Chemical hair relaxers have adverse effects a myth or reality.

CONTEXT: Hair plays an important role in one's personality and builds confidence. Now-a-days, chemical hair relaxers are used very commonly in the society. We document the adverse effects reported by the sample that have used any one of the professional chemical hair relaxers. AIM: To study the adverse effects reported by the sample who underwent repeated chemical hair relaxing. SETTINGS AND
DESIGN: Cross-sectional questionnaire based study done on a sample taken from a medical college and hospital campus in Mangalore.
MATERIALS AND METHODS: The sample was restricted to females and to those who underwent it more than once. A questionnaire was given to a sample of 90, which matched our criteria. STATISTICAL ANALYSIS: SPSS software 17.
RESULTS: Adverse effects reported by the sample after undergoing the procedure were found to be a high 95.56%, out of which the following are the common adverse effects reported; frizzy hair in 67%, dandruff in 61%, hair loss in 47%, thinning and weakening of hair in 40%, greying of hair 22%, and split ends in only 17%.
CONCLUSIONS: Very few studies have been conducted on the adverse effects of hair straightening products in India. From our study, it can be stated that most of the samples had adverse effects, which was as high as 95.56%. Hence from the details elicited from this study, we can conclude that, usage of chemical hair relaxers does cause adverse effects and is "not a myth." Thus, it is necessary to make available a less harmful chemical hair relaxer to the society.

INTRODUCTION

A chance discovery made by Garrett Morgan, an African-American tailor was the first one to discover an alkaline based chemical used to polish machine needles, which incidentally caused straightening of hair.[1] Historically, they were mainly used by Negroid woman to straighten their curly hair and easy management. Hot comb method has been replaced by chemical hair relaxers that allow permanent hair straightening.[2] Chemical based hair relaxers are broadly classified as “Lye” relaxers, no-lye relaxers and “thio” relaxers.[3] We have carried out a questionnaire based study of the adverse effects reported by a sample from repeated use of chemical hair relaxers.

MATERIALS AND METHODS

The sample taken for this study was from the students and faculty of AJ Institute of Medical Sciences, Mangalore. The sample was restricted to females and to those who underwent it more than once, with a time frame of over 1 year from the first application. A cross-sectional questionnaire was prepared to gather demographic data, reason for straightening, and various adverse effects experienced. A questionnaire was given to a sample of 90, which matched our criteria. Men, pregnant women, lactating mothers, samples with prior history of hair loss and scalp disease were excluded. Informed written consent was obtained from all subjects.

RESULTS

The demographic data shows more number of samples belongs to the age group of 21-25 years who have undergone repeated chemical hair relaxers [Table 1].

Table 1

Age wise distribution of the sample

The above table very clearly shows that beautification (53%) as the single most important reason for chemical hair relaxers, followed by ease of management (30%) [Table 2].

Table 2

Reason among the sample for under going the procedure

The above figure show the maximum percentage of sample i.e., 38% used chemical relaxers up to 4 times and the least were 2% who used up to 10 times [Table 3].

Table 3

Sample wise distribution of no. of times straightening carried out

In our sample, the most important adverse effect were found to be frizzy hair (67%) [Figures 1 and 2], followed by dandruff (61%), hair loss (47%) [Figure 3], thinning and weakening of hair (40%) [Table 4].

Figure 1

Frizzy and dry hair

Figure 2

Widening of central partition with frizzy hair

Figure 3

Hair loss over the centre of the scalp.

Table 4

Adverse effects among sample taken

DISCUSSION

Traditionally chemical straightening of hair was achieved by alkaline disruption of the disulphide bonds in the cortex of the hair shaft.[4] Because of the pH (9-12) in chemicals used it causes considerable damage leaving the hair dry and fragile.[5] In our study, we have not discussed about the chemicals used in hair relaxing products as it is beyond the scope of the study. In this study, the common complaints associated with the use of chemical hair relaxers were frizzy hair (67%), dandruff (61%), hair loss (47%), thinning and breakage of hair (40%) as the most commonly encountered problems [Figure 4]. These finding had some similarities as observed in a study done by Swee W,[4] in which they found 95% of their subjects had hair loss and hair breakage. The possibility for this difference could be due to the nature of the chemical used and the frequency of procedure done. The common type of hair discoloration found was greying of hair, observed in 22% of the samples as compared to green, red, orange, or yellowish hue in a study carried out by Swee W.[4] In our study we found split ends to be an adverse side-effect in 17%, which is not commonly reported [Figure 5]. It has been stated that long term use of such products can be harmful as it is believed to enter the scalp through scalp lesions and burns.[6] A case report done by Kaur et al. showed deep seated staphylococcal infection related to usage of hair relaxers, especially in immuno-compromised individuals.[7] Another interesting conclusion carried out by Wise et al. was the increased risk of uterine leiomyomata associated with hair relaxers.[6] Fortunately there is null association between chemical hair relaxers and occurrence of breast cancer found in a study carried out by Rosenberg et al.[3] Seeing all this side-effects along with our study it is evident that there are very few serious systemic adverse effects associated with chemical relaxers, however, there is a definite correlation between hair relaxers and cutaneous adverse effects.

Figure 4

Thinning of hair after repeated use of chemical hair relaxers

Figure 5

Split ends post procedure