“You got this,” Jackie Provost would tell herself when her stylist left the hair relaxer on too long, gritting her teeth and gripping her chair as it burned her scalp. The monthly two-hour, $120 hair appointment was the easiest way for Provost to smooth and straighten her thick, textured hair into a style considered “acceptable” for the workplace. She says she sensed the pain “wasn’t the best thing.” But it wasn’t until about a decade later when, as a volunteer for the Los Angeles nonprofit Black Women for Wellness (BWW), she wondered whether the chemical-laden relaxer was actually bad for her health.
In 2015, as BWW drafted its report on the health impacts of hair products marketed to black women, Provost learned about how these products often contain what are known as endocrine-disrupting chemicals, which mimic or interfere with the normal signaling of hormones like estrogen. Studies have linked these chemicals to breast and other cancers. Provost had lost both her grandmothers to cancer; both had ovarian cancer, and her maternal grandmother had also had breast cancer. “We just have this higher risk of [cancer], and I’m adding these chemicals,” she says. “Why am I adding a predisposition for something that I don’t have to?”
Around three years ago, Provost—now 37 and a consultant for community health centers—stopped relaxing her hair and studied YouTube tutorials on natural hair care, which more black women had begun embracing. Now she washes and moisturizes her hair using apple cider vinegar and shea butter-based conditioner, often styling it into twists. Recent research has only affirmed her choice to go natural. An April study of hair products marketed to black women and children found that they contained chemicals that had, in previous research, been associated with not only endocrine disruption, but also asthma. Many of the chemicals weren’t listed on the products’ ingredient labels.
Led by Jessica Helm, a postdoctoral fellow at the Silent Spring Institute outside Boston, the study looked at 18 hair products that a sample of women in New York City—a large fraction of them black—reported using most frequently in a survey. These included three relaxers, three anti-frizz agents, a hot-oil treatment, six lotions, a leave-in conditioner, and four root stimulators.
The findings from the study, published in the journal Environmental Research, may point to one reason why black women experience more hormone-related health complications, such as preterm birth, diabetes, obesity, and an earlier start to menstruation (linked to increased breast cancer risk) than white women, as well as why black women and children have higher rates of asthma than their white counterparts, Helm says. Breast and endometrial cancer are on the rise among black women, who also tend to experience more aggressive forms of these cancers than white women.
As is often the case with issues like this, more research is needed to confirm these connections. “Research has suggested that endocrine-disrupting chemicals are associated with these conditions, but we can’t say whether they explain health disparities between black and white women,” says Kyla Taylor of the National Institute of Environmental Health Sciences. Ami Zota, an assistant professor of environmental and occupational health at George Washington University Milken Institute School of Public Health, adds that “no one is trying to say the chemicals [in the study] are the only risk factor for preterm birth” or other health conditions; rather, “it could be one factor contributing to the stark disparities we see today,” she says. “The researchers are suggesting ideas that need to be further investigated.”
Zota says it’s also important to note that the scientists “specifically targeted chemicals that have been either linked to asthma or endocrine disruption in animal studies.” The links between hair products and some conditions that disproportionately affect black women, such as uterine fibroids and an earlier start to menstruation, have also been examined in human epidemiological studies—but the links between hair products and other conditions, such as asthma and preterm birth, have not, she says. While animal and human biological systems have many similarities, allowing animal studies to offer some indication of what we might see in ourselves, “there are important differences.” Animals are exposed to these chemicals in the lab differently from how we’re exposed to them day-to-day, and at much higher dosages than those found in hair products.
What’s more, the study looked only at 18 products, and only those used by a sample of women in New York City. Also, it measured only the concentrations of chemicals in these products, so while we can infer some of the effects of these chemicals on the body from previous research, “we can’t draw direct conclusions about health relevance from this data,” Zota says.
Helm and her team homed in on 66 chemicals that an earlier study had associated with asthma or endocrine disruption, and had detected in a number of personal care products. They measured the concentration of the chemicals in each hair product.
The researchers detected 45 of the 66 chemicals, with each product containing between four and 30. Most of them contained parabens, added as preservatives. Growing evidence suggests that parabens could contribute to breast cancer development. (“The mechanism is, however, quite complex,” says Philippa Darbre, a professor emeritus of oncology at the University of Reading. Five types of parabens are commonly used in consumer products, and each woman seems to respond to them differently.) The hair lotions had the highest paraben levels; Queen Helene Cholesterol Hair Conditioning Cream and Luster's Pink Classic Light Oil Moisturizer Hair Lotion contained over 0.2 percent methyl paraben by weight.
A majority of the products examined in Helm’s study also contained cyclosiloxanes, used for conditioning and spreadability. A recent study led by Darbre found that exposing human breast cells to cyclosiloxanes can cause them to lose expression of the BRCA1 gene, a mutation known to boost breast cancer risk. (It’s worth noting that this study was done on human breast cells grown in the lab, not in human bodies. “Only a few human epidemiologic studies have examined the health effects of siloxanes,” Zota says.) One cyclosiloxane, decamethylcyclopentasiloxane (D5), had the highest concentration of any chemical Helm's team examined. The anti-frizz products tested—John Frieda Collection Frizz-Ease Hair Serum, Original Formula; Schwarzkopf Citre Shine Anti-frizz Serum; and Smooth 'N Shine Polishing Instant Repair Hair Polisher, Extra Strength—contained 38 to 46 percent D5 by body weight.
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Two of the hair relaxers—Soft & Beautiful Just for Me No-Lye Conditioning Relaxer (Children’s Coarse) and PCJ Pretty-n-Silky No-Lye Conditioning Creme Relaxer (Children’s Regular)—had the highest concentrations of five chemicals regulated in California or banned in the European Union. Both are for children. (Tonic reached out to the companies mentioned for comment. Only Luster responded, telling us that they are not familiar with this study and the findings and that "all products currently manufactured and sold by Luster Products Inc. are safe and effective for consumer use as intended," according to FDA standards and guidelines.)
“That's a concern because we know children are most susceptible to endocrine-disrupting chemicals, and exposure to these types of chemicals may increase the risk of breast cancer later in life,” Helm says. She adds that they’re also linked to disruptions in neural and reproductive development, as well as to changes in hormone levels, potentially implicating them in hormone-related problems, such as uterine fibroids and polycystic ovary syndrome. And it may not be just those two relaxers that are possible cause for concern. Other brands not tested in the study may contain many of the same chemicals, Helm says. She suggests considering alternatives to chemical relaxers, such as natural hair styles, or styling with gentle heat or braids.
Using these products while pregnant may even impact the developing fetus. For instance, diethyl phthalate, or DEP, the most frequently detected chemical, could be associated with increased weight gain during pregnancy, which might not only increase the risk of gestational diabetes and other health problems for the mother, but also the risk of her child becoming obese later on. Many phthalates (although not DEP) are associated with reproductive birth defects in boys, Helm says. Studies have linked exposure to a phthalate known as DEHP—found in relaxers—in the womb to genital abnormalities in newborn boys, which may later affect their reproductive health.
So if you do use these hair products, how much and how often do you need to use them before they pose a risk to your health? “Unfortunately, there’s no really good answer,” says Nneka Leiba, director of the Environmental Working Group’s healthy living science team. Tracing a health problem to specific chemicals in consumer products is tricky.
Due to genetics, lifestyle and other factors, everyone’s individual risk is different. For instance, someone could smoke for decades and not suffer any health consequences, while another person exposed simply to secondhand smoke goes on to develop lung cancer. Likewise, with worrisome chemicals in consumer products, “if your risk is already high, using these products could be the tipping point” that results in disease, Leiba says.
Establishing a causal link between a chemical in consumer products and disease is also hard because of the time it can take after an exposure for a disease to appear. Diseases like breast cancer take several years to develop, meaning that investigating whether specific chemicals in a certain type of product can increase the risk of developing them could require large, expensive, time-intensive studies. And assessing exposure is difficult because a plethora of products we use day-to-day can contain the same chemicals.
That said, these products are still cause for concern, since black women often use multiple hair products every day—sometimes more than once a day—adding up to a lot of exposure over a lifetime.“We also know these chemicals can have effects in combination,” Helm adds. “We know chemicals in consumer products show up in our bodies,” she says. “If there’s evidence they cause harm, why not take steps to reduce our exposure?” But it’s not as simple as scaling back on hair products that contain the chemicals detected in the study—84 percent of them weren’t even listed on the products’ ingredient labels.
For now, when it comes to breast cancer risk, “the only safe way forward is for people to cut down or out” using all personal care products Darbre says. That may hold especially true for black women, in light of Leiba and colleagues’ findings that fewer safer alternatives exist for those looking for products specifically marketed to them. Forty percent of products aimed at the general public in EWG’s Skin Deep beauty product database scored low in ingredients that could pose a health risk—versus less than 25 percent of products marketed to black women. (Zota cautions that Skin Deep is “not a perfect database because it’s relying on what’s listed on the label”—which, as Helm’s study found, may not provide a complete picture of the chemicals in a product. But “it’s still a useful resource, because it’s free and user-friendly.”)
Zota says Helm’s findings speak to a broader problem of women of color being exposed to more beauty product-related chemicals than white women, since the marketing for products targeted at them—hair relaxers and skin whiteners for instance—pressure them to fit white beauty standards. In a recent American Journal of Obstetrics and Gynecology commentary, she notes that women of color spend more money than the national average on beauty products. “A lot of these beauty practices are really pathways to social mobility, and even better jobs,” she says.
Indeed, twice as many black women as white women feel pressure to straighten their hair for the workplace, according to a report released last year. In 2010, a black Alabama woman lost a job offer from a call center when she refused to cut her dreadlocks. Now, she wants to take her case to the Supreme Court, after an appeals court ruled the dreadlock ban wasn’t discriminatory.
Jackie Provost hopes Helm’s findings not only raise awareness in the black community, but also help those outside it realize how much time, money, and anxiety goes into making black hair conform to white standards—only for it to potentially harm black people’s health.
“What I find is really missing in the country is having empathy for the black experience,” she says. “This is just another way to understand our experience, the decisions and choices we have to make on a daily basis, the direct impact on our health, and the role society plays in deciding what is normal and acceptable, and how it influences those decisions.”
Update: This post has been updated to reflect a response to our request for comment.
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