Following the 2022 publication of the NIH’s 10-year epidemiological study that found an association between hair straightening products and uterine cancer, thousands of Black women filed lawsuits alleging hair product companies sold hair relaxers containing chemicals that increased their risk of developing uterine cancer — and failed to warn customers. Meanwhile, the FDA missed its own deadline this month to propose a ban on one of the harmful ingredients (formaldehyde) in hair relaxers.
This is all part of a larger story about racist beauty standards in the U.S., and the physical and emotional harms they cause to women of color.
Looking “White” to Succeed
When asked in an interview what motivated her to straighten her hair, a Black woman who is now rocking beautiful natural curls told the NBC News reporter: “I wanted a job.”
“She wanted a job!” All five women on camera laughed.
“Going to an employer with an Afro back in those days — would not have cut it.”
It still doesn’t. Having non-white features continues to hinder one’s growth in many job markets. TV personality and news anchor Julie Chen disclosed that she had blepharoplasty — double eyelid surgery — when she was a young journalist because an agent suggested that if she got the surgery, a better job market would open up for her.
The billion-dollar global blepharoplasty industry — one of the most performed plastic surgeries — was popularized in the 1950s as a tool for Korean women to assimilate to the U.S. after the Korean War. It has been categorized by ethicists as a racial surgery aimed to efface defining ethnic features. In other words, the intention of the surgery is to make Asian women look more white.
Last year, Rosie Perez, the Oscar-nominated Puerto Rican actress, opened up in an interview with Variety, saying that her agent also suggested that she surgically alter her appearance to look more white.
“She told me that if I dyed my hair blond and got a nose job, ‘I can get you more jobs.'”
Even within the same race, lighter skin tones can lead to a better chance of getting job offers and higher socioeconomic status. Racist beauty standards and colorism don’t just serve as a glass ceiling in Hollywood. They create a “sticky floor” across industries.
The Health Consequences
Racist beauty standards can cause harm far beyond financial health. They can literally kill.
The NIH study found an 80% higher risk of developing uterine cancer among women who had used hair straighteners at least once in the past year. And if they had used these products more than four times in a year, this number rose to 155%. Though these risk increases didn’t discriminate among racial and ethnic groups, Black women are disproportionally affected. Many Black women start using hair relaxers at a younger age, and often with higher prevalence and frequency. Furthermore, studies suggest the products marketed to Black women specifically are more likely to contain certain toxic chemicals.
Published in 2023, the Black Women’s Health Study found that using hair relaxers more than twice a year or for more than 5 years was associated with a 50% increased risk of uterine cancer among postmenopausal Black women (but not premenopausal Black women). Though this study and the NIH study only looked at a person’s use in the recent past, it’s not hard to imagine the cumulative carcinogenic effect of these toxins over decades, especially starting at a young age in developing bodies.
Skin bleaching offers another glimpse into the dark side of racist beauty standards. In a November 2023 Analytical Fact Sheet, the World Health Organization emphasized that the practice of skin bleaching has roots in the transatlantic slave trade and has become a public health concern in Africa, where the global lifetime prevalence of the practice is 27.1%. Even in the U.S., skin bleaching is not uncommon.
Skin bleaching products frequently contain hydroquinone, steroids, and mercury, all of which have been linked to toxic effects in humans. These include increased risks of a paradoxical abnormal darkening of the skin (ochronosis), skin cancer, mercury poisoning, kidney disease, endocrine disorders, and even life-threatening adrenal problems.
Building on the physical harm, these products often contain derogatory images and messages that deem Black skin less valuable. In other words, the worse Black women feel about themselves, the more money these industries can make. In 2022, the FDA banned the sale of hydroquinone-containing products over the counter and issued warning letters to a dozen companies that were doing so. The agency then launched the Skin Facts! Initiative to advocate for safe use of skin lightening products nationwide.
The Harms of Delayed Action
Unfortunately, this action to protect consumers from predatory companies took decades to initiate. Researchers had been raising red flags about potential mercury poisoning among African women from skin bleaching products since the 1970s, and the worrisome side effects of hydroquinone since the 1980s. Hopefully, with the NIH’s comprehensive research, it won’t take the FDA another half a century to regulate industries and protect American consumers from uterine cancer. But the missed deadline to propose a formaldehyde ban is not a reassuring sign.
To be clear, the choice to alter one’s appearance, either temporarily or permanently, is deeply personal and demands respect. A nose job in a Black woman or an eyelid surgery in an Asian woman may have nothing to do with wanting to look more “white.” Regardless of the motivation, one should not have to justify one’s personal choices. But society has a moral obligation to ensure people can make these choices freely and with full information.
What’s Needed?
The first step is to acknowledge the history and presence of racism that is pervasive and insidious in defining beauty and health. In Knight Dunlap’s 1920 book, Personal Beauty and Racial Betterment, the eugenic psychologist defined any “signs of [non-white] race” to be “general negative characters” of beauty and therefore an indication for an “inferior race.” And as recently as 2016, a study conducted by the University of Virginia demonstrated that half of participating white medical trainees endorsed at least one racist myth about Black bodies, such as “Blacks’ skin is thicker than whites’.”
Racist standards of beauty and health are more than skin-deep. So long as we are still making people of color feel less than by embracing these false beliefs — therefore leaving people no choice but to alter themselves to fit in — we are perpetuating systemic racism.
The second step is to right the historical wrong by educating the public widely and enforcing the elimination of harmful practices promptly and according to existing data. This job — in the case of potentially carcinogenic chemicals in beauty products — should fall on the regulatory bodies such as the FDA. It certainly shouldn’t be the job of those individual women suffering from cancer to inform the rest of the society by filing highly publicized lawsuits.
“If you all had known the risks associated with the chemicals found in hair straighteners/relaxers, would you still have used them?” the NBC News reporter asked the five Black women joining the suit against hair product companies.
The answer was straightforward: “No.”
And that is exactly what racist beauty standards take away from women of color: the ability to say “No.”
Mengyi (Zed) Zha, MD, is a physician in Washington and an agented nonfiction writer. Her work in progress is one on medical misogyny and racism.
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