When Your Hair Is Killing You
We first published this story in 2018; we’re republishing it now in response to a new study that outlines the first epidemiological association between the use of hair-straightening products and the risk of uterine cancer. While the study, published in the Journal of the National Cancer Institute in October 2022, did not establish a cause-and-effect relationship between hair straighteners and cancer of the uterus, it found that women who used chemical hair straighteners had a higher risk of developing uterine cancer than women who never used them. That fact alone is grim; add to it the fact that 60 percent of the participants who reported using hair straighteners identified as Black. The study also underscored that some of the chemicals detected in straighteners—parabens and formaldehyde among them—have known endocrine-disrupting effects. The New York Times’s report on the study added that uterine cancer has been on the rise among all women in the United States, but that Black women die of the reproductive cancer at twice the rate of White women.
The data surrounding other reproductive cancers—like ovarian cancer, which the story below focuses on—is similarly sobering. Even though Black women actually have lower rates of ovarian cancer than White women do, they die of it at markedly higher rates, according to a 2009 study in the American Journal of Epidemiology. One of those women was Donna, the subject of our original story below. She died on October 6, 2022.
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Like many Black women, Donna (she requested that her name be changed), a motivational speaker, development coach, and author from North Carolina, had chemically straightened her hair for years. A former Olympian in track and field, she started at 15, when she and her best friend were finally allowed to buy an at-home relaxer kit.
“We were excited,” Donna recalls. It was something of a rite of passage into Black womanhood, even if it did smell acridly of ammonia. For the next three decades, Donna continued straightening, using popular drugstore-brand relaxers every six weeks. Occasionally she’d make a trip to the hair salon, where they’d slather her head in higher-strength relaxer. But at 51, Donna, a woman with warm brown eyes and a brilliant smile, stopped abruptly.
“I was getting really bad headaches. I finally put two and two together and realized they were happening after I did the relaxer,” she says. “This didn’t feel right.”
Not only did Donna quit relaxer; she got rid of all hair- and personal-care products in which she found ingredients suspected to harm human health. Then, roughly 30 years after she’d started using relaxer, Donna was diagnosed with ovarian cancer: “[At one point] I had 11 tumors. When you get a diagnosis like that, you do all the research you can. Everything had to change.” Donna became aware of more potentially harmful ingredients in products when she was at Uchee Pines, a holistic retreat in Alabama. Uchee Pines focuses on rehabilitation through exercise, vegetarian nutrition, massage, herbs, and supplements. Donna returned home committed to a clean beauty regimen and a mainly plant-based diet. “I had lost 22 pounds,” she says. “I felt great.”
Hair-care products marketed to Black women contain higher percentages of endocrine-disrupting chemicals (EDCs) than those marketed to the general public, according to a 2018 study from Silent Spring Institute, a scientific research organization that studies health-disrupting chemicals with a focus on breast cancer prevention. [Editor’s note: Most recently, under an initiative called the POWER Study, Silent Spring has used social media and the reach of influencers to alert Black women to the presence of harmful ingredients in beauty products, with the ultimate goal of lessening racial health disparities.] EDCs are associated with cancer, birth defects, and other serious health issues. Social norms around hair texture are likely why hair products marketed to Black women would have different chemical profiles than those aimed at White women, explains Nneka Leiba. [Editor’s note: Leiba was director of the Environmental Working Group’s Healthy Living Science program at the time this article was written; she’s now principal program manager of sustainable shopping at Amazon.]
The Silent Spring study examined 18 different formulas, including hot-oil treatments, antifrizz polishes, leave-in conditioners, root stimulators, hair lotions, and at-home relaxers, all of which had been selected based on a 2004–2005 survey of popular hair care among women. The scientists tested formulas for the presence of 66 different chemicals suspected to have endocrine-disrupting or carcinogenic properties. They detected 45. Seventy-eight percent of the formulas contained parabens, and 84 percent of the EDCs detected weren’t listed in the product ingredients. “Hair relaxers and root stimulators consistently contained higher numbers of endocrine-disrupting chemicals,” says Jessica Helm, an environmental health scientist and the lead author of the Silent Spring study. Shockingly, the two relaxers for kids had the highest levels of several EDCs specifically banned in the European Union. (The EU has banned over 1,300 ingredients in beauty products; the US prohibits only 11.)
“During certain stages of development, like puberty, the body is changing and is particularly susceptible to the effects of chemicals,” says Helm. “So it’s concerning that we found the highest levels of some of these chemicals in products marketed to children.” The professional relaxer Donna was treated with at the salon is classified as a potential endocrine disruptor and categorized as a 10 (on a scale of 1 to 10), the highest hazard level on Skin Deep, the EWG’s online cosmetics database, which has assessed over 70,000 personal-care products for toxicity. (Both the EWG’s Healthy Living app and Silent Spring’s Detox Me app offer astute, researched tips on how to minimize toxic exposure. You can also look for the EWG’s verified seal on product packaging; the EWG’s verified program has banned or restricted over 13,000 ingredients.)
“There’s a large natural-hair movement happening,” says Leiba. Indeed, sales of relaxer to salons have been declining—from about $71 million in 2011 to $30 million in 2021, according to market research firm Kline & Company; in a 2017 analysis by marketing intelligence agency Mintel, 79 percent of consumers had worn a natural hairstyle in the past year. “But it shouldn’t be assumed that products for natural styles are pure,” Leiba says. The EWG found these products, too, included ingredients of concern, like parabens and formaldehyde releasers.
“The load of [potentially harmful] chemicals in hair-care products—specifically parabens, phthalates, and heavy metals—affects the endocrine system,” says Atlanta-based founder and CEO of CentreSpringMD Taz Bhatia, MD, a board-certified pediatrician and integrative health expert specializing in women’s health. “Although research continues to be conducted and debated, we are learning that chemical exposure is not about a onetime occurrence, but a cumulative load that reaches a tipping point.”
Roughly 25 percent of women diagnosed with ovarian cancer are genetically predisposed to the disease, but EDC exposure may significantly contribute to the onset of illness, Bhatia says. We eat EDCs in food (they are present in many pesticides and herbicides), and they saturate our household cleaning products and even our mattresses and sofas (in flame retardants). EDCs are everywhere and, in some cases, difficult to avoid. But they can be avoided in beauty and personal-care products.
“Hair care may be an extra source of exposure, contributing to a higher total body burden of these chemicals,” says Helm. The added exposure from Black hair-care products might also factor into the health disparities between Black women and the rest of the US population—especially since Black people spend more money on beauty products than any other demographic group, according to a 2018 Nielsen report. Black women suffer disproportionately from other hormone-related issues, such as preterm birth, uterine fibroids, obesity, and infertility, and Black girls go through puberty and start menstruating earlier than White girls. Scientists from Berkeley and the University of California, San Francisco conducted a continuous study of over 1,200 girls, tracked from 2005 to 2011, and found that by age seven, 23 percent of the Black girls in the study had started to develop breasts, compared with 10 percent of the White girls. A study in the journal Molecular Carcinogenesis found that EDCs may also promote the growth of ovarian cancer cells. “Black women and children have significantly higher concentrations in their bodies of monoethyl phthalate, an endocrine-disrupting chemical commonly used in fragranced products, as well as two types of parabens, another class of endocrine disruptors, according to a large, representative sample of the US population,” says Tamarra James-Todd, an environmental reproductive epidemiologist at the Harvard T.H. Chan School of Public Health. James-Todd coauthored a study published in the Journal of Immigrant and Minority Health in 2011 investigating the potentially dangerous role of EDCs in Black hair products. Roughly 49 percent of African Americans studied used products containing chemicals considered hormonally active, including those that are able to mimic estrogen. This is important because breast cancer risk is related to estrogen exposure. In contrast, less than 8 percent of Caucasians in the study used these products.
“Almost everything in life has a safe range and an unsafe range.… Water and sunlight in high quantities can be lethal,” says Alex Kowcz, the chief scientist and executive vice president at the Personal Care Products Council, a national trade association that represents cosmetic and personal-care industry businesses that manufacture, distribute, and supply products marketed in the US. “The ingredients used in Black hair-care products go through the same safety-assurance process as other cosmetic and personal-care product ingredients. One of the weaknesses of the Silent Spring study is that it fails to recognize that cosmetic and personal-care product ingredients have a safe level of use.” But a 2012 review of studies published in the journal Endocrine Reviews shows that endocrine disruptors can have biological activity at very low doses, and that concentrations don’t need to be large to have ill effects. “We have noticed concerning trends in our health—increasing rates of certain cancers, infertility, and earlier onset of puberty in young girls—that mirror many of the findings from lab studies that assess the safety of many of the ingredients in personal-care products,” says Leiba. “But some manufacturers still tout, ‘There’s no proof it has the same effect in humans.’ The longer we wait on the proof they require, the more our health will be affected. We should be asking for proof the ingredients are safe before we are exposed.”
Meanwhile, Donna says she has all the proof she needs. “I’m down from 11 tumors to 1, and it’s shrinking,” she says. “I’m on a less-invasive type of chemotherapy. I’m walking almost six miles a day, and my plan is to run either the New York marathon or a half-marathon in the next two years. I’m so blessed and thankful that I’m able to encourage other people and let them know that if I can do it, they can do it, too.” She credits her energy and optimism to the power of the mind and to her dramatic lifestyle changes. “Ten of us were diagnosed at the same time,” she says. “We built a bond; we became friends. I shared what I’d learned about clean products, healthy eating, reducing sugar. I told them to stop putting those chemicals in their bodies. But they all still got their perms every two weeks and kept using regular makeup. Now I’m the only one who is still alive.”
