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Geczik AM, Falk RT, Xu X, Wiafe-Addai B, Yarney J, Awuah B, Biritwum R, Vanderpuye V, Dedey F, Adjei E, Aitpillah F, Osei-Bonsu E, Oppong J, Titiloye N, Edusei L, Nyarko K, Clegg-Lamptey JN, Wiafe S, Ansong D, Ahearn TU, Figueroa J, Garcia-Closas M, Brinton LA, Trabert B. Relation of circulating estrogens with hair relaxer and skin lightener use among postmenopausal women in Ghana. J Expo Sci Environ Epidemiol 2023; 33:301-310. [PMID: 34992224 PMCID: PMC9256865 DOI: 10.1038/s41370-021-00407-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Revised: 12/09/2021] [Accepted: 12/16/2021] [Indexed: 06/14/2023]
Abstract
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.
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Affiliation(s)
- Ashley M Geczik
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Roni T Falk
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Xia Xu
- Protein Characterization Laboratory, Leidos-Frederick, Inc, Frederick National Laboratory for Cancer Research, Frederick, MD, USA
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Seth Wiafe
- Loma Linda University, School of Public Health, Loma Linda, CA, USA
| | - Daniel Ansong
- Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Thomas U Ahearn
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Jonine Figueroa
- The University of Edinburgh, Cancer Research UK Edinburgh Center, Edinburgh, UK
| | - Montserrat Garcia-Closas
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Louise A Brinton
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Britton Trabert
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA.
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