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Heading Off Hair-Care Disasters:
Use Caution With Relaxers and Dyes
By Michelle Meadows
It's never a good sign when the hairdresser panics. That's
what happened to Barbara Cabrera-Avila, 38, when she returned
to the salon about six weeks after having her hair straightened
a couple of years ago. The cause for alarm: several bald
spots in the back of her head.
The Adelphi, Md., resident began having her curls straightened
at the age of six so her hair would be easier to comb and
style. She says over-processed hair likely played a role
in her hair loss, and stress could have been a factor. What's
certain is that three dermatologists advised her to take
a break from hair straighteners, also known as relaxers.
Barbara says giving up the straight hair she had grown comfortable
with wasn't easy. After all, people's personal preferences
about how they want to look tie into self-esteem--a fact
that makes for good sales in the hair business. In addition
to paying for trims and cuts to achieve a certain look, consumers
spend millions of dollars each year to get hair that's different
from what nature intended--whether it's to tame tight curls,
give flat hair a boost, or get rid of the gray.
According to the Food and Drug Administration's Office of
Cosmetics and Colors, hair straighteners and hair dyes are
among its top consumer complaint areas. Complaints range
from hair breakage to symptoms warranting an emergency room
visit. Reporting such complaints is voluntary, and the reported
problem is often due to incorrect use of a product rather
than the product itself. FDA encourages consumers to understand
the risks that come with using hair chemicals, and to take
a proactive approach in ensuring their proper use. The agency
doesn't have authority under the Federal Food, Drug, and
Cosmetic Act to require premarket approval for cosmetics,
but it can take action when safety issues surface.
When the Product Is the Problem
When consumers notify FDA of problems with cosmetics, the
agency evaluates evidence on a case-by-case basis and determines
if follow-up is needed, says Allen Halper, an FDA consumer
safety officer. FDA looks for patterns of complaints or unusual
or severe reactions. The agency may conduct an investigation,
and if the evidence supports regulatory action, FDA may request
removal of a cosmetic from the market.
Take the example of two popular hair relaxer products by
World Rio Corp.--the Rio Naturalizer System (Neutral Formula)
and the Rio Naturalizer System with Color Enhancer (Black/Licorice).
After receiving complaints about these products in November
and December of 1994, FDA warned the public against using
them. Consumers complained of hair loss, scalp irritation,
and discolored hair.
In December 1994, the World Rio Corp., Inc. of Los Angeles,
Calif., announced that it stopped sales and shipments of
the product. But reports indicated that the company continued
to take orders, and the California Department of Health also
stepped in to stop sales. In January of 1995, the U.S. Attorney's
Office in Los Angeles filed a seizure action against these
products on behalf of FDA. By then, the agency had received
more than 3,000 complaints about the Rio products.
Although most relaxers are alkaline, this product was formulated
to be acidic. In the resulting consent decree of condemnation
and permanent injunction, FDA alleged that the products were
potentially harmful or injurious when used as intended, that
they were more acidic than declared in the labeling, and
that the labeling described the products as "chemical free" when "allegedly
they contained ingredients commonly understood to be 'chemicals.'"
Safer Straightening
FDA has received complaints about scalp irritation and hair
breakage related to both lye and "no lye" relaxers. Some
consumers falsely assume that compared to lye relaxers, "no
lye" relaxers take all the worry out of straightening.
"People may think because it says 'no lye' that it's not
caustic," says FDA biologist Lark Lambert. But both types
of relaxers contain ingredients that work by breaking chemical
bonds of the hair, and both can burn the scalp if used incorrectly.
Lye relaxers contain sodium hydroxide as the active ingredient.
With "no lye" relaxers, calcium hydroxide and guanidine carbonate
are mixed to produce guanidine hydroxide.
Research has shown that this combination in "no lye" relaxers
results in less scalp irritation than lye relaxers, but the
same safety rules apply for both. They should be used properly,
left on no longer than the prescribed time, carefully washed
out with neutralizing shampoo, and followed up with regular
conditioning. For those who opt to straighten their own hair,
it's wise to enlist help simply because not being able to
see and reach the top and back of the head makes proper application
of the chemical and thorough rinsing more of a challenge.
Some stylists recommend applying a layer of petroleum jelly
on the scalp before applying a relaxer because it creates
a protective barrier between the chemical and the skin. Scratching,
brushing, and combing can make the scalp more susceptible
to chemical damage and should be avoided right before using
a relaxer. Parents should be especially cautious when applying
chemicals to children's hair and should keep relaxers out
of children's reach. There have been reports of small children
ingesting straightening chemicals and suffering injuries
that include burns to the face, tongue, and esophagus.
How often to relax hair is a personal decision. According
to Pearl Freier, an instructor at the International Academy
of Hair Design in South Daytona, Fla., relaxing at intervals
of six to eight weeks is common, and the frequency depends
on the rate of a person's hair growth. Leslie F. Safer, MD,
a dermatologist in Albany, Ga., who has treated women with
scalp irritation from relaxers, says straightening every
six weeks is too frequent, in his opinion. Relaxers can cause
hair breakage in the long term, he says, and blow drying
and curling can do more damage.
Consumers should be aware that applying more than one type
of chemical treatment, such as coloring hair one week and
then relaxing it the next, can increase the risk of hair
damage. "The only color we recommend for relaxed hair is
semi-permanent because it has no ammonia and less peroxide," compared
with permanent color, Freier says.
Hair Dye Reactions
As with hair relaxers, some consumers have reported hair
loss, burning, redness, and irritation from hair dyes. Allergic
reactions to dyes include itching, swelling of the face,
and even difficulty breathing.
Coal tar hair dye ingredients are known to cause allergic
reactions in some people, FDA's Lambert says. Synthetic organic
chemicals, including hair dyes and other color additives,
were originally manufactured from coal tar, but today manufacturers
primarily use materials derived from petroleum. The use of
the term "coal tar" continues because historically that language
has been incorporated into the law and regulations.
The law does not require that coal tar hair dyes be approved
by FDA, as is required for other uses of color additives.
In addition, the law does not allow FDA to take action against
coal tar hair dyes that are shown to be harmful, if the product
is labeled with the prescribed caution statement indicating
that the product may cause irritation in certain individuals,
that a patch test for skin sensitivity should be done, and
that the product must not be used for dyeing the eyelashes
or eyebrows. The patch test involves putting a dab of hair
dye behind the ear or inside the elbow, leaving it there
for two days, and looking for itching, burning, redness,
or other reactions.
"The problem is that people can become sensitized--that
is, develop an allergy--to these ingredients," Lambert says. "They
may do the patch test once, and then use the product for
10 years" before having an allergic reaction. "But you're
supposed to do the patch test every time," he says, even
in salons.
And what about ending up with something other than the exact
shade of strawberry blonde on the shelf? "Don't think the
color on the box is the color you'll get," says Freier, the
cosmetology instructor. "There are so many variables, like
what chemicals are already in your hair and what your natural
color is, that go into how your hair will turn out."
When using all hair chemicals, it's critical to keep them
away from children to prevent ingestion and other accidents,
and to follow product directions carefully. It sounds basic,
but some people don't do it, says FDA's Halper. "If it says
leave on hair for five minutes, seven minutes doesn't make
it better," he says. "In fact, it could do damage."
Michelle Meadows is a staff writer for FDA Consumer.
FDA encourages voluntary reporting of adverse reactions
to hair products to: FDA, Center for Food Safety and Applied
Nutrition, Office of Cosmetics and Colors, 200 C St. S.W.,
Washington, DC 20204, 202-205-4706. *
Hair Color and Cancer
Over the years, some studies have indicated a possible link
between hair dye use and cancer, while others have not. In
February 1994, FDA and the American Cancer Society released
an epidemiologic study involving 573,000 women. Researchers
found that women who had ever used permanent hair dyes showed
decreased risk of all fatal cancers combined and also of
urinary system cancers. The study also revealed that women
who had ever used permanent hair dyes showed no increased
risk of any type of hematopoietic cancer (cancer of the body's
blood-forming systems).
This research, published in the Journal of the National
Cancer Institute, did suggest that prolonged use (20 years
or more of constant use) of black hair dye may slightly increase
the occurrence of non-Hodgkin's lymphoma and multiple myeloma,
but these cases represented a small fraction of hair dye
users. This study followed previous NCI studies that raised
concern about the use of hair dyes and higher rates of non-Hodgkin's
lymphoma.
In another study, published in the October 5, 1994, issue
of the Journal of the National Cancer Institute, researchers
from Brigham and Women's Hospital in Boston followed 99,000
women and found no greater risk of cancers of the blood or
lymph systems among women who had ever used permanent hair
dyes.
Then in 1998, scientists at the University of California
at San Francisco questioned 2,544 people about their use
of hair-color products. After integrating the results of
this study with those of animal and other epidemiologic studies,
they concluded that there was little convincing evidence
linking non-Hodgkin's lymphoma with normal use of hair-color
products in humans. The study was published in the December
1998 issue of the American Journal of Public Health.
FDA continues to follow research in this field.
--M.M.
To read more about hair care products from the Food and
Drug Administration, please click here: http://www.cfsan.fda.gov/~dms/fdahdye.html
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