Ask any Black woman about that study that dropped last month and she’ll likely know what you’re talking about. On October 17, new research from the National Institute of Health (NIH) came out linking hair relaxer use to increased rates of uterine cancer. The report followed 33,497 diverse women in the U.S. aged 35 to 74 for nearly 11 years and found that women who “frequently” use hair straightening products (defined as more than four times a year) were more than twice as likely to develop uterine cancer. Approximately 60 percent of the participants who reported using straighteners self-identified as Black women, and “although the study did not find that the relationship between straightener use and uterine cancer incidence was different by race, the adverse health effects may be greater for Black women due to higher prevalence of use.”

The news made its way from the headlines onto Twitter and TikTok feeds and into many group chats, reigniting calls for Black women to ditch the chemicals and go natural for the sake of our health. But unfortunately, the quest to avoid harmful ingredients isn’t as simple as just “embracing” our curls.

Black women are held to an impossible beauty standard (it’s worth noting that hair-based discrimination is still legal in 31 states), and are expected to meet that standard with products that aren’t designed with us in mind—which means piling on more and more products to achieve our desired look. Not only does this keep us tethered to an arsenal of beauty products, but it also heightens our exposure to potentially harmful ingredients—heightening the risk of turning our self-care routines into self-destruction.

The complex relationship between Black women and their beauty routines

In Black culture, whether you wear your hair natural or chemically treated, it must always look on point. We dedicate hours—and tons of products—to twisting, setting, laying, greasing, and wrapping so that no baby hair is out of place and no curl is undefined. “The big picture is that Black women, we use more personal-care products in general,” says Heather Woolery-Lloyd, MD, a board-certified dermatologist in Miami. “It’s not a roll-out-of-bed culture.”

Black Americans spend more on beauty products than any other group. A 2021 study found that while Black people comprise 13 percent of the population, we account for 22 percent of the $42 billion spent on personal care. This all ties back to the ridiculously high standards Black people are held to both by others and ourselves.

“When you talk about beauty as currency for women in general and how complicated that gets for Black women, you understand the importance of trying to look as perfect as you can at all times,” says Alese Adams, a 23-year-old beauty enthusiast from Nashville, Tennessee, whose relationship to beauty has been shaped by these pressures. “You’re not only criticized for your race, you’re criticized for your womanhood, so your looks are criticized twice as hard as everybody else’s. There is a lot of pressure to try to look put together at all times.”

So a decade ago, when millions of Black women began wearing their natural hair (in a move to step away from Eurocentric beauty standards while cutting down chemical exposure), the drive toward perfection didn’t disappear—it shapeshifted. Though sales of hair relaxers marketed to Black women decreased by 40 percent between 2008 and 2015, sales of natural hair styling products increased by 27 percent between 2013 and 2015. And there’s nothing “natural” about using half a bottle of conditioner to detangle, then layering on fifty ‘leven products to smooth, define, and perfect.

“I felt a huge, huge, huge pressure to make my natural hair as perfectly coiled as I could possibly make it. I have 4C hair—it took everything to get my hair to try to force it to be what I wanted it to be,” says Adams. “Having natural hair is so expensive, those products cost so much money, and you have to have five, six different products just to get through one wash day. And you have to use so much of the product to get your hair to be slippery enough to be able to detangle without losing half your head to shedding.”

Relaxers are only part of the risk

The issue with slathering on so many products is that the more of them you use, the more likely you are to expose yourself to potentially harmful ingredients—and this is especially true for Black women. In 2016, the Environmental Working Group (EWG) assessed almost 1,200 products marketed specifically to Black women and concluded that fewer products made without hazardous ingredients are available for this group; and in 2019, researchers found that the prevalence of endocrine-disrupting chemicals is higher in hair products used by Black women than in products used by white women.

These endocrine-disrupting ingredients were the focus of the NIH study, and according to Dr. Woolery-Lloyd,  can bind to and activate hormone receptors, throwing off function and leading to a range of health issues. Phthalates and some parabens (which are commonly found in beauty products, including relaxers) are the most well-known ingredients under the endocrine disruptors umbrella, but they are only a small part of the problem. Even natural oils, like lavender and tea tree, are proven endocrine disruptors, and a small 2018 study linked the use of these oils on baby boys to breast development.

“It’s not so clear-cut because, unfortunately, we’re exposed to endocrine disruptors in things that we consider ‘natural,'” says Dr. Woolery-Lloyd. “Someone who doesn’t use a relaxer but puts 16 products on her hair every single day, she’s getting a lot of exposure to endocrine disruptors too…it’s not like she’s safe.”

It’s also worth noting that potentially harmful ingredients can be even more harmful when they’re found in hair products (than, say, in skin- or body-care products) because your scalp tends to absorb chemicals more easily than other areas of skin. Your hair routine shouldn’t need to involve tons of different creams, oils, mousses, and sprays. (Not only is that expensive and potentially harmful on a hormonal level, but product overload can clog the scalp, creating an unhealthy environment that makes it difficult for your hair to truly thrive.)

“[As Black women], we’re constantly covering our hair, scalp, and body with products that have endocrine-disrupting chemicals,”  says Dr. Woolery-Lloyd. “This study showed a higher rate of uterine cancer with relaxer use, but there are studies that have shown a higher rate of early periods with hair oil use. There’s another study that shows a higher rate of breast cancer with hair dye use. I don’t know if it’s specific to relaxers—it’s unique to all of the chemicals that we put on our skin and hair.”

Working toward safe and effective beauty products for Black women

Though there’s a mounting pile of research confirming that Black women are being put at risk by their beauty products (just look at the half-dozen examples linked above), we still don’t have the full picture. Yes, hair relaxers have the potential to disrupt your hormones, but so do hair dyes and natural oils, and there isn’t concrete evidence to show that one is better or worse than the others. Researchers still can’t say for sure which ingredients are safe, which are not, and what levels of exposure constitute as harmful—which can make things confusing for anyone trying to figure out how to safely style their hair.

“I wish I could have more black-and-white answers for you but I don’t. What I can tell you is that overall, Black women use more products that can influence hormones,” says Dr. Woolery-Lloyd. “All of the stuff that we use is not well-regulated, and we need to do a lot of research to figure out what is safe and what we can avoid.”

Even the NIH report doesn’t give us clear results: The survey the report was based on asked how frequently respondents used “straighteners, relaxers, or pressing products,” and it’s unclear how many of the women were using chemical relaxers versus straightening their hair with heat; and each of the women enrolled in the study had a sister with breast cancer, which (though rare) could mean that they have a predisposition to certain types of cancer, including uterine cancer. And though relaxers can increase your risk of uterine cancer, your overall risk of contracting the disease is still relatively low: According to the NIH study, 1.64 percent of women who never used hair straighteners develop uterine cancer by age 70, compared to 4.05 percent of women who use them frequently. “This doubling rate is concerning. However, it is important to put this information into context: uterine cancer is a relatively rare type of cancer,” said Alexandra White, Ph.D., head of the NIEHS Environment and Cancer Epidemiology group and lead author on the new study.

We’ve barely scratched the surface when it comes to understanding how beauty products impact our health, but the one thing we know for sure is that we need safer, more efficacious products. If Black women can achieve their desired styles by using less, it will lower their exposure, plain and simple. “There’s an opportunity there for products that are a little more versatile,” says Dr. Woolery-Lloyd. “We’ll see a shift to minimalism with hair care where Black women won’t need these six-step hair-care regimens.”

In the past year, we’ve started to see strides being made in this direction. Increased funding to textured-hair research and Black-founded beauty brands has allowed for better product formulation. Plus, standards are shifting.  The Crown Act has made hair-based discrimination in 19 states (with proposed legislation filed in 25 more), and we’re seeing more Black women breaking the mold with minimalist natural hair routines gaining traction on TikTok.

And for what it’s worth, Adams went back to a relaxer two days after the NIH study went viral. “I did what I could do to make me feel better about myself. Not that I feel like I look prettier straight-haired—that’s not the case. But I just appreciate having something that’s easier to manage,” she says. “Being a Black person in America, everything I do is a risk. So at the least, I wanna enjoy my crown.”