Peerless Hair Salon in Cleveland Heights is quiet on a Tuesday morning in April. One client wraps up her appointment under a hair dryer while another waits her turn by the front window. A third settles into a chair.
The salon has called Taylor Road home for eight years but Sherry Harvey has styled hair for more than 25. The Cleveland native has seen hair trends come and go, just like hair products — including chemical hair relaxers.
Like many salons, Peerless Hair Salon doesn't use relaxers, and hasn't for years.
"It's the stuff that you put in deceased people. Yeah, no," said Nodja D., who owns Peerless Hair Salon.
"The question is, how did it ever make it to the market?" Harvey added.
The U.S. Food and Drug Administration is tentatively scheduled to announce a proposal this month that would ban use of formaldehyde in hair products, 12 years after the chemical was classified as a carcinogen by the National Research Council.
Formaldehyde has been a common ingredient in chemical hair relaxers sometimes used by Black women to straighten curly hair. Products that contain formaldehyde, formalin or methylene glycol are applied before a heat tool is used to straighten the hair. When the solution is heated, formaldehyde is released into the air as a gas.
The health risks
Some salon-goers have complained of noxious fumes, headaches and nosebleeds after exposure to formaldehyde products. Others have reported much worse outcomes.
Findings from a 10-year National Institutes of Health study published in 2022 found that women who frequently used hair straightening products were more than twice as likely to develop uterine cancer as with those who did not use the products. About 60% of the women who used those products were Black.
Of the 33,497 U.S. women followed during the study, 378 uterine cancer cases were diagnosed. The study found that the risk of developing uterine cancer by age 70 was more than two times higher for women who frequently used straighteners compared to those who never did.
A 2019 National Cancer Institute study also found that uterine cancer rates have been rising in the U.S., particularly among Black women.
Formaldehyde is also used in building materials, insulation, pesticides and other cosmetic and consumer products. Embalming fluids use formaldehyde as a preservative.
Use of harsh chemical products has waned in many salons, said Harvey of Peerless Hair Salon, adding that chemical hair relaxers used to be much more caustic and hard on the scalp.
"Just like anything over time, technology and research allows you to make a better product, and so that's where we are. Today is just a much better product," Harvey said.
Nodja D. noted that much of the warning she'd heard about formaldehyde in hair products stemmed from keratin hair treatments and the Brazilian Blowout brand. The FDA found that Brazilian Blowout contained methylene glycol, a liquid form of formaldehyde, and that the company failed to warn users about associated risks, according to the Occupational Safety and Health Administration.
The FDA in 2011 issued a warning to Brazilian Blowout stating that it is "an adulterated cosmetic because it contains a hazardous substance that may adversely affect users when it is used as described in the labeling."
However, such products were allowed to remain on the market and questions loom about why it's taken the FDA so long to enact a ban even after the risks were known.
Evidence for the carcinogenicity of formaldehyde was first reported in 1979, according to the Centers for Disease Control and Prevention. OSHA issued a warning to salons about the risks of formaldehyde products in 2011.
Nodja D. said she hasn't received any formal warnings about formaldehyde products yet. She noted that cosmetology schools teach students about such products, but it's up to stylists to be aware of any dangers.
"They taught you the product and you had to know the main ingredient in a product and what that product is supposed to do," Harvey explained.
"Sometimes it's just based off of self knowledge. You have to go in and do your own research, like kind of look up what products it is that you're using, or see what the cause and effect of something would be," Nodja D. said, adding that many stylists consider formaldehyde products to be "old school," so her salon doesn't use them anyway.
Cosmetologists are required to renew their licenses every other year. That's when many of them receive new updates and warnings about products.
Even so, Harvey said, "it is definitely up to you to educate yourself in the areas in which you feel like you may be weak, or that you want to gain more knowledge. It is on you to make that happen."
Harvey also said part of being a good stylist is having conversations with her clients about the products she uses on them — including any adverse effects they may have in combination with medications they’re taking.
“Medication plays a very big part in how your hair is affected by the chemicals, and a lot of times, when you are prescribed certain medications, the effects of your hair is not made known to you," Harvey said.
Urging the FDA to take action
U.S. Reps. Shontel Brown (OH-11) and Ayanna Pressley (MA-07) urged the FDA to investigate chemical hair straighteners last year, amid those studies that suggested the products pose serious health risks.
"As a result of anti-Black hair sentiment, Black women have been unfairly subjected to scrutiny and forced to navigate the extreme politicization of hair,” the lawmakers wrote in a letter to the FDA. “Manufacturers of chemical straighteners have gained enormous profits, but recent findings unveil potentially significant negative health consequences associated with these products.”
The subject is personal for Brown, who said she's used hair relaxers and dealt with uterine fibroids. Though use of formaldehyde hair relaxers hasn't been directly linked to the condition, Brown said it's important for Black women to be aware of the risks of such products.
"They were highly marketed to us, and we are often encouraged to wear our hair a certain way, in straight hair styles, which is not many of our natural hair patterns," Brown explained.
Hair discrimination has also pushed Black women toward use of products to alter their hair's appearance. A 2023 study found that Black women’s hair is more than twice as likely to be perceived as unprofessional in the workplace. It also determined that two-thirds of Black women said they change their hair for a job interview, and of those, 41% changed their hair from curly to straight.
Though Nodja D. and Harvey have been mindful of the products they use on clients, the fact that such products were ever permitted to begin with is concerning to them.
"It's definitely alarming because you don't wait until something gets to the back end to do your research, or it's harmful, or you have the side effects that's going on with different women before you notice it," Nodja D. said.
Peerless Hair Salon uses ammonium thioglycolate straightening products. That chemical compound can curl or straighten hair depending on how it's used, according to Nodja D.
A 2009 study determined that ammonium thioglycolate could be a skin irritant, but there was no evidence of carcinogenicity. Use of if bore low concerns for cancer, reproductivity and development, according to Environmental Working Group, a nonprofit research and advocacy group.
What's next
The FDA is tentatively expected to share more details of its proposed ban on formaldehyde and formaldehyde-releasing chemicals in hair products this month.
Reps. Brown and Pressley applauded the FDA's proposal, but Brown noted that awareness and accountability remain important in preventing more products from making people sick. She and Pressley will await the details of the FDA's proposal before taking any additional action, she said.
"The evidence is clear, and we have to look at the evidence and hold people accountable," Brown said, through "regulations [or] penalties for folks that continue to move forward with things that they know that are harmful. So we certainly don't want to impede capitalism, but we certainly don't want it to be at the expense of people's health."
There's also ongoing litigation for those who have suffered health consequences after using chemical hair straighteners.
More than 8,000 lawsuits have been consolidated and filed in a Chicago federal court, alleging that cosmetic companies — including L’Oreal and Revlon — failed to warn consumers about the risks of some of their products. The lawsuits also allege the brands intentionally targeted people of color when marketing the products. That litigation is currently in the discovery phase.
"It's very big in the African-American community, the more melanated people are the ones who see the effects," Harvey said.
But she also noted that she's seen more women embracing their natural hair styles in recent years.
“People have been phasing from the chemicals and doing more natural styles, such as locs or just wearing their hair in their natural curl pattern, which is beautiful," she said.
