Studies link chemical hair relaxers to health risks, spurring shift among Black women

Maria Loren Ackies remembers the first time she went to the salon to get her hair professionally straightened.

“I was 14 and I was so excited,” Ackies, 49, of West Hempstead, recalled. But her mood quickly changed.

“The chemicals smelled horrible,” she said, noting they also caused a burning sensation on her scalp. “You would sit there for as long as you could so it could get as straight as it could ... I could barely sit three minutes.”

The use of chemical hair relaxers, once a common treatment for adults and children, particularly in the Black community, has come under increased scrutiny in recent years, as studies have found possible long term health risks tied to some products. Thousands of lawsuits have been filed and are now part of a single case, and informational sessions on Long Island and elsewhere are being held that could yield more plaintiffs.

Some of the chemicals include parabens, bisphenol A, metals and formaldehyde, as well as sodium hydroxide, also known as lye.

Manufacturers of the products point out that studies stop short of showing a direct link between cancer and use of the products. Some of the research is dependent on how often women have used the products over a period of time.

Historically, some Black women have said they felt pressure to use these products, because their natural hair would not have been accepted in certain settings, including school and work. Others prefer chemical straighteners because they can be more effective and make the hair easier to maintain.

Ackies said she and her three daughters won’t use hair relaxers and knows many people who are “shying away from it or finding alternative ways to achieve those results.” That shift is driven, at least in part, by a growing body of research that has found use of chemical hair relaxers associated with several negative health outcomes, ranging from early puberty to a reduction in fertility to a higher risk of developing ovarian and breast cancers.

Since Black women tend to use these products with more frequency, the negative health impacts may be greater for them, researchers said. Experts noted that Black women already face a range of other serious health disparities, such as a higher maternal mortality rate, and are more likely to die from breast cancer than white women.

A 2022 National Institutes of Health study stated that women who used chemical hair-straightening products were at higher risk for uterine cancer compared to women who did not report using these products. That opened the gates to a flood of lawsuits: More than 8,000 have been folded into a multidistrict litigation case pending in U.S. District Court, Northern Illinois District.

Less than a year later, more research determined the risk was even greater for postmenopausal Black women who reported long term use of chemical hair relaxers.

“Hair products such as dye and chemical straighteners/relaxers contain a number of chemicals that may act as carcinogens or endocrine disrupters and thus may be important for cancer risk,” Alexandra White, lead author of the 2022 study, wrote in an email to Newsday. She leads the Environment and Cancer Epidemiology Group at the National Institute of Environmental Health Sciences (NIEHS), based in North Carolina at the Research Triangle Park and part of the National Institutes of Health.

The Personal Care Products Council, which represents many of the companies that manufacture the chemical hair straighteners, has maintained that “science and safety” are vital to its industry and questioned the findings of some studies. 

“A fundamental principle of epidemiology is that association is not the same as causation; one does not necessarily lead to the other,” Kimberly Norman, the group’s senior director of safety and regulatory toxicology, said in a statement after the 2022 uterine cancer study was released.  

‘Cultural standard’

Ackies said she would get her hair straightened, a process also known as getting a perm, once or twice a year because it was the “cultural standard.” But one particularly bad episode about eight years ago left her scalp bloody, she said.

“That was my turning point,” said Ackies, who cofounded Melanin & Muscles, a business that focuses on self-care for women through health and wellness. “Even my mom, who has been perming her hair forever, decided to go natural.”

Women who have used these products for decades and believe they led to cancer and other health problems are suing large beauty corporations. The multidistrict case specifically said the companies misrepresented the potential health impacts of hair relaxer use and targeted “women of color and taking advantage of centuries of racial discrimination and cultural coercion which emphasized — both socially and professionally — the necessity of maintaining straight hair.”

Attorney Heather Palmore, of Amityville, said: “We are starting to see a trend away from chemical hair relaxers, and more toward healthy, protective styles that allow us to also advance cultural pride in our appearance.”

Palmore, who is working with one of the lead counsels on the federal lawsuit, has been holding forums on Long Island and speaking with potential plaintiffs about the issue. The work hits close to home.

“My mother had ovarian cancer and used hair relaxer incessantly,” Palmore said. “My cousin passed away in May from ovarian cancer, and she, too, used hair relaxer frequently.”

The studies have not uncovered a direct link between use of chemical hair relaxers and cancers, though research continues to find some women who use them may be at a higher risk.

Palmore, who was a high school athlete in Malverne, recalled that her mother decided to have her daughter’s hair chemically straightened when Palmore was 12 so it would be easier to manage.

“At the beginning, I would straighten my hair with a [hot comb], but my hair would immediately sweat out due to the long practices and large number of games,” she said. “My dad was opposed to it, but [he] didn't have to do my hair.”

She said she continued to use chemical straighteners as a trial attorney for other reasons.

“I felt an added pressure to make sure that I presented a certain way — which included making sure that my hair was ‘acceptable’ to everyone,” Palmore said. She stopped using relaxer during the COVID-19 pandemic, she noted.

Less time-consuming

For decades, women with thick, wavy and curly hair have searched for ways to straighten it. The process of washing and styling hair for some women and children could sometimes be tedious and time-consuming.

Many Black women recount watching their mothers warm up metal combs on a stove to straighten their hair with heat. Chemical straighteners, also known as perms, could be a simpler process.

“When there were special occasions, they would use a hot comb,” said Chantae Aruz, a 39-year-old mom of four from West Hempstead who cofounded Melanin & Muscles with Ackies. “After a time, I had enough of that. When I was in 10th grade, I went to a salon and got my first perm.”

Hairstylist Krystal Forde, who has a suite in Freeport and travels to clients in Nassau and Suffolk counties, said she has seen a decrease in the number of people asking for perms in recent years — for different reasons.

“Some are scared because of the possible health effects people are talking about now,” said Forde, who has been styling hair since she was a teen and then a student at Temple University in Philadelphia. “Others are just like, ‘I’m over this.’ ”

There are clients who still prefer the chemical relaxers, Forde said, because they are more effective than straightening hair with a silk press or other nonchemical means. She also uses chemical relaxers on her own hair.

“With the silk press, it’s straight for the time being, but as soon as it hits humidity or moisture, it’s done,” she said. “You can get that look, it’s still a little bit more high-maintenance than just having a relaxer where you don’t have to worry about wetting your hair because it’s staying straight.”

Forde said she hasn’t seen the chemical relaxer products she uses named in any of the lawsuits. Since she specializes in repairing damaged hair, she works with the client to determine which treatments are best.

“If I feel like someone can’t take a relaxer or their scalp is cut or oozing, I’m not going to give them a relaxer,” she said. “I definitely don’t just do what the client wants.”

FDA considering formaldehyde ban

One area of focus for researchers over the years has been how the chemicals in relaxers interfere with the endocrine system. Disrupting that system could lead to early menstruation, cancer and problems with the reproductive health system.

“Straighteners in particular have been found to include chemicals such as phthalates, parabens, cyclosiloxanes and metals, and may release formaldehyde when heated,” said White, lead author of the 2022 study.

White and other researchers used data on more than 33,000 women between the ages of 35 and 74 from 2009 to 2019 who were already part of the ongoing, long term NIEHS “Sister Study,” which is following 50,000 women whose sisters had breast cancer.

They determined that women who used hair-straightening products more than four times a year were twice as likely to develop uterine cancer than those who didn’t use them.

Scientists said they are still trying to understand which chemicals are triggering the increased risk of cancer and other health problems in women. Since relaxers are considered cosmetics and are not approved by the Food and Drug Administration before they hit the shelves, their chemical composition is unclear, according to Lauren Wise, a professor at the Boston University School of Public Health’s Department of Epidemiology.

Her studies found that greater frequency of relaxer use was associated with an increased risk of health problems such as uterine fibroids — tumors that are rarely cancerous — and lowered fertility.

“Relaxers can also cause burns, lesions and inflammation on the scalp, facilitating entry of chemical ingredients into the body,” said Wise, noting that studies have shown tested ingredients in products do not necessarily match the ingredients on labels.

“Consumers cannot rely on these ingredient labels to avoid exposure to harmful chemicals,” Wise said.

In 2023, the FDA proposed a ban on the use of formaldehyde and formaldehyde-releasing chemicals as an ingredient in hair-smoothing products or hair-straightening products. The Personal Care Products Council wrote in an email that it would support the ban. FDA officials wrote in an Aug. 7 email that the proposed ban is a “high priority” but is still in the rule-making process, which can be lengthy and complex. The agency said it could not comment on timing or content of the proposed ban.

Formaldehyde is considered a probable human carcinogen by the Environmental Protection Agency.

‘One less thing to worry about’

Aruz said she stopped using relaxers for good when she was pregnant with her first daughter.

“I started researching things and realized chemicals might seep into your bloodstream,” she recalled. “I didn’t want to be putting chemicals in my body when I was pregnant.”

The same goes for her girls, who range in age from 2 to 14.

“One less thing to worry about,” Aruz said. “There are other ways to style your hair.”

Wise said she agrees that it’s “essential” to eliminate exposure to potentially harmful chemicals, but that can be challenging since labels are not always accurate.

“Ideally, we would not place the burden on individuals to reduce their risk,” Wise said. “If we could pass legislation that required U.S. companies to accurately list all ingredients in their products and that requires companies to remove potentially harmful chemicals from their products, these would be important steps toward reducing exposure.”

By Lisa L. Colangelo

lisa.colangelo@newsday.com@lisalcolangelo

Lisa joined Newsday as a staff writer in 2019. She previously worked at amNewYork, the New York Daily News and the Asbury Park Press covering politics, government and general assignment.