Hair straighteners and the risk of uterine cancer: More studies are necessary to get this straight
By Temitayo Ogunleye, MD, FAAD
Nov. 9, 2022
Vol. 4, No. 45
What do we tell our patients about use of hair straighteners and its relation to uterine cancer?
The risk of uterine cancer is low, and even with the noted increases in risk, this relative increase in risk is still low. Furthermore, since the types of straighteners used were not specified, it is difficult to know what kinds of products patients should avoid. The questionnaire asked, “In the past 12 months, how frequently have you straightened or pressed your hair, or used hair pressing products,” which could include relaxers, keratin treatments, heat protectants, grease, or any other number of products. Also, while this study only proved association and not causality, since the women in the cohort specifically had a family history of breast cancer, it is possible that these women have a genetic susceptibility to ingredients in these products that may increase their risk but may not be generalizable.
That said, it is reasonable to recommend at least a reduction in frequency in use of various hair straightening products/methods to patients who are specifically concerned. Use 4 times per year or less reduced this association, and as dermatologists, we typically recommend limiting potentially damaging hair care behavior for improvement in hair loss/health anyway. Currently, there is not enough evidence to recommend discontinuation of straightening in all patients. Notably, the study confirmed known risk factors for uterine cancer such as age>50, obesity, and lower physical activity (related to obesity), so in patients who are concerned it is always helpful to reinforce other methods of reducing risk such as weight loss and exercise.
Point to Remember: A new study associated frequent use of hair straighteners with an increased risk of uterine cancer. This should be considered preliminary data. Until further studies are forthcoming, it would be prudent to advise our concerned patients who want to straighten their hair to diminish the frequency of use until this risk is defined further.
Our editor’s viewpoint
Warren R. Heymann, MD, FAAD
Along with Dr. Chris Adigun, I had the pleasure of being interviewed on the NPR broadcast “The People’s Pharmacy” on Saturday, Oct. 22, 2022 discussing topics related to hair and nails. Earlier that week, the New York Times article mentioned by Dr. Ogunleye was published. I was not aware of the article — I was much too ensconced in the Phillies’ magical run (congratulations Dusty Baker and the Houston Astros). When asked about it, all I could say was that I have not seen the original study, but, generally speaking, I would not panic or rely on a single epidemiological study — confirmatory studies are always warranted. Indeed, the conclusion of the abstract in Chang et al is: “These findings are the first epidemiologic evidence of association between use of straightening products and uterine cancer. More research is warranted to replicate our findings in other settings and to identify specific chemicals driving this observed association.” As Dr. Ogunleye correctly asserts — association does not mean causation. There are many variables in this study that must be sorted out before we tell our patients to avoid straightening their hair. Given the attention this article has received, I anticipate that further studies will define this association to help guide ourselves and our patients.
Rabin, R. C. (2022, October 17). Hair straighteners may pose a small risk for uterine cancer, study finds. The New York Times. Retrieved October 28, 2022, from https://www.nytimes.com/2022/10/17/health/hair-straighteners-black-women-cancer.html
Chang, C.-J., O’Brien, K. M., Keil, A. P., Gaston, S. A., Jackson, C. L., Sandler, D. P., & White, A. J. (2022). Use of straighteners and other hair products and incident uterine cancer. JNCI: Journal of the National Cancer Institute. https://doi.org/10.1093/jnci/djac165
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