Elevated formaldehyde concentration in “Brazilian keratin type” hair-straightening products: A cross-sectional study

Micronuclei and other nuclear anomalies in exfoliated urothelial cells and urinary 8-hydroxy-deoxyguanosine levels among Turkish hairdressers

Hairdressers are constantly occupationally exposed to many chemicals have the potential to cause allergies and carcinogenic effects, act as skin and eye irritants and induce oxidative stress and DNA damage. This study aimed to evaluate occupation-induced genotoxicity based on the presence of micronucleus (MN) and other nuclear anomalies in urothelial cells and measure oxidative DNA damage based on the 8-hydroxy-2'-deoxyguanosine level in the urine of Turkish hairdressers. Originality of this study comes from that there was no study on MN and other nuclear anomalies frequencies and oxidative DNA damage in urine samples of hairdressers in the literature. The mean±standard deviation frequency (‰) of micronucleated (MNed) cells was higher in the hairdresser group (n=56) (4.81±7.87, p<0.001) than in the control group (n=56) (0.93±1.85). Nuclear buds were not observed in either group. While the frequency of basal cells was higher in the control group (446.6±106.21) than in the hairdresser group (367.78±101.51, p<0.001), the frequency of binuclear, karyolytic, pycnotic and karyorrhectic cells were higher in the hairdresser group (0.41±0.80, p<0.001; 438.02±118.27, p<0.001; 0.43±0.76, p<0.001; and 47.27±28.40, p<0.001) than in the control group (0.04±0.27, 358.57±95.71, 0.05±0.23 and 24.41±14.50). Condensed chromatins were observed only in the hairdresser group. Specific gravity adjusted 8-hydroxy-2'-deoxyguanosine level was statistically lower in the hairdresser group (908.21±403.25 ng/mL-SG) compared to the control group (1003.09±327.09 ng/mL-SG) (p=0.024). No significant correlation was found between the 8-hydroxy-2'-deoxyguanosine level and the frequency MN. The amount of formaldehyde released during Brazilian keratin treatment was higher than the American Conference of Governmental Industrial Hygienists -Threshold Limit Value (ACGIH-TLV; 0.1 ppm). Similarly, the amount of ethyl acetate released in three salons was above the recommended limit (400 ppm). These findings suggest that hairdressers have an increased risk of genotoxicity and cytotoxicity owing to occupational exposure, regardless of age, working hours, smoking and alcohol consumption.

Afro-Ethnic Hairstyling Trends, Risks, and Recommendations

Hairstyling trends among Black women fluctuate with social, cultural, and environmental pressures. Dermatologists should be aware of current trends and their associated risks in order to provide the best care to this population. In order to summarize the updated trends and associated health risks for the most common hairstyles worn by Black women, a literature review was performed. PubMed and EMBASE were used to identify articles related to hair styling practices, studies on the effects or risks of various styling practices, and magazine articles citing current styling trends among women of African descent. All hairstyles were found to have associated health risks; however, natural styles had the fewest adverse associations of all styles reviewed. Central Centrifugal Cicatricial Alopecia (CCCA) is the most cited hair disorder in this population, possibly linked to both chemical relaxants and traction styles. Additional studies are needed to further establish causality between these styles and CCCA. Additionally, while acceptance of natural hairstyles is on the rise, there is more work to be done throughout society to help protect and encourage women who choose to wear Afrocentric styles. Dermatologists should be well versed in these hairstyles and ready to lend appropriate advice to patients when it is requested.

Psoriasiform skin reaction due to Brazilian keratin treatment: A clinical-dermatoscopic study of 43 patients

Introduction:

Hair straightening products like the Brazilian Keratin Treatment (BKT) contain high concentrations of formaldehyde, and its use is associated with adverse effects. In 2016, seven cases of eczema-like psoriasiform skin reaction secondary to BKT were described for the first time. We aim to investigate the clinical characteristics and dermatoscopic findings of patients with psoriasiform skin reactions due to BKT.

Materials and Methods:

A cross-sectional study was performed from October 2017 to June 2020. Patients who developed erythema and scales on the scalp following the use of BKT were included. Age, sex, number of BKTs, time elapsed between BKT and the skin reaction, pull test, and dermatoscopic findings were investigated. Descriptive and inferential statistics were used.

Results:

We found 43 patients with a mean age of 35 ± 10 years, predominantly females in 42 (98%) cases. The mean number of BKTs was 2 ± 2. The mean length of time elapsed to present the reaction was 12 ± 17 months and this was related to the number of BKTs (P = 0.01). The pull test was positive in 37 (86%) patients. The most frequent dermatoscopic findings were perifollicular scales in 42 (98%), red patches in 35 (81%), and peripilar desquamation resembling the outer skin of an onion bulb in 32 (74%).

Conclusion:

Hair straightening products are widely used and the psoriasiform skin reaction that develops afterward might be underdiagnosed. It is important to investigate the background of BKT in conjunction with the clinical and dermatoscopic findings suggestive of this cutaneous reaction.

Personal-Care Cosmetic Practices in Pakistan: Current Perspectives and Management

To look superior and acceptable in society, people from all over the world use various types of cosmetic products to enhance or alter their facial appearance and body texture. In recent times, an exponential surge in cosmetic use has been observed in Pakistan, and hence spending money on personal-care products is high. However, there are many reported facts about high loads of lead, mercury, copper, and others hazardous and cancerous elements in local Pakistani cosmetic brands. Consumers of these brands are at high risk of many clinical issues, including cancer. As such, it is a necessity to make people aware of the devastating harmful effects related to cosmetic use. The aim of this study was to provide information for stakeholders and raise awareness in the general public about the use of these local unauthorized personal-care cosmetic products, along with government strategies to stop this cosmetic blight on human health.

Risk factors for frontal fibrosing alopecia: A case-control study in a multiracial population

BACKGROUND

Frontal fibrosing alopecia (FFA) is a chronic cicatricial alopecia with unknown etiology and a worldwide rising incidence.

OBJECTIVE

The objective of this study was to evaluate the association of FFA with demographic and exposure factors in a Brazilian multiracial population.

METHODS

A multicenter case-control study was conducted in 11 referral centers throughout Brazil. The study was a case-control study that prospectively recruited 902 participants (451 patients with FFA and 451 sex-matched control individuals). Study participants completed a thorough questionnaire comprising variables grouped as baseline demographics, environmental exposure, diet, hormonal factors, allergies, and hair and skin care.

RESULTS

When adjusted by sex, age, menopause, and skin color, FFA was associated with hair straightening with formalin (odds ratio [OR], 3.18), use of ordinary (nondermatologic) facial soap (OR, 2.09) and facial moisturizer (OR, 1.99), thyroid disorders (OR, 1.69), and rosacea (OR, 2.08). Smokers (OR, 0.33) and users of antiresidue/clarifying shampoo (OR, 0.35) presented a negative association with FFA. There was no association with the use of sunscreen.

LIMITATIONS

Recall bias.

CONCLUSIONS

The association with moisturizers, ordinary facial soap, and hair straightening with formalin and the negative association with antiresidue/clarifying shampoo reinforce the possibility of an exogenous particle triggering FFA.

Polymeric Hydrogel Coating for Modulating the Shape of Keratin Fiber

Hydrogel coating was explored to modulate the shape of keratin hair fiber. The motivation was the development of an eco-friendly methodology with non-toxic chemicals to modulate keratin fiber. Polymeric hydrogel of acrylic acid and N-N-dimethylacrylamide was prepared by free-radical polymerization in aqueous solution, using nano-alumina particles as crosslinker and potassium persulfate as an initiator. Physico-chemical properties of the hydrogel was investigated by Fourier transformer infrared spectrum (FTIR), thermal analysis and swelling ratio behavior. After hydrogel coating, morphological modification was observed from straight to curly hair effect. The influence of hydrogel coating on hair fiber was evaluated by perming efficiency supported by X-ray diffraction and morphological characterization (SEM and AFM). The durability of hydrogel coating was tested until four wash processes maintaining around 65% the new configuration of the hair fiber.

Cosmetics and Cancer: Adverse Event Reports Submitted to the Food and Drug Administration

There have been numerous controversies surrounding cosmetic products and increased cancer risk. Such controversies include associations between parabens and breast cancer, hair dyes and hematologic malignancies, and talc powders and ovarian cancer. Despite the prominent media coverage and numerous scientific investigations, the majority of these associations currently lack conclusive evidence. In 2016, the US Food and Drug Administration (FDA) made publically available all adverse event reports in Center for Food Safety and Applied Nutrition's Adverse Event Reporting System (CAERS), which includes complaints related to cosmetic products. We mined CAERS for cancer-related reports attributed to cosmetics. Between 2004 and 2017, cancer-related reports caused by cosmetics represented 41% of all adverse events related to cosmetics. This yielded 4427 individual reports of cancer related to a cosmetic product. Of these reports, the FDA redacted the specific product names in 95% of cancer-related reports under the Freedom of Information Act exemptions, most likely due to ongoing legal proceedings. For redacted reports, ovarian cancer reports dominated (n = 3992, 90%), followed by mesothelioma (n = 92, 2%) and malignant neoplasm unspecified (n = 46, 1%). For nonredacted reports, or those reports whose product names were not withheld (n = 218), 70% were related to ovarian cancer attributed to talc powders, followed by skin cancer (11%) and breast cancer (5%) attributed to topical moisturizers. Currently, CAERS is of limited utility, with the available data having been subjected to significant reporter bias and a lack of supportive information such as demographic data, medical history, or concomitant product use. Although the system has promise for safeguarding public health, the future utility of the database requires broader reporting participation and more complete reporting, paired with parallel investments in regulatory science and improved molecular methods.

Asthma from hair straightening treatment containing formaldehyde: Two cases and a review of the literature

We report two cases of formaldehyde-containing hair straighteners causing new onset asthma. Formaldehyde has been reported to cause asthma in other settings. The purpose of this article is to examine two cases of asthma in hairdressers exposed to hair smoothing products and to review the relevant literature on formaldehyde exposure and asthma. The results indicated that both subjects developed asthma from repeated occupational exposure to formaldehyde during hair treatments. Both subjects became unable to tolerate hair straightening activity in their vicinity. Formaldehyde-containing hair smoothing products are sources of exposure, and the risk of developing asthma is high in salon settings where hair straightening is performed using formaldehyde.

A novel mass spectrometric method for formaldehyde in children's personal-care products and water via derivatization with acetylacetone

RATIONALE

New legislation in the state of Minnesota prohibits the sale of children's personal-care products (PCPs) that contain more than 500 ng/mg formaldehyde. Previous attempts to quantify formaldehyde in PCPs use nonspecific derivatization procedures that employ harsh reagents and/or nonspecific detection. Derivatization of formaldehyde by acetylacetone occurs under mild conditions and is specific for formaldehyde but it has not been investigated using high-performance liquid chromatography/tandem mass-spectrometry (HPLC/MS/MS).

METHODS

To determine formaldehyde, PCPs were dissolved and then interferences were minimized by graphitized-carbon solid-phase extraction. Formaldehyde was derivatized to 3,5-diacetyl-1,4-dihydrolutidine (DDL) using an acetylacetone solution. Post-derivatization, samples were diluted and analyzed by HPLC/MS/MS. Quantification was performed by isotopic dilution. Product-ion spectra were acquired for DDL and D₁₂ -DDL. The mass shifts between the two product-ion spectra were used to assign fragment structures. To confirm molecular formulas, high-resolution accurate-mass analysis of the DDL product ions was performed by quadrupole time-of-flight MS.

RESULTS

Structures were proposed for all product ions of DDL above 10% relative intensity. Method accuracy ranged between 96-104% for all matrices at all concentrations tested. Method precision was less than 4% relative standard deviation. The reporting limit was 10 ng/mg in PCPs and 100 μg/L in water. Twenty children's PCPs were tested to demonstrate the method and formaldehyde was reported in five from 23-1500 ng/mg. Of those five, two samples contained formaldehyde above the Minnesota regulatory limit.

CONCLUSIONS

The developed method allows for the accurate quantification of formaldehyde in PCPs at levels below those required by a new regulation on children's products in Minnesota. The method includes a derivatization procedure that is newly adapted to HPLC/MS/MS; therefore, structures were proposed for the product ions of the derivative (DDL). Copyright © 2017 John Wiley & Sons, Ltd.

Green and Sustainable Technology for High-Efficiency and Low-Damage Manipulation of Densely Crosslinked Proteins

A two-step technology using nontoxic and eco-friendly chemicals is developed for the durable setting of densely/highly crosslinked proteins, such as wool and hair. Currently, most technologies for morphological modification are effective only for materials from non-highly-crosslinked proteins and cellulose. Before their morphological change, only water is needed to interrupt hydrogen bonds and ionic linkages, which stabilize the relative positions of molecules in non-highly-crosslinked proteins and cellulose. However, highly crosslinked proteins contain disulfide crosslinks, which are insusceptible to water. Thus, the controlled cleavage of disulfide bonds is required for creating new morphologies of highly crosslinked protein materials, such as hair and wool. Herein, cysteine and citric acid (CA) were used for the two-step setting of highly crosslinked proteins. This recipe showed better morphological change and less mechanical loss than commercial hair styling products. A reaction between CA and keratin was proposed, and verified via NMR and Raman spectra and titration. This technology could be a prospective alternative to achieve durable hair setting, anticrease finishing of wool textiles, and other durable morphological changes needed for highly crosslinked proteins.

Changing the shape of hair with keratin peptides

Here we propose a solution which will replace harsh reducing agents at alkaline pH by peptide formulations acting at neutral pH to change hair shape through the re-conformation of disulphide bonds.

Hair Breakage in Patients of African Descent: Role of Dermoscopy

Dermoscopy represents a useful technique for the diagnosis and follow-up of hair and scalp disorders. To date, little has been published regarding dermoscopy findings of hair disorders in patients of African descent. This article illustrates how dermoscopy allows fast diagnosis of hair breakage due to intrinsic factors and chemical damage in African descent patients.

Developing effective worker health and safety training materials: hazard awareness, identification, recognition, and control for the salon industry

OBJECTIVE

In addition to formaldehyde, workers in salons can be exposed to other chemical irritants, sensitizers, carcinogens, reproductive hazards, infectious agents, ergonomic, and other physical hazards. Worker health and safety training is challenging because of current product labeling practices and the myriad of hazards portending risk for a wide variety of health effects.

METHODS

Through a Susan B. Harwood Targeted Topic Training grant from the Occupational Safety and Health Administration and assistance from salon development and training partners, we developed, delivered, and validated a health and safety training program using an iterative five-pronged approach.

RESULTS

The training was well received and resulted in knowledge gain, improved workplace safety practices, and increased communication about health and safety.

CONCLUSIONS

These training materials are available for download from the Occupational Safety and Health Administration's Susan B. Harwood Training Grant Program Web site.

Eczema-Like Psoriasiform Skin Reaction due to Brazilian Keratin Treatment

The use of formaldehyde and formaldehyde releasers in hair-straightening formulations started in Rio de Janeiro in 2003. The technique is known as BKT, Brazilian keratin treatment. The aim of this study was to analyze the types of skin reactions presented by patients due to BKT. We describe 7 patients with severe erythema and scurf on the scalp which developed shortly after BKT. The lesions were eczema-like psoriasiform, located mainly on the scalp. Some patients also developed eczema-like lesions and pustules on the face, neck, upper arms, and upper trunk. Dermatoscopic findings included erythema, perifollicular and interfollicular scurf. The peripilar desquamation resembled the outer skin of an onion bulb. Scalp biopsies revealed psoriasiform and spongiotic psoriasiform patterns, one of them similar to anti-TNFα biologic drug psoriasiform alopecia. The possible consequences of the absorption of formaldehyde by hairdressers or clients are still to be verified by the scientific community; however, the skin and scalp reactions observed in our cases suggest a drug reaction phenomenon and not only eczemas of irritant or allergic origin.

Clinical and anthropological perspectives on chemical relaxing of afro-textured hair

The culturally engrained practice of 'relaxing' afro-textured hair has been linked with hair and scalp disorders. Herein, we discuss the evolution of human hair types, focusing in particular on afro-textured hair. We explore the biological features of this hair type, and discuss the different methods employed to straighten afro-textured hair, focusing in particular on chemical straightening. We also examine clinical, anthropological, and psychological issues associated with this latter practice. Examples of common scalp pathologies associated with chronic hair relaxing, such as alopecia, hair breakage, caustic burns and irritant contact dermatitis, are also highlighted. The data presented herein should enable clinicians to engage in culturally appropriate discussions with their patients about issues of appearance and conformity.

Hair cosmetics: an overview

Hair cosmetics are an important tool that helps to increase patient's adhesion to alopecia and scalp treatments. This article reviews the formulations and the mode of action of hair cosmetics: Shampoos, conditioners, hair straightening products, hair dyes and henna; regarding their prescription and safetiness. The dermatologist's knowledge of hair care products, their use, and their possible side effects can extend to an understanding of cosmetic resources and help dermatologists to better treat hair and scalp conditions according to the diversity of hair types and ethnicity.