Hidden Dangers: Beauty Products, Black Women, and the Implications for Nursing Practice
A recent Consumer Reports investigation found carcinogens and lead in multiple synthetic braiding hair brands, raising concerns about toxic exposure. Chemical relaxers, long used to straighten hair, have also been linked to hair thinning, burns, and potential hormone disruption, while tight protective styles increase the risk of traction alopecia. Growing research and recent investigations have highlighted a serious health concern: many hair products and styling products may contribute to long-term health risks such as cancer and fibroids. In this article, I explore the reported health risks associated with hair product use, particularly among Black women, who are disproportionately exposed to these toxic substances. I discuss the implications for nursing practice, education, and future research, highlighting opportunities for DNP projects and PhD nurse-led investigations and entrepreneurs to address this urgent public health issue. If you read until the end, you’ll read my personal hair journey and how it started with a blog.
Article #99
Snapshot of Key Concerns in this Article
The consequences of prolonged exposure to the chemicals commonly found in hair and personal care products are profound:
• Increased Cancer Risk: Studies suggest a link between hair relaxers and increased risk of breast, ovarian, and uterine cancer.
• Hormonal Imbalances and Fibroids: The use of chemical hair straighteners has been associated with a higher prevalence of uterine fibroids in Black women.
• Reproductive Health Issues: Endocrine disruptors have been linked to fertility problems and early onset puberty (with the use of hair oil and perm).
• Respiratory and Neurological Concerns: Inhalation of certain toxic chemicals can contribute to respiratory diseases and neurodevelopmental disorders (Johnson et al., 2022).
Introduction: Health and Environmental Justice for Black Women
At a time when health equity and environmental justice are at the forefront of public health discussions, addressing the regulation, education, and safety of Black hair products (hair relaxers/straighteners, and dyes) is critical. As conversations around beauty, health, and regulation continue to evolve, it is essential to center the health of Black women in the discussion. Hair care is deeply embedded in cultural identity, self-expression, and beauty standards, particularly among Black women. From synthetic braids to chemical straighteners, a wide range of hair products are marketed to meet styling needs. However, many of these products contain harmful chemicals that pose significant health risks. Despite widespread use, there is little to no regulation ensuring product safety, leaving consumers vulnerable to carcinogenic compounds, endocrine disruptors, and other hazardous substances (Schildroth et al., 2024).
How Cultural Beauty Practices Intersect with Health Risks and Wealth in the Black Community
Black women commonly use certain hair care products or styling practices like protective styles for convenience, aesthetic preference, and to align with long-held cultural beliefs (that begin as young as toddler age and are repeated every 2-3 weeks in some cases) about what is considered ‘acceptable’, ‘tame’, ‘well-kept', and ‘professional'. Researchers from the Study of Environment, Lifestyle, and Fibroids (SELF) reported that hair relaxers/straighteners are commonly used two or more times per year by 9% of children aged 5, 34% by age 10, and 73% by the age of 15 (Schildroth et al., 2024; Wise, 2015). Some of these cultural beliefs and norms are a result of restrictive workplace policies that discriminate against textured hair in preference for styles that promote Eurocentric beauty preferences (Schildroth et al., 2024).
By 2028, the hair wig and extension global market will exceed $19.12 billion, with Black women in the United States and the continent of Africa being the primary consumers (Thomas et al., 2023). Approximately 34% of adult Black women in the US reported using synthetic braids in 2022, with synthetic braids being the most popular styling choice for women ages 18-34. This exposure is particularly concerning as our population already experiences high rates of endocrine disorders, breast cancer mortality, and uterine disease. These health risks are compounded by inadequate regulation and a lack of consumer awareness (Thomas, 2023).
Hidden Dangers: Chemicals of Concern in Synthetic Hair and Hair Products
Protective styles, like braids, cornrows, bantu knots, faux locs, Senegalese twists, and wigs, are hairstyles that minimize manipulation and protect natural hair from damage and breakage, allowing it to be retained. When it comes to protective styles, Black women typically use either human or synthetic hair with synthetic hair being more popular due to costs. One of the most popular synthetic hair types is Kanekalon (one I previously used). It is frequently recommended due to its Afro-textured appearance and decreased tendency to unravel. It is made of modacrylic fibers (made of acrylonitrile and vinyl chloride; see below). Protective styles are viewed as taking less time to maintain daily and, due to the high costs and convenience, tend to be worn for 4-6 weeks or longer; beyond 6 weeks is not recommended (Kelly et al., 2016; Thomas, 2023).
Multiple studies have identified harmful chemicals in commonly used hair and personal care products. Exposure to chemicals of concern is believed to occur through the skin, air, ingestion, and perhaps through contamination of the indoor environment (Johnson et al., 2022).
• Acrylonitrile and Vinyl Chloride:
--Found in synthetic braids and weaves. The Environmental Protection Agency (EPA) classifies acrylonitrile as a probable carcinogen. The National Cancer Institute has found a direct link between vinyl chloride and leukemia, lymphoma, and rare cancers (liver, brain, and lung) (Thomas, 2023, p. 1).
--The Occupational Safety and Health Administration (OSHA) limits exposure to acrylonitrile and vinyl chloride to 2 ppm (0.002 g/L) and 1 ppm (0.001 g/L), respectively, over an 8-hour period. In contrast, stylists braiding a full head of hair often use eight 26-inch packs of synthetic extensions, leading to prolonged exposure to approximately 800 grams of modacrylic fiber for up to six weeks (Thomas, 2023).
• Endocrine-Disrupting Chemicals (EDCs): Found in relaxers and straighteners, these compounds interfere with hormonal balance and have been linked to reproductive health issues. Examples of EDCs are phthalates, phenols, parabens, metals, and formaldehyde (Schildroth et al., 2024).
• Phthalates and Parabens: Although these chemicals have a relatively shorter half-life it almost doesn’t matter because they are so widely used in hair products (hair spray, gels, oils, and mousses) used by Black children and women. Studies have shown that this increased exposure has been associated with hormone disruption, fibroids, and even breast cancer (Schildroth et al., 2024).
• Flame Retardants: Used in synthetic hair, although not required by current fire safety laws. These are absorbed into the scalp over prolonged wear. Similarly, volatile organic compounds (VOCs) are found and emitted from synthetic fibers when exposed to heat or hot water used to seal hairstyles like braids. Studies show that exposure to VOCs may exacerbate asthma, a disorder that plagues the Black community. While some states have banned flame retardants due to adverse effects, there is no ban at the federal level (Thomas, 2023).
Despite these risks, there are no stringent regulations governing the ingredients in hair products, allowing companies to continue marketing potentially harmful products to consumers (Schildroth et al., 2024). In one study, researchers found that chemicals associated with EDCs and asthma were found in 18 hair products most commonly used by African American and African Caribbean women. Similarly, an analysis of 25 personal care products revealed that 80% of carcinogens, EDCs, and respiratory and developmental toxins were not and did not have to be labeled per regulatory exemptions in place for fragrances and flavor ingredients (Johnson et al., 2022).
As mentioned, these chemicals of concern are also found in personal care products and heavily used by Black, Vietnamese and Latina women who use 8-30 products (which vary based on ethnicity) daily (Johnson et al., 2022). A study by Johnson et al. (2022) analyzed over 500 products commonly used by women of color and found more than 50% contain chemicals of concern (Johnson et al., 2022). There is no comprehensive list of EDCs, but there is the Endocrine Disruption Exchange, or TEDX, list which identifies endocrine disrupting substances. Of the more than 500 products researchers analyzed, they found a total of 59 chemicals of concern, but only 15 of those chemicals are included on the TEDX list (Johnson et al., 2022).
Environmental Justice and Product Safety Gaps
The beauty industry’s regulatory failures reflect broader issues of environmental racism. The lack of oversight disproportionately impacts communities of color, placing Black women at higher risk without clear warnings or alternatives.
Implications for Nursing Practice
Nurses play a critical role in addressing the health risks associated with hair product exposure. Key areas of intervention include:
• Patient and Consumer Education: Aspiring and practicing dermatology nurses and nurse practitioners should educate the public on the risks of toxic chemicals in hair products and guide safer alternatives.
• Routine Screening: Dermatology, women’s health, and primary care nurse practitioners can incorporate questions about hair product use into patient histories, especially for those experiencing hormonal imbalances, reproductive health concerns, or chronic illnesses.
• Advocacy and Policy Change: Students, practicing clinicians, and researchers should advocate for increased regulation, safer formulations, and transparency in product labeling to protect consumers. A good starting point can be The Toxic Free Cosmetics Act of 2025 in California.
Integrating This Topic into Nursing Education
Bridging the Knowledge Gap
Despite the significant health impact, nursing and medical curricula rarely address the risks associated with personal care products. There is an urgent need to integrate environmental health into nursing education and advocacy efforts by:
• Incorporating case studies on the impact of hair product exposure.
• Teaching about environmental justice and the implications for public health.
• Training nurses to identify and address chemical exposures in their practice.
• Encourage nurses and nurse practitioners to join boards, write policy, and speak to legislators about the problems and solutions needed to improve this public health concern, including gaps in medical and beauty training and licensing requirements, and manufacturer regulations/guidelines/rating system.
DNP Project Ideas
• Educational Interventions: Facilitate the development of education programs, competencies, or assessment and evaluation algorithms at cosmetology schools for safer hair care practices and consumer education, including the health risks associated with the chemical makeup of hair products and healthy hair styling practices.
• Screening Protocols: Implement a screening tool, practice protocol, or standard operating procedures to help clinicians and healthcare entities implement a chemical exposure assessment in clinical and community settings.
• Community-Based Research: Partner with local organizations to study consumer awareness, behaviors, and beliefs about product safety perceptions.
PhD Nurse-led Research Opportunities
• Longitudinal Studies: Investigate long-term health effects of hair product exposure among Black women.
• Interdisciplinary Research: Collaborate with environmental scientists and dermatology professionals (in practice and the market) to assess toxicity levels in commonly used products and formaldehyde-releasing preservatives
• Policy Research: Evaluate the impact of beauty industry regulations on public health outcomes on the local and national level. Consider collaborating with our global partners in African to establish international market standards.
The Role of Entrepreneurs in Driving Change
Entrepreneurs also have a powerful role to play in creating safer, healthier alternatives and increasing awareness about toxic exposures in hair care. We can:
• Develop Non-Toxic Hair Products – Innovate and bring clean, chemical-free alternatives to the market, like plant-based synthetic hair and organic hair care solutions.
• Educate Consumers – Use social media, blogs, and brand messaging to inform people about the dangers of toxic hair products and promote healthier options.
• Advocate for Industry Regulations – Partner with policy groups, health organizations, and lawmakers to push for greater transparency and safety regulations in the beauty industry.
• Support Research & Innovation – Collaborate with scientists, healthcare providers, and universities to fund or conduct research on safer hair practices and product formulations.
• Create Business Models that Prioritize Health – Lead with ethical sourcing, sustainability, and consumer well-being, proving that profit and public health can coexist. Promote a seal of approval for companies that follow the model.
Conclusion & Call to Action
The widespread use of unregulated, toxic hair products poses a critical public health risk, particularly for Black women. Nurses and nurse practitioners have an opportunity to educate, advocate, and research solutions to mitigate these risks. By integrating environmental health education into nursing curricula, conducting evidence-based research, and pushing for policy changes, dermatology nurses and NP can help ensure that beauty does not come at the cost of health.
About Me
-I started wearing human and synthetic hair braiding hair that would be sealed with heat or hot water in elementary school (a practice I continued until I graduated college with my first undergraduate degree).
-I received my first perm in middle school and my last perm in 2003 after losing a significant portion of hair. After I stopped getting perms, I consistently wore weaves for six years.
-I started noticing I couldn’t breathe as well as my classmates in 5th grade when we had to complete timed runs in PE. I was finally diagnosed with asthma at the age of 19.
-I started getting my hair dyed in high school using permanent and semi-permanent dyes until I went natural. After going natural, I started using henna.
-I stopped covering my loose natural hair in 2009 and then loc’d in June 2017, a journey I documented on YouTube and SnapChat.
I owe 100% of what I know about taking care of my natural hair, and the mental journey that is required to see the beauty in it, to the Black Women who created the natural hair community. My journey then and now, started with a blog. Specifically, I want to thank Leila, the founder of the Black Girl with Long Hair blog, who showed me the power of imagery and community. Many of us don’t learn healthy hair care practices in our community or see how to do in mainstream media. This lack of knowledge in our community continues despite the widespread use of information and education. Instead, cultural norms and practices, and workplace policies (including in the military) are passed down and compared to European beauty standards.
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Thomas C. G. (2023). Carcinogenic materials in synthetic braids: an unrecognized risk of hair products for Black women. Lancet regional health. Americas, 22, 100517.
Wise L. A. (2015). Study of Environment Lifestyle and Fibroids (SELF): Advancing the Field of Fibroid Epidemiology. Journal of women's health (2002), 24(11), 862–864.
Kimberly Madison, DNP, AGPCNP-BC, WCC
I am a Board-Certified Nurse Practitioner, educator, and author dedicated to advancing dermatology nursing education and research with an emphasis on skin of color. As the founder of Mahogany Dermatology Nursing | Education | Research, I aim to expand access to dermatology research, business acumen, and innovation using artificial intelligence and augmented reality while also leading professional groups and mentoring clinicians. Through engaging and informative social media content and peer-reviewed research, I empower nurses and healthcare professionals to excel in dermatology and improve patient care.
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