BACKGROUND: Hair relaxers and skin lighteners have been commonly used by African women, with suggestions that they may have hormonal activity. OBJECTIVES: To investigate the relationship of hair relaxer and skin lightener use to serum estrogen/estrogen metabolite levels. METHODS: We utilized the postmenopausal population-based controls of the Ghana Breast Health Study to estimate adjusted geometric means (GM) and 95% confidence intervals of individual circulating estrogen levels by hair relaxer/skin lightener exposure categories. RESULTS: Of the 585 postmenopausal women included in our analysis, 80.2% reported hair relaxer use and 29.4% skin lightener use. Ever hair relaxer use was positively associated with estriol (adjusted GM 95.4 pmol/L vs. never 74.5, p value = 0.02) and 16-epiestriol (20.4 vs. 16.8, p value = 0.05) particularly among users of lye-based hair relaxers. Positive associations between scalp burns and unconjugated estrogens were observed (e.g., unconjugated estrone: 5+ scalp burns 76.9 [59.6-99.2] vs. no burns 64.0 [53.7-76.3], p-trend = 0.03). No association was observed between use of skin lighteners and circulating estrogens. SIGNIFICANCE: This study presents evidence that circulating 16-pathway estrogens (i.e., estriol and 16-epiestriol) may be increased in users of lye-based hair relaxer products. Among hair relaxer users, unconjugated estrogen levels were elevated in women with a greater number of scalp burns. IMPACT STATEMENT: In this population-based study of hair relaxer and skin lightener use among postmenopausal women in Ghana, altered estrogen metabolism was observed with hair relaxer use, particularly among women using lye-based products or with a greater number of scalp burns. In contrast, skin lightener use was not associated with differences in estrogen metabolism in this population. Continued investigation of the potential biological impact on breast cancer risk of hair relaxer use is warranted.
BACKGROUND: Hair relaxers and skin lighteners have been commonly used by African women, with suggestions that they may have hormonal activity. OBJECTIVES: To investigate the relationship of hair relaxer and skin lightener use to serum estrogen/estrogen metabolite levels. METHODS: We utilized the postmenopausal population-based controls of the Ghana Breast Health Study to estimate adjusted geometric means (GM) and 95% confidence intervals of individual circulating estrogen levels by hair relaxer/skin lightener exposure categories. RESULTS: Of the 585 postmenopausal women included in our analysis, 80.2% reported hair relaxer use and 29.4% skin lightener use. Ever hair relaxer use was positively associated with estriol (adjusted GM 95.4 pmol/L vs. never 74.5, p value = 0.02) and 16-epiestriol (20.4 vs. 16.8, p value = 0.05) particularly among users of lye-based hair relaxers. Positive associations between scalp burns and unconjugated estrogens were observed (e.g., unconjugated estrone: 5+ scalp burns 76.9 [59.6-99.2] vs. no burns 64.0 [53.7-76.3], p-trend = 0.03). No association was observed between use of skin lighteners and circulating estrogens. SIGNIFICANCE: This study presents evidence that circulating 16-pathway estrogens (i.e., estriol and 16-epiestriol) may be increased in users of lye-based hair relaxer products. Among hair relaxer users, unconjugated estrogen levels were elevated in women with a greater number of scalp burns. IMPACT STATEMENT: In this population-based study of hair relaxer and skin lightener use among postmenopausal women in Ghana, altered estrogen metabolism was observed with hair relaxer use, particularly among women using lye-based products or with a greater number of scalp burns. In contrast, skin lightener use was not associated with differences in estrogen metabolism in this population. Continued investigation of the potential biological impact on breast cancer risk of hair relaxer use is warranted.
Authors: Britton Trabert; Louise A Brinton; Garnet L Anderson; Ruth M Pfeiffer; Roni T Falk; Howard D Strickler; Sarunas Sliesoraitis; Lewis H Kuller; Margery L Gass; Barbara J Fuhrman; Xia Xu; Nicolas Wentzensen Journal: Cancer Epidemiol Biomarkers Prev Date: 2016-02-05 Impact factor: 4.254
Authors: Louise A Brinton; Jonine D Figueroa; Daniel Ansong; Kofi M Nyarko; Seth Wiafe; Joel Yarney; Richard Biritwum; Michelle Brotzman; Jake E Thistle; Ernest Adjei; Francis Aitpillah; Florence Dedey; Lawrence Edusei; Nicholas Titiloye; Baffour Awuah; Joe Nat Clegg-Lamptey; Beatrice Wiafe-Addai; Verna Vanderpuye Journal: Carcinogenesis Date: 2018-04-05 Impact factor: 4.944
Authors: Louise A Brinton; Britton Trabert; Garnet L Anderson; Roni T Falk; Ashley S Felix; Barbara J Fuhrman; Margery L Gass; Lewis H Kuller; Ruth M Pfeiffer; Thomas E Rohan; Howard D Strickler; Xia Xu; Nicolas Wentzensen Journal: Cancer Epidemiol Biomarkers Prev Date: 2016-04-12 Impact factor: 4.254
Authors: M H Maneli; L Wiesner; C Tinguely; L M Davids; Z Spengane; P Smith; J C van Wyk; A Jardine; N P Khumalo Journal: Clin Exp Dermatol Date: 2015-07-26 Impact factor: 3.470
Authors: Patricia F Coogan; Lynn Rosenberg; Julie R Palmer; Yvette C Cozier; Yolanda M Lenzy; Kimberly A Bertrand Journal: Carcinogenesis Date: 2021-07-16 Impact factor: 4.944