Hair Relaxers, Cancer Risks and Black Women’s Health
The hair and beauty industry and the Black community go back generations. Hair has always played a key role in self-expression, but it has often come at a hidden health cost.
Hair thinning and loss, inflammation and scalp conditions only touch the surface because, as recently as 2022, studies and lawsuits have increasingly circulated the news exposing the increased cancer risk for those who frequently and repeatedly use hair relaxers.
Often from as young as five years old, the ‘creamy crack’ that so many Black women have used to achieve straighter and longer hair has come under intense scrutiny. The additional layer surrounding this complex and alarming news is a conversation that is only bubbling within proximity of the US, despite hair relaxers and similar chemically straightening treatments having a global resurgence. Breaking down the recent studies, speaking to health experts and understanding the temperament in the UK, Black Skin Directory explores the impact of the studies, the profound health implications associated with hair relaxers and safer alternatives for straight hair.
Hair Relaxer Origins & The Psychology of Straight Hair for Black Women
Hair relaxers have a longstanding and complex relationship with Black hair history. Invented by Garrett.A. Morgan in the 20th century, the relaxer straightened afro-textured and curly hair by semi-permanently breaking down the bonds of the hair shaft using heavily abrasive chemicals – sodium hydroxide and guanidine carbonate. In a time when Black people were victims to European beauty ideals, rules and regulations surrounding how our hair should be worn, we were under constant pressure and persecution to break, mould and re-conform our hair texture to appease others. We only have to call on Beyonce’s famous line in her record Sorry, ‘he better call Becky with the good hair’, with ‘good hair’ referring to long and straight hair as a cultural zeitgeist to underpin the snippet Black women have to go through with a constant reference to straight hair, correlating to attractiveness and desirability.
“One common question often arises is why Black women seem to be wedded to straight hair. The answer is complex and multifaceted. On the one hand, there is a long-standing societal pressure for Black women to conform to Eurocentric beauty standards, which often means having straight hair. This pressure can be both overt and subtle, and it can be challenging to resist, even for those aware,” explains Dr Afiya Mbilishaka, psychologist, hairstylist and research scientist.
Diving deeper into the complex hold Eurocentric beauty ideals have had on Black women for generations, fashion psychologist Shakaila Forbes-Bell explains, “It’s easier for straight hair to be favoured over kinky or coily hair. Especially if you receive more compliments and acceptance when straightening your hair. Subconsciously, this will be hard on your ego and sense of self to part with.”
Along with messages from brands such as ORS’ ‘smooth & shine’ and ‘extra-strength for coarse and resistant hair textures’, Black women have faced awful advertising from big beauty brands. Raveen ads dating between 1960-1974 say, ‘It helps my hair look longer, more beautiful, more glamorous’ or an ad for their no-lye relaxer, ‘She knows what to do, do you?’ while showcasing a Black woman with straight and shiny hair. It set up years of a conscious and subconscious precedent for Black women to embark on a straightened hair journey without the awareness, research, consideration or care from conglomerates that has now resulted in life-threatening health concerns.
The Hair Relaxer Landscape
The hair relaxer market size is estimated to have accumulated to $719.8 million in 2024, owing to the increase in social media. Due to its longstanding history integrated with hair styling and its complex link to hair straightening, there are many variations on the shelves today. There are three different types of relaxers – lye, no lye and natural.
Lye relaxers, which, according to UK based Consultant Dermatologist and Hair Specialist, Dr Sharon Wong, “sodium hydroxide or essentially caustic soda which is a potent alkaline chemical that breaks the disulfide bonds that gives hair its texture and shape.” Then, there are no-lye relaxers – the form seen circling TikTok today – with milder chemicals such as potassium hydroxide or lithium hydroxide. “These chemicals are not as strong as lye but are still sufficiently alkaline to break chemical bonds in hair. Relaxers are well known to cause external damage to the hair, resulting in breakage but also the possibility of chemical scalp burns if misapplied,” says Dr Wong. Finally, natural relaxers. In contrast, they claim to use only natural ingredients such as coconut oil and shea butter to achieve straight hair; but bear in mind the term ‘natural’ in the same wave as clean and sustainable beauty is not regulated.
Cancers, Health Risks and Relaxers
In the last five years, this lack of regulation has caused concern and resulted in studies leading to lawsuits and, as recent as this January, the FDA’s (The Food and Drug Administration in the US) ban of formaldehyde in relaxer products. In 2022, the National Institutes of Health released a study reporting that hair straightening chemicals have a higher associated risk with uterine cancer. The study followed over 33,000 US women (60% being self-identified Black women) between 35 and 74 for almost 11 years, seeking to identify risk factors, including breast and other cancers. The study diagnosed 378 uterine cancer cases. Study leader Alexandra White, PhD, head of the NIEHS Environment and Cancer Epidemiology group, explains that “we estimated that 1.64% of women who never used hair straighteners would go on to develop uterine cancer by the age of 70; but for frequent [hair relaxer] users, that risk goes up to 4.05%.”
“We estimated that 1.64% of women who never used hair straighteners would go on to develop uterine cancer by the age of 70; but for frequent [hair relaxer] users, that risk goes up to 4.05%.”
That’s double the usual rate. What is equally important to be aware of is that uterine cancer (targeting the female reproductive system) is a rare cancer and, as highlighted in the study, accounts for 3% of all new cancer cases. The findings, along with other documented studies, including the updated 2023 British Women’s Health Study (BWHS), revealed that Black women who use hair products containing lye at least seven times a year for more than 15 years had a 30% increased risk of developing cancer. Further investigation, including in 2021, shows chemical hair straighteners can raise the risk of hormone-related cancers in women.
“Black women who use hair products containing lye at least seven times a year for more than 15 years had a 30% increased risk of developing cancer.”
“Yes, we should be concerned,” says Eleanore Richardson, Trichologist at Fulham Scalp and Hair Clinic. “The studies provide robust and progressive data, and they show that relaxers can increase the risk of uterine cancer and have been linked to other estrogen-dependent cancers such as breast cancer and cervical cancer. They are increasing the chance that the body may succumb to cancer later down the line,” she adds.
Dr Catherine Fairris, Aesthetic Doctor & President of the British College of Aesthetic Medicine echoes, “many studies have shown that hair relaxers and straighteners contain ingredients such as formaldehyde, phthalates, parabens, and other endocrine-disrupting compounds that mimic the body’s hormones, seep into the body through scalp absorption and interfere with the body’s hormone levels and can cause growth cancer cells as well as early puberty, fibroids and diabetes.” Concluding that “there is certainly enough mounting evidence to suggest that hair straighteners and relaxers should be approached with extreme caution.”
It’s why there are over 6,000 liability cases in the US, and likely more will follow in the coming years, given the widespread use of hair relaxers globally. The US Hair relaxer lawsuit filed towards the end of 2022 alleges that cosmetic companies knew these products were harmful but failed to warn consumers of their prolonged health risks. As consolidation occurs in the coming years, the US courts will eventually hold jury trials to test the cases.
Solicitor, specialist in women’s health litigation, member of the American Association for Justice (AAJ) and partner at Penningtons Manches Cooper, Elise Bevan, commented in a recent article, “The number of women potentially affected is enormous. It has been estimated that over 80% of Black women in the UK use hair relaxers regularly. That means every Black woman diagnosed with uterine or ovarian cancer is a potential claimant. Of course, it’s important to note that not all women who use hair relaxers will develop uterine cancer. The study revealed an increased risk of cancer for women who used hair straighteners. The risk of uterine or ovarian cancer will also vary depending on factors such as age, family history, and overall health.” Bevan also explains that the topic is in its early stages in the UK, and law firms such as Cooper are investigating the merits of bringing the relaxer claim to the UK.
The Ignored Risks and UK Sentiment
But, with the ever-increasing evidence and lawsuits against some of beauty’s most prominent businesses, including L’Oreal and Revlon, the concern doesn’t seem to have stopped women from using hair relaxers or being banned from purchase. Curious about why that is, Tamika Gibson, Master Licensed Cosmetologist and Founder of Bold Hold expresses that “(relaxers) have been a part of our culture for so long that many may be desensitized from the risks because we’ve seen so many family members and celebrities use relaxers and it's just something we’ve been accustomed to. And, although efforts have been made to educate our culture about the potential harm from relaxers, the information hasn’t been as widespread as needed for people to understand the risks and altogether boycott them truly. Some look at it as if it’s so harmful; why is it still being sold at retail stores? That alone could convince someone with hair struggles that the risks aren't high.”
From a studies perspective, Dr Wong says needs more work. “Whilst the studies show an association between relaxer use and cancer, the studies do not evaluate specific brands or analyse individual ingredients in these products. The exact causative agent is unknown, although the studies mention parabens, metals and formaldehyde. The authors suggest Black women have a greater risk due to the more frequent use of chemical straighteners and their exposure to products from an early age. Still, there isn’t sufficient and exact data to draw definitive conclusions.” Yet what Dr Wong does conclude from the studies is it would be advisable to reduce hair relaxer frequency at the very least.
As for the lack of awareness outside of the US, Richardson says, “From a Black hair perspective, we tend to lag about five years behind the US as techniques and expertise transfer over. It may have also created a lag in recognising the health implications from isolated and anecdotal case studies to being able to recognise and populate a pattern.” A clear missing link is the exact and widespread data and studies needed globally and, most notably for Richardson, overcoming the healthcare bias, racial discrimination and the Black pay gap. The government and health services need to focus on improving health outcomes for Black women. Our public health service must provide clear direction about whether such products are safe on the public market and, if so, what warnings they need to display to the buyer.
However, despite experts requiring more studies for definitive answers, UK-based feminist group Level Up is tired of waiting and is urging the ban of relaxers. “We should be able to trust that products we use won’t harm us, and Black women who regularly use hair relaxers should be concerned about the potential risk to their health. If they can’t make hair relaxers safe, they should remove them from the shelves. The price of beauty should never be our health,” says Seyi Falodun-Liburd, Co-Director at Level Up, who since 2021 has been urging L’Oreal to release their safety data sheets. “L’Oréal does extensive testing on their products, so we know they have the information; they just refuse to share it. Corporations are understandably secretive about strategies and launches, but that should not be the case regarding our health,” she adds. Other vital campaigns pursuing the prioritising of Black women’s health include the Campaign for Safe Cosmetics, which aims to protect communities from toxic chemicals and the Cosmetic Toiletry & Perfumery Association (CTPA), which works to deliver excellence in the personal care industry.
“If they can’t make hair relaxers safe, they should remove them from the shelves. The price of beauty should never be our health.”
TikTok, Relaxer Resurgence and Alternatives
If conclusive data were released for consumers to see first-hand, it would likely stop the resurgence that is currently taking place. Currently, 80.4 million views have been amassed on TikTok, hair relaxers, and other hair straightening treatments, such as texture releases, which are just as popular as weaves, wigs, and extensions. “I believe we are seeing a resurgence in relaxers because of people wearing a leave-out with their sew-in or other styles where the natural hair is exposed more often. Leave-outs are making a comeback, and having a relaxer prevents reverting,” says Gibson.
What is clear is that there are very little to no educated conversations about the health risks of relaxers. Yes, women are reaching for no-lye relaxers, but what needs to be addressed is the education piece because no-lye is still as risky. “Some brands market their hair relaxers as “no lye” while listing lye in the ingredients under another name (sodium hydroxide), meaning that consumers are being put at risk even when they think they’re making an informed decision,” says Falodun-Liburd.
Then there are texture releases, Brazilian blow dries, keratin straightening, and hair botox, which are firm favourites for hair straightening. “Women still want a lower maintenance style, and having a hair straightening treatment allows them not to worry so much about their hair reverting due to weather or working out, and it’s much easier to blend for people with thicker hair,” adds Gibson.
However, regardless of how easy it is, for Richardson, it’s important to be aware of their harmful qualities. “The straightening processes use a formaldehyde-forming chemical to stick to the outside of the hair shaft and fix the hair in shape once it is straightened using high heat levels. Heat causes the release of formaldehyde, a known carcinogen associated with respiratory tract cancers,” she explains, “this is a danger not only to the customer but more significantly to the hairstylist who will have more frequent exposure.”
So, for those wanting to straighten their hair or have straight hair, the safest options are full wigs, weaves and extensions or straightening your hair with heat straighteners (be aware it’s not as long-lasting and can pose heat damage if not correctly cared for). “As far as I can see if you’re looking to alter the curl pattern of your hair permanently, there will always be hair health degradation as a minimum and physical health effects with the current options on the market,” says Richardson, “Whilst we are starting to wake up to the dangers of relaxers and hopefully consumers begin to move away from them permanently, we also need to address Afro hair discrimination and providing clear information about caring for natural Afro hair so that relaxing your hair doesn't have to feel like the only styling option you have that allows society to drop some bias.”
So, where does Black Skin Directory stand?
“I support everyone’s right to make a choice how to style their hair, I also want us to make safe choices, that don’t jeopardise our health. I welcome legal initiatives such as The Halo Code and The CROWN Act, because they help to break down discrimination.”
There is enough data to say hair relaxers and straighteners are risky to those who use them. Yes, the next step requires more qualitative and extensive studies being carried out globally to draw out the exact ingredients and formulations that cause cancer, conglomerates being held accountable and urged to share their studies, and governments forcing the change in the industry.
However, we also have a role to play, the Black community has its own issues with the sometimes negative portrayal of Afro hair, Black women (and men) are also responsible for seeking out more education about the dangers of hair relaxers, speaking to experts and making educated business (salons specifically) and personal choices to avoid risking their health. In a time when we have never had as much choice for straight hairstyles, we need to seek safer alternatives and prioritise our health and hair health at all costs.
“Personally, I believe we need to love on Afro hair more, it’s God given and there is nothing wrong with it. Whilst I support everyone’s right to make a choice how to style their hair, I also want us to make safe choices, that don’t jeopardise our health. I welcome legal initiatives such as The Halo Code and The CROWN Act, because they help to break down discrimination that can often make Black women feel like they have no choice but to use hair relaxers. I welcome more discussion in safe spaces on how we teach Black women how to manage their hair so it isn’t a tedious or time-consuming process. Brands need to be more transparent about their products and be held accountable if they have knowingly put the Black women in harms way.” Dija Ayodele, Founder of Black Skin Directory