Hair Relaxers and Fibroids?- An Update from Dr. Wise

I agree with those of you that mentioned that correlation is not the same as causality, and agree with Sophie when she said that it’s at least worth a closer look.

According to the study, of the Black women that were diagnosed with having uterine fibroids, a disproportionate amount of those women have used relaxers, a fact that raises the hypothesis that relaxer use may be correlated with increased risk of fibroid development. One factor that complicates this hypothesis is that while black women are more likely to develop uterine fibrosis, black women in general are also more likely to use relaxers. The investigators attempted to control for this, along with many other factors in the study. For instance, if it was the case that they only had one binary measure of relaxer use (use/non-use), then those results would be fairly thin. However, according to the abstract, they analyzed relaxer use, frequency of use, duration of use, and frequency of scalp burns. So the study suggests that use, in general, is correlated with fibroid development; the more you use it, the more frequently you use it, the longer you have used it, and the more often your scalp is burned during use, the more likely you are to develop uterine fibroids. This alone is disturbing.

I’d love to speak with the investigators… if it turns out after more research that there is a causal relationship between relaxer use and fibroid development then we could have a family conversation about whether or not we should change our behavior (refusing to use or demanding better or safer products, etc). No matter what, we certainly shouldn’t demonize Black women for relaxer use…this is a health issue that we should be able to discuss freely and safely here. It’s a family health issue like any other. Like, if momma develops diabetes, we don’t get together and argue and yell at her about all the good soul food meals she’s cooked (queue Mekhi Phifer and Nia Long), instead, we develop a strategy about how to best move forward and save our family. We’re all in this together and must, as a community work to keep ourselves healthy. We can’t make a choice about our genes, nor escape our Blackness, but we can, in an open forum such as this, figure out how best to use the information that we have to make healthy, informed decisions, whether it’s the food we eat, the things we say to each other, how we feel about ourselves, or the products we put on our body.

*My friend and intern Jon tracked down the article and after reading it, Hubby rendered his opinion-

Strengths of the Study-

• Careful sample selection and panel study format (these are the same people being followed for a period of time and reporting relaxer use prior to fibroid development)

• Many control variables, the most important of which are time-varying (controlled for throughout the duration of the study)

• Relaxer use is disaggregated into 4 categories, 3 of which are independently confirmed.

• Significance levels are consistent and strong

• Correlation is not causation, BUT, the authors test the causal mechanism directly. They’re not just attacking relaxed black women, but rather have a logic as to why they think relaxers are causing fibroids. The authors believe, but cannot prove, that relaxers contain Phthalates. They can’t prove it because, like our dietary supplements, manufacturers who make relaxers are not subject to regulation by the FDA and don’t have to report what’s inside of these products. It has been demonstrated elsewhere, though not conclusively, that phthalates are associated with uterine fibroid development. However, they have a strong suspicion because, most of these products report having ‘fragrance’ in them and we know that 100% of fragrance contains phthalates. In short, the authors think that these phthalates are introduced into the body when the chemicals burn the scalp. One of the ‘relaxer’ variables, measures the number of burns experienced by users and it turns out more burns are associated with a higher likelihood of fibroids.

• More Black women use relaxers than not, BUT, the authors test a sub-group of women who have been relaxing for ten years or more. Among these women (fried, dyed and laid to the side types), those who relax more often per year (7 or more times) develop uterine fibroids more often.

Limitations of the study-

• Some people dropped out of the study… approximately 3000 people were lost during the course of the 10 year study.

• There was no distinction made for the type of relaxer used. But, many Black women also didn’t know what type of relaxer they were using anyway, so this was probably adequately controlled for through randomization.

• Black women with higher levels of European ancestry relax less. As a result, technically, the study can not distinguish the effect of being African from that of relaxing more. So, it may be the case that Black women are getting fibroids more often because they’re Black, not because they relax.

• This is only one study… there is no larger body of work to compare it to.
  

Hubby asks, why were so many people willing to either accept or dismiss the study without further information? Whether it’s true or not, would it make you feel a certain way?