After the 2022 publication of the NIH’s 10-year epidemiological study linking hair-straightening products to uterine cancer, thousands of black women filed lawsuits alleging companies had sold hair relaxers containing chemicals that increased their risk of developing uterine cancer – and failed to warn customers.
Meanwhile, the US Food & Drug Administration (FDA) missed its own deadline this month to propose a ban on one of the harmful ingredients (formaldehyde) in hair relaxers.
This is all part of a larger story about racist beauty standards in the US, and the physical and emotional harms they cause to women of colour, writes Dr Mengyi Zha in Medpage Today.
Looking ‘white’ to succeed
When asked in an interview what had once motivated her to straighten her hair, a black woman told a TV reporter: “I wanted a job.”
“Going to an employer with an Afro back in those days … would not have cut it.”
It still doesn’t. Having non-white features continues to hinder one’s growth in many job markets.
American TV personality and news anchor Julie Chen disclosed that she had blepharoplasty – double eyelid surgery – when she was a young journalist because an agent suggested that if she got the surgery, a better job market would open up for her.
The billion-dollar global blepharoplasty industry is one of the most performed plastic surgeries and was popularised in the 1950s as a tool for Korean women to assimilate to the US after the Korean War.
It has been categorised by ethicists as a racial surgery aimed to efface defining ethnic features. In other words, the intention of the surgery is to make Asian women look more white.
In an interview last year, Rosie Perez, the Oscar-nominated Puerto Rican actress, said her agent also suggested that she surgically alter her appearance to look more white.
“She told me that if I dyed my hair blonde and got a nose job, she could get me more jobs.”
Even within the same race, lighter skin tones can lead to a better chance of getting job offers and higher socioeconomic status.
Health consequences
Racist beauty standards can cause harm far beyond financial health. They can literally kill. The NIH study found an 80% higher risk of developing uterine cancer among women who had used hair straighteners at least once in the past year. And if they had used these products more than four times in a year, this number rose to 155%.
Though these risk increases didn’t discriminate among racial and ethnic groups, black women are disproportionally affected. Many start using hair relaxers at a younger age, and often with higher prevalence and frequency.
Furthermore, studies suggest the products marketed to black women specifically are more likely to contain certain toxic chemicals.
Published in 2023, the Black Women’s Health Study found that using hair relaxers more than twice a year or for more than five years was associated with a 50% increased risk of uterine cancer among postmenopausal black women (but not premenopausal black women).
Though this study and the NIH study only looked at a person’s use in the recent past, it’s not hard to imagine the cumulative carcinogenic effect of these toxins over decades, especially starting at a young age in developing bodies.
Skin bleaching offers another glimpse into the dark side of racist beauty standards.
In a November 2023 Analytical Fact Sheet, the World Health Organisation emphasised that the practice of skin bleaching has roots in the transatlantic slave trade and has become a public health concern in Africa, where the global lifetime prevalence of the practice is 27.1%.
Even in the US, skin bleaching is not uncommon.
Skin bleaching products frequently contain hydroquinone, steroids, and mercury, all of which have been linked to toxic effects in humans. These include increased risks of a paradoxical abnormal darkening of the skin (ochronosis), skin cancer, mercury poisoning, kidney disease, endocrine disorders, and even life-threatening adrenal problems.
In 2022, the FDA banned the sale of hydroquinone-containing products over the counter and issued warning letters to a dozen companies that were doing so. The agency then launched the Skin Facts! Initiative to advocate for safe use of skin lightening products nationwide.
The harms of delayed action
Unfortunately, this action to protect consumers from predatory companies took decades to initiate. Researchers had been raising red flags about potential mercury poisoning among African women from skin bleaching products since the 1970s, and the worrisome side effects of hydroquinone since the 1980s.
Hopefully, with the NIH’s comprehensive research, it won’t take the FDA another half a century to regulate industries and protect American consumers from uterine cancer. But the missed deadline to propose a formaldehyde ban is not a reassuring sign.
To be clear, the choice to alter one’s appearance, either temporarily or permanently, is deeply personal and demands respect. A nose job in a black woman or an eyelid surgery in an Asian woman may have nothing to do with wanting to look more “white”.
Regardless of the motivation, one should not have to justify one’s personal choices. But society has a moral obligation to ensure people can make these choices freely and with full information.
What’s needed?
The first step is to acknowledge the history and presence of racism that is pervasive and insidious in defining beauty and health. In Knight Dunlap’s 1920 book, Personal Beauty and Racial Betterment, the eugenic psychologist defined any “signs of [non-white] race” to be “general negative characters” of beauty and therefore an indication for an “inferior race”.
And as recently as 2016, a study conducted by the University of Virginia demonstrated that half of participating white medical trainees endorsed at least one racist myth about black bodies, such as “blacks’ skin is thicker than whites’”.
The second step is to right the historical wrong by educating the public widely and enforcing the elimination of harmful practices promptly and according to existing data.
This job – in the case of potentially carcinogenic chemicals in beauty products – should fall on regulatory bodies like the FDA. It certainly shouldn’t be the job of those individual women suffering from cancer to inform the rest of the society by filing highly publicised lawsuits.
“If you all had known the risks associated with the chemicals found in hair straighteners/relaxers, would you still have used them?” a reporter asked five black women joining the suit against hair product companies.
The answer was straightforward: “No.”
And that is exactly what racist beauty standards take away from women of colour: the ability to say “No”.
Mengyi (Zed) Zha, MD is a physician in Washington.
Skin_Bleaching_in_Africa_regional_fact_sheet_Nov23
Popularity of skin lightening products among SA health science students
Medpage Today article – The Sickening Reality of ‘White’ Beauty Standards (Open access)
See more from MedicalBrief archives:
US court to hear 60 consolidated lawsuits over L’Oreal hair straightener claims
FDA mulls ban on hair-straighteners
Uterine cancer risk linked to hair-straightening products – US study
FDA’s plan to ban hair relaxer chemical ‘far too late’