Hair relaxers tied to cancer among Black women

LaTonya Shuler, 50, of Indianapolis, had planned to have children. But at age 32, she was diagnosed with uterine cancer. After six weeks of radiation and a hysterectomy for Shuler, a home health aide worker, her plans were dashed.

Now in remission, Shuler checks in with her physician once a year to make sure that the cancer that took away her ability to bear children doesn’t return. It wasn’t until Shuler’s sister mentioned that perms were bad — the same perms that Shuler had been “dibbling and dabbling” with since junior high — that she learned what may have caused her cancer.

“At the time, I didn’t know how I contracted uterine cancer, but then everybody started saying the perms that we use could be the cause of it,” she said.

When Shuler saw a commercial saying hair relaxers were giving people uterine cancer, she reached out to Chicago-based law firm Wallace Miller to become a plaintiff in litigation against more than a dozen manufacturers of hair relaxers, including L’Oreal, SoftSheen-Carson and Revlon, among others. The 82-page complaint filed in Chicago in May, which consolidates nearly 250 lawsuits from across the country, says plaintiffs are seeking punitive damages for injuries they say resulted from the use of relaxers.

According to the complaint, “Plaintiffs’ use of toxic chemical straightening products designed or manufactured by the defendants was a direct result of defendants’ wrongful marketing practices. Defendants systematically misrepresented and continue to misrepresent the significant health impacts of hair relaxer use, all while targeting women of color and taking advantage of centuries of racial discrimination and cultural coercion which emphasized — both socially and professionally — the necessity of maintaining straight hair.”

The complaint alleges women and children were exploited for profit and hair relaxer products were advertised as “organic,” “natural,” “botanicals,” and “safe,” all while manufacturers had knowledge that the hair relaxer products they designed, manufactured, advertised and sold contained carcinogens. “Defendants failed to give appropriate and adequate warning of such risks,” the complaint says.

The complaint cited studies such as the 2021 Dove CROWN Research Study, which showed that 45% of Black and brown girls in all school environments reported hair discrimination, and the National Institutes of Health 11-year Sister Study released in October 2022, which studied about 34,000 women age 35 to 74 and found that those who had used hair relaxers at least four times in the previous year were more than twice as likely to develop uterine cancer.

According to a July 6 Reuters story, L’Oreal and other beauty industry companies have asked a U.S. judge in Chicago to dismiss the complaint, arguing that hair relaxers do not cause cancer and other health problems. Godrej SON Holdings, a defendant in the litigation, declined to comment to the Tribune. Calls and messages to other manufacturing firms involved in the litigation were not returned.

Molly Wells, a partner at Wallace Miller and one of the leads at the firm working on the relaxer litigation, said the discovery process is just starting, but given the complexity of the number of parties involved and the amount of discovery that has to be done, she doesn’t expect a trial date for years.

Wells said this type of litigation raises awareness of issues that people otherwise wouldn’t know about.

“When people are injured by a product, litigation is involved and then people start to look more closely at it — not just people but the FDA and regulatory agencies,” Wells said.

For Shuler, that closer look can’t come soon enough. She thinks not enough people are aware of the risks of relaxers. Dr. Nita Lee, assistant director at the University of Chicago’s Comprehensive Cancer Center Community Outreach and Engagement team, specializes in diagnosing and treating patients with gynecologic malignancies. Since the NIH study was released, she said, she’s been answering more questions from patients surrounding hair relaxing products and uterine cancer cases and having nuanced discussions about it.

“If there are women who’ve had uterine cancer, I’m honest about ‘there’s a lot of factors,’” Lee said.

She doesn’t say hair relaxers are a “don’t do this or else” type of mandate, but she does say it’s important to a pause and think about if they are right for you.

“I counsel people more in the context of are there ways that you can be a more researched consumer in terms of things as best as we can?” Lee said. “And then think about the other risks for uterine cancer: diet quality, carrying extra weight, hypertension, diabetes — things that are more modifiable and have a more direct link to uterine cancer than just hair straightener use. If you have postmenopausal vaginal bleeding, or irregular bleeding, you should get checked out for endometrial cancer.

“The study doesn’t say which type of hair straighteners were used; just straighteners in general,” Lee said. “I think it comes down to the idea of being more conscious of what we’re putting in or on our bodies. If you’re using the product, look at what the ingredients are, be more aware. Whatever you want to do to your hair, find out if this is the one that’s the safest on the market? Are there any that use more natural compounds?”

The NIH study said that several chemicals that have been found in straighteners — such as parabens, bisphenol A, metals and formaldehyde — could be contributing to the increased uterine cancer risk observed.

“It’s not where we can say DDT, this particular chemical within the pesticide, is measurable and associated with XYZ,” said Jasmine McDonald, assistant professor of epidemiology at Columbia University.

She has been studying hair care and Black women’s health prior to the NIH study’s release. “It’s an observational study based on the product,” McDonald said. “If you compare it to smoking, you’re not measuring each individual chemical within the cigarette. It’s the actual product; the cigarette is associated with increased risk because the cigarette contains a mixture of carcinogenic chemicals. … The relaxers contain a mixture of carcinogenic chemicals. This could be formaldehyde, this could be things that are hormonal endocrine disruptor chemicals (that interrupt your natural hormonal processes) — that’s phthalates, parabens. It could be the introduction of estrogenic compounds. The idea is that there’s a mixture of chemicals and no chemical works in a silo.”

LaPagent Holton, 41, of San Antonio, is another plaintiff. The registered nurse said she started relaxing her hair when she was 12. When she and her husband were ready to have a child (she always wanted four), she went in to consult with her gynecologist. Her physician found fibroids, and upon closer inspection, found different colored polyps in her uterus. A biopsy found endometrial cancer in March 2015.

One oncologist recommended a hysterectomy. But Holton pressed for preservation of her uterus and her ability to be a mom. She and her husband found another oncologist and the rest of her cancer-fighting team online. With stage 1 cancer, her team opted to give her high doses of hormones such as progesterone for six months to block the estrogen that uterine cancer feeds off to see if they could reverse it. And they did.

Holton, who is now in remission, was able to have a child — her son, Israel — using in vitro fertilization after she lost one baby at 12 weeks of pregnancy. Her son was delivered at 35 weeks on Jan. 24, 2019, and had a two-week stay in the neonatal intensive care unit. He is getting ready to start pre-K this fall.

“He was only 4 pounds, 6 ounces. … They told me that had I not gotten him out, he would have died,” Holton said. “I had low amniotic fluid and the intrauterine growth restriction, he wasn’t growing. My uterus was basically falling apart. They said had they waited another day, he would have died in my uterus because it was not conducive to life at all. And after that I ended up developing postpartum preeclampsia. I had to be readmitted. My baby — I was upstairs, he was downstairs, it was crazy. It was very traumatic to have all of that, but we all made it.”

When Holton saw Illinois attorney April Preyar’s social media post about relaxers and uterine cancer, Holton reached out. Preyar is working with the Wallace Miller firm on the case.

Wells said there is a misconception about the regulatory framework in the United States. “FDA regulations … there’s bigger pieces of government that are involved in setting those regulations and that is the floor of what needs to be done, the baseline, not the ceiling,” she said. “It’s really incumbent upon companies to do all the research and provide all the information to the FDA. That’s why you see this stuff happening, because our government, our society has decided that we’re going to put a floor versus a ceiling type regulation on these companies.”

Preyar said some of the women who have reached out to her about the litigation have said they’ve been hearing whispers about relaxers and cancer for years, while others think it is a fear that will pass.

Lee said the NIH data is a good place to start a discussion on relaxer usage, but doesn’t give all the answers. She said OB/GYN oncologists like her have been saying uterine cancer is a growing problem for years. She said she’s seen it rise about 2% per year, and she hopes the NIH study brings more awareness so more pointed research is conducted.

“Uterine cancer is increasing in this country very starkly, especially among minority women. And death rates from uterine cancer are much higher in Black women than any other category,” Lee said. “It’s not like, ‘Over the last 20 years hair straightening has increased.’ It’s been going on, obviously. But I think the NIH study came at a time where we’re really attuned to try to figure out what’s happening with Black women and uterine cancer.”

Tracey Bell, owner of 95.1 FM Chicago, said she started her career working in marketing for two of manufacturers in the complaint, SoftSheen-Carson and Namaste. She said there are lye and no-lye relaxers, the former often used by professional stylists and the latter used by consumers at home. But no one has found a way to relax hair without the straightening chemicals, she said.

“Relaxers are such a large part of the industry in terms of revenue and sales, it’s never going away,” Bell said.

Other manufacturers in the litigation include Dabur International USA, Namaste Laboratories, Dermoviva SkinEssentials, AFAM Concept, Parfums deCoeur, McBride Research Laboratories, Avlon Industries, Beauty Bell Enterprises, Luster Products and Sally Beauty Holdings.

Bell says the real travesty is that nobody seems to care. “It’s Black women. Nobody cares except us. We are so marginalized and looking for a convenience of anything that we can get, a lot of times we don’t even care enough ourselves,” she said.

Holton said she’s blessed and lucky to be here with her son because the only sign that there was a problem was she was experiencing more heavy bleeding during her period than what was normal for her. Holton’s advice to others who think they may have suffered because of hair relaxers’ effects: Advocate for yourself. Listen to your body. Pay attention to the signs. Don’t disregard something. Whatever you are concerned about, speak up. Get a second opinion.

“Make your voice heard because it can literally save your life, save your fertility,” she said. “Anytime we talk about our reproductive health, people shy away and suffer in silence, but you should talk about it. Don’t get comfortable being uncomfortable.”

Holton is hoping to see changes with the litigation. “Even if they don’t pull relaxers from the shelves,” she said, “I would hope that they would at least put a warning label on them. Then everybody can make a decision; everyone has a right to make a decision regarding their health.”

drockett@chicagotribune.com