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Reflections on Emerging Research: Beauty Products and Potential Cancer Risk Among Women of African Descent

, by Dalana Johnson, MPH, Julia Gage, PhD, MPH, Fatou Jallow, PhD, Taylor Ladson, MPH, Vidya Vedham, PhD, Erinma Elibe, MPH

Throughout history, beauty product use has largely been influenced by cultural norms which uphold Western standards of beauty. Recent research suggests that some commercial beauty products may have harmful effects, including increased cancer risk.

Quote by Tracee Ellis Ross that states Hair is like a portal into our souls, and so much of our identity, especially as Black women, is connected to our hair because of how the world sees us.

As Black History Month comes to a close, we want to highlight this growing area of cancer research that has potential importance for women of African descent across the globe. 

Discussions about medical research within the Black community should begin with an acknowledgment of our painful history. For generations Black communities have experienced tremendous distrust of medical research, resulting from a legacy that includes the Tuskegee Syphilis Study, Eugenic sterilization in North Carolina, and the Story of Henrietta Lacks. Similarly, cancer research historically has too often failed to adequately engage, study, or prioritize the needs of people of African descent. (1

In the US, Black women with breast, ovarian, uterine, and endometrial cancers have worse outcomes than White women due to lower healthcare access and more aggressive tumor biology. (2, 3, 4) NIH-funded research has contributed to our growing understanding of how harmful beauty products might contribute to some of these hormone-related cancers among Black women.

For example:

  • The Sister Study found that use of chemical hair straightening products is associated with increased incidence of endometrial cancer risk in African American Women (5, 6), as well an association of adolescent use of permanent hair dye with pre-menopausal breast cancer risk. (7)
  • The Women’s Circle of Health Study described an association between use of hair relaxers and hair dye, specifically dark hair dye, and aggressive breast cancer risk in African American women. (8, 9
  • The Black Women’s Health Study observed an association between use of hair relaxers containing Lye and aggressive breast cancer risk in African American women. (10)
  • The Ghana Breast Health Study found an association between use of hair relaxers and breast cancer in women of African descent. (11

Important efforts are underway to better understand the contents of these products (such as endocrine-disrupting chemicals), which are often used throughout a woman’s life, and variations over time and across populations worldwide. (12, 13) We anticipate future research will further elucidate these associations through studies that engage affected communities and large representative cohorts like NCI Connect – a 200,000-person study designed to better understand cancer etiology. Foundational research is also needed to understand the potential biologic mechanisms of carcinogenesis.

Image of smiling African American mother and child.
Credit: Shutterstock

If confirmed, increased cancer risk associated with beauty/personal care products would have serious implications for women of African descent across the world, given the widespread use of these products including chemical hair relaxers/straighteners, hair dyes, and skin lighteners. Although advertisers increasingly portray beauty in an inclusive manner across all races and ethnicities, it is important to increase and amplify messages that specifically value natural Black beauty. Public health awareness efforts are also essential to educate affected communities about research related to beauty products and cancer risk. (14, 15, 16, 17)

In conclusion, we are personally grateful for these NIH-supported investigations and concerned about the extent to which personal beauty products may impact cancer risk for women of African descent in the US and globally. We are also grateful for ongoing efforts to improve trust between researchers and the Black community and translate research findings into improved public health. (18, 19)

All women of African descent, regardless of where they live, deserve to participate in and benefit from cancer research toward achieving the highest possible health status. We look forward to a diverse coalition of women across academia, government, and advocacy groups continuing to help us understand and mitigate the potentially harmful effects of beauty products used by women of African descent. 

Selected References
  1. Santaliz Casiano, A., et al., Endocrine-Disrupting Chemicals and Breast Cancer: Disparities in Exposure and Importance of Research Inclusivity. Endocrinology, 2022. 163(5).

  2. Pinheiro, P.S., et al., Endometrial Cancer Type 2 Incidence and Survival Disparities Within Subsets of the US Black Population. Front Oncol, 2021. 11: p. 699577.

  3. DeSantis, C.E., et al., Breast cancer statistics, 2019. CA Cancer J Clin, 2019. 69(6): p. 438-451.

  4. Clarke, M.A., et al., Racial and Ethnic Differences in Hysterectomy-Corrected Uterine Corpus Cancer Mortality by Stage and Histologic Subtype. JAMA Oncol, 2022. 8(6): p. 895-903.

  5. Chang, C.J., et al., Use of Straighteners and Other Hair Products and Incident Uterine Cancer. J Natl Cancer Inst, 2022. 114(12): p. 1636-1645.

  6. White, A.J., et al., Use of hair products in relation to ovarian cancer risk. Carcinogenesis, 2021. 42(9): p. 1189-1195.

  7. White, A.J., et al., Adolescent use of hair dyes, straighteners and perms in relation to breast cancer risk. Int J Cancer, 2021. 148(9): p. 2255-2263.

  8. Llanos, A.A.M., et al., Hair product use and breast cancer risk among African American and White women. Carcinogenesis, 2017. 38(9): p. 883-892.

  9. Rao, R., et al., Associations of hair dye and relaxer use with breast tumor clinicopathologic features: Findings from the Women's circle of Health Study. Environ Res, 2022. 203: p. 111863.

  10. Coogan, P.F., et al., Hair product use and breast cancer incidence in the Black Women's Health Study. Carcinogenesis, 2021. 42(7): p. 924-930.

  11. Brinton, L.A., et al., Skin lighteners and hair relaxers as risk factors for breast cancer: results from the Ghana breast health study. Carcinogenesis, 2018. 39(4): p. 571-579.

  12. Berger, K.P., et al., Personal care product use as a predictor of urinary concentrations of certain phthalates, parabens, and phenols in the HERMOSA study. J Expo Sci Environ Epidemiol, 2019. 29(1): p. 21-32.

  13. Eberle, C.E., et al., Hair dye and chemical straightener use and breast cancer risk in a large US population of black and white women. Int J Cancer, 2020. 147(2): p. 383-391.

  14. Zota, A.R. and B. Shamasunder, The environmental injustice of beauty: framing chemical exposures from beauty products as a health disparities concern. Am J Obstet Gynecol, 2017. 217(4): p. 418 e1-418 e6.  

  15. Wang, V.A., et al., Acculturation and endocrine disrupting chemical-associated personal care product use among US-based foreign-born Chinese women of reproductive age. J Expo Sci Environ Epidemiol, 2021. 31(2): p. 224-232.

  16. Patton, T.O., Hey Girl, Am I More than My Hair?: African American Women and Their Struggles with Beauty, Body Image, and Hair. NWSA Journal, 2006. 18(2): p. 24-51.

  17. Dodson, R.E., et al., Personal care product use among diverse women in California: Taking Stock Study. J Expo Sci Environ Epidemiol, 2021. 31(3): p. 487-502.

  18. Llanos, A.A.M., et al., Chemical Relaxers and Hair-Straightening Products: Potential Targets for Hormone-Related Cancer Prevention and Control. J Natl Cancer Inst, 2022. 114(12): p. 1567-1569.

  19. McDonald, J.A., et al., The Environmental Injustice of Beauty Products: Toward Clean and Equitable Beauty. Am J Public Health, 2022. 112(1): p. 50-53.

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