensitive鈥攅specially for older generations.
鈥淭here was the expectation that this is what you do, you straighten your hair so that it looks like other ethnic groups,鈥 says Lumpkins. 鈥淪traightened hair was seen as a representation of professionalism, and it was a representation of beauty.鈥
Lumpkins says this societal pressure makes public health communication on this topic difficult.
鈥淭here are people whose straighteners were burning their scalp, but they went back and did another appointment,鈥 Lumpkins says. 鈥淭he hair fell out, but they said, 鈥業鈥檓 going to go back when my hair gets better, and I鈥檓 going to get my hair straightened鈥. Now, that鈥檚 not healthy.鈥
鈥淏lack women鈥檚 hair is an important part of who they are and it really does impact a major part of their life, their health, and their well-being.鈥
鈥擟rystal Lumpkins, PhD, MA
If the FDA decides to ban formaldehyde in relaxers, it will still be up to the consumer to weigh other chemical risk factors in the decision to straighten their hair. For Lumpkins, that means continued discussion amongst Black women鈥攑articularly medical doctors and salon owners.
鈥淲hat I have found is very important when engaging with the stakeholders is: how do you leverage risk like this that's culturally sensitive and culturally appropriate? And how do we pragmatically and scientifically look at how to tailor that information that is relevant and drives the importance of informed decision making?鈥 says Lumpkins. 鈥淚f there are products that don鈥檛 use formaldehyde, if there's a safe alternative, then maybe those relaxers are safe for women to use.鈥
Ultimately, people who use chemical hair straighteners will have to make the best decision for their own hair-care and health needs.
鈥淏lack women鈥檚 hair is an important part of who they are,鈥 says Lumpkins. 鈥淎nd it really does impact a major part of their life, their health, and their well-being.鈥