What’s the deal with keratin treatments?

By Isabel Platt
National Center for Health Research

keratin treatmentsHave you ever gotten a keratin treatment? A Brazilian Blowout? Maybe you’ve heard that they make hair silky smooth and relaxed and cost about $400. Or maybe you’ve heard that they can cause cancer. But which is true?

While it’s true that keratin treatments can make your hair look better, they are also dangerous to your health and to your stylist’s health.

What is a keratin treatment?

Keratin is a protein found in the hair, nails, and skin. In a keratin treatment, cream containing formaldehyde (or another chemical that releases formaldehyde) is brushed into the hair, which is then blown dry and flat-ironed. The combination of formaldehyde, heat, and compression all react with the keratin in the hair, making curly or wavy hair more relaxed.[end Best options for straight hair « Hair Straighteners. Environmental Working Group. 2011. Available at: http://www.ewg.org/hair-straighteners/our-report/how-to-get-straight-hair-whats-the-best-option/. Accessed August 1, 2013.]

What are the health risks of formaldehyde?

Formaldehyde is a colorless, strong-smelling gas that causes health problems when inhaled, sprayed into the eyes, or absorbed through the skin. It can irritate the eyes, nose, and throat, cause coughing and wheezing, and trigger a severe allergic reaction of the skin, eyes, and respiratory tract. Repeated exposure at high levels can also cause cancer.[end OSHA Fact Sheet: Formaldehyde. Available at: https://www.osha.gov/OshDoc/data_General_Facts/formaldehyde-factsheet.pdf. Accessed August 1, 2013.] Formaldehyde is released at more highly concentrated levels when heated, so stylists that perform keratin treatments and customers that repeatedly get them are at a greatest risk for these health problems.[end HAZARD ALERT – Hair Smoothing Products That Could Release Formaldehyde. Occupational Safety & Health Administration. Available at: https://www.osha.gov/SLTC/formaldehyde/hazard_alert.html. Accessed August 1, 2013.]

Which products and ingredients are dangerous?

The Occupational Safety & Health Administration (OSHA) and the Environmental Working Group (EWG) list Brazilian Blowout, Brasil Cacau Cadiveu, Keratin Complex Smoothing Therapy, Marcia Teixeira, Keratin Express, KeraGreen, Tahe, and R&L as dangerous keratin treatments.3 [end Brands that hide formaldehyde « Hair Straighteners. Environmental Working Group. 2011. Available at: http://www.ewg.org/hair-straighteners/our-report/hair-straighteners-that-hide-formaldehyde/. Accessed August 1, 2013.] All of these treatments contain either formaldehyde or another chemical that releases formaldehyde when heated. The following chemicals are all considered formaldehyde by OSHA: methylene glycol, formalin, methylene oxide, paraform, formic aldehyde, methanal, oxomethane, oxymethylene, or CAS Number 50-00-0.3

Isn’t a Brazilian Blowout “formaldehyde-free”? No!

Brazilian Blowout is one of the most common brands of keratin treatments. As a result of the 2010 controversy over formaldehyde in keratin treatments, Brazilian Blowout created a formula that they advertised as “formaldehyde-free.” While there is no formaldehyde listed in the ingredients, the main chemical used is methylene glycol, which releases  formaldehyde when heated, such as during the treatment process. In August 2011, the FDA issued a warning letter to Brazilian Blowout saying that the product is “misbranded” because the “formaldehyde-free” label is false or misleading, and that the formaldehyde is also too dangerous when inhaled.[end Warning Letters – Brazilian Blowout 8/22/11. Food and Drug Administration. 2011. Available at: http://www.fda.gov/ICECI/EnforcementActions/WarningLetters/ucm270809.htm. Accessed August 1, 2013.] Brazilian Blowout is actually one of the most dangerous treatments because almost 12% of the product is formaldehyde, which is three times as much as most other keratin treatments.4

In response to the FDA’s letter, Brazilian Blowout changed the labeling on their original formula to warn consumers about health risks, and created an alternative product called Brazilian Blowout ZERO+, which does not contain any formaldehyde. But according to a company representative, the new product does not leave the hair as smooth as the original.1

How do we protect stylists and ourselves?

Because stylists are at greatest risk for formaldehyde exposure, OSHA issued a set of guidelines to protect their health. If workers have been exposed to formaldehyde above a set amount, their health must be monitored and they must be reassigned to a job with significantly less exposure. The salon is required to install ventilation systems, use lower heat settings on blow dryers, and monitor formaldehyde levels at all times using a Consumer Sampling and Analysis Kit.[end An update on formaldehyde. Available at: http://www.cpsc.gov/PageFiles/121919/AN%20UPDATE%20ON%20FORMALDEHYDE%20final%200113.pdf. Accessed August 1, 2013.] Other workers should also be trained annually to safely handle chemicals and be provided personal protective equipment, including gloves, aprons, and eyewash stations.3

If you want to protect workers from the health risks of formaldehyde, don’t get a keratin treatment. If you are thinking of getting regular keratin treatments anyway (Brazilian Blowout recommends getting treatments every 12 weeks), remember that you also put yourself at greater risk for irritation, for allergic reactions, and even for cancer.

We agree with other experts who say that the FDA should prohibit the use of formaldehyde in hair straightening products, and that the Federal Trade Commission should crack down on false advertising by products labeled as “formaldehyde-free.”[end Executive Summary « Hair Straighteners. Environmental Working Group. 2011. Available at: http://www.ewg.org/hair-straighteners/our-report/executive-summary/. Accessed August 1, 2013.] Try to manage your frizzy hair without formaldehyde by only using a blow dryer and flat iron, or, like Carrie Bradshaw, just let your hair fly wild.

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All articles on our website have been approved by Dr. Diana Zuckerman and other senior staff.

This article was updated in 2015.