There are very few Black women over the age of 40 who have not used relaxers to straighten their hair, which isn’t to say, of course, that Black women and girls far younger than that haven’t used them, too. They remain a common method of straightening tightly curled hair. Many of us have felt pressure to straighten our natural hair, in part because hair discrimination remains such a pervasive issue in the workplace. An October 2022 study published by the National Institutes of Health linked these products to an increased risk of uterine cancer. So did the Black Women’s Health Study published by Boston University on Oct. 10. Last month, the Food and Drug Administration proposed a ban on formaldehyde — and chemicals that release formaldehyde — as ingredients in hair straightening products marketed in the U.S.
As a Black woman who used such hair-straightening products and suffered hair loss because of them, this issue is deeply personal to me.
As an obstetrician/gynecologist who serves as president of the National Medical Association, the oldest and largest group of Black doctors in the U.S., I strongly affirm the proposed ban and I urge the FDA to continue and expand its efforts to help keep consumers safe.
As a Black woman who used such hair-straightening products and suffered hair loss because of them, this issue is deeply personal to me. The presence of toxic chemicals in hair products contributes to racial health disparities in the U.S. These products have been on the market for many years and were never properly studied. We’re unable to calculate the damage they’ve caused.
Formaldehyde is a known carcinogen. And according to the FDA, using hair relaxers with formaldehyde or formaldehyde-releasing chemicals “is linked to short-term adverse health effects, such as sensitization reactions and breathing problems, and long-term adverse health effects, including an increased risk of certain cancers.”
However, little action was taken until two Black women in Congress — Rep. Shontel Brown, D-Ohio, and Rep. Ayanna Pressley, D-Mass. — in a March letter urged the FDA to act. “Manufacturers of chemical straighteners have gained enormous profits,” they wrote, “but recent findings unveil potentially significant negative health consequences associated with these products.”
Last year’s NIH study found that women who frequently use hair relaxers containing formaldehyde had twice the risk of developing uterine cancer compared to women who did not (4.05% vs. 1.64%). At the same time, racial disparities clearly exist in cancer outcomes for Black women compared to white women in the U.S.
Consumers may assume that the FDA keeps harmful ingredients out of cosmetic products such as these. Unfortunately, that’s not true. Hair relaxers are not FDA approved; they’re FDA regulated. And as Kimberly Bertrand, an associate professor at Boston University Chobanian & Avedisian School of Medicine, told NBC News, those products are “very poorly regulated.” Also, she said, manufacturers mask some dangerous chemicals as “fragrance and preservatives, so women don’t really know what they’re being exposed to.”
Formaldehyde isn’t the only problematic ingredient in the hair relaxers that are predominantly used by Black women.
Formaldehyde isn’t the only problematic ingredient in the hair products that are predominantly used by Black women. Testing has shown that some hair products contain heavy metals, which may accumulate in the body and increase the risk of cancer. Some contain “endocrine disruptors” — chemicals like phthalates, phenols and parabens, all linked to hormonally driven cancers like uterine, breast and ovarian cancer.
Another study found that “hormone-disrupting” chemicals were more likely to be present in hair products marketed to Black women. About 50% of products advertised to Black women contain these chemicals, compared to only about 7% that are advertised to white women, according to Dr. Tamarra James-Todd, a researcher at Harvard University’s Chan School of Public Health. That study included hair relaxers as well as hair oils, gels, lotions, pressing combs, moisturizers and leave-in conditioners. These products contain endocrine disruptors, yet many Black women use them daily.
After @RepShontelBrown & I wrote to the FDA asking about the health impacts of chemical hair relaxers, the agency took action.
— Congresswoman Ayanna Pressley (@RepPressley) October 18, 2023
This is a win for public health—and a testament to the power of having Black women represented in Congress. https://t.co/VYyBo7LMJJ
Complicating all this is the issue of discrimination. For some women, a hairstyle is just a beauty choice. For Black women, it’s often so much more than that. It can mean the difference between being offered a job and having to continue a job search. As a Harvard Business Review article noted, “Afro-textured hair is stereotyped and stigmatized around the world. Even in places where there are protections against race-based hair discrimination, Black women bear the brunt of the burden when it comes to hair bias.”
As a Black woman physician, I’ve felt this pressure. I used chemical hair straighteners, and I remember the pain of the scalp burns they caused. Ultimately, using hair straightening products cost me all my hair. Black women were 80% more likely than white women to agree with this statement: “I have to change my hair from its natural state to fit in at the office.” Why did I put myself through that? Because styles that feature Black hair in its natural texture — such as braids, twists, bantu knots or locs — are often wrongly judged as “unprofessional.” According to the 2019 CROWN Workplace Research study, Black women were 80% more likely than white women to agree with this statement: “I have to change my hair from its natural state to fit in at the office.” According to the 2023 CROWN Workplace Research study, more than a fifth of Black women (ages 25-34) report having been sent home from work because of their hair. A quarter of Black women believed they’d been denied a job because of their hair, and among Black women ages 25-34, a third of them believed the same. Hair discrimination has led to proposed legislation such as the CROWN Act. CROWN stands for “Creating a Respectful and Open World for Natural Hair,” and prohibits race-based hair discrimination (denial of educational opportunities or employment) of people who wear natural hairstyles. Although 23 states have adopted CROWN Act legislation or legislation that’s similar, there’s still no law prohibiting hair discrimination at a federal level in the U.S. Even so, and despite the professional pressure that the CROWN research studies capture, there are signs that Black women are rejecting hair-relaxing products in greater numbers. Sales of chemical relaxers to hair professionals and salons declined from $71 million in 2011 to $30 million in 2021. The FDA’s proposed ban should be seen as just a first step. We need more research into what repeated use of hair relaxers does to the human body. We need more explicit labeling on hair products and reporting requirements for potentially harmful substances used in hair products. We need CROWN Act legislation in the remaining states and federal legislation that does the same. But hiring managers and employers shouldn’t have to be made to stop discriminating against Black women with natural hairstyles. They should stop because it’s wrong to make the chemical alteration of one’s hair a prerequisite for employment, and they should stop because forcing women to alter their hair in that way may increase their risk for cancer.
Yolanda Lawson
Dr. Yolanda Lawson, is the 124th president of the National Medical Association, the nation's oldest and largest organization representing Black physicians and health professionals. Dr. Lawson is a board certified obstetrician-gynecologist and the founder of MadeWell OBGYN in Dallas. 
