TY - JOUR
T1 - Relation of circulating estrogens with hair relaxer and skin lightener use among postmenopausal women in Ghana
AU - Geczik, Ashley M.
AU - Falk, Roni T.
AU - Xu, Xia
AU - Wiafe-Addai, Beatrice
AU - Yarney, Joel
AU - Awuah, Baffour
AU - Biritwum, Richard
AU - Vanderpuye, Verna
AU - Dedey, Florence
AU - Adjei, Ernest
AU - Aitpillah, Francis
AU - Osei-Bonsu, Ernest
AU - Oppong, Joseph
AU - Titiloye, Nicholas
AU - Edusei, Lawrence
AU - Nyarko, Kofi
AU - Clegg-Lamptey, Joe Nat
AU - Wiafe, Seth
AU - Ansong, Daniel
AU - Ahearn, Thomas U.
AU - Figueroa, Jonine
AU - Garcia-Closas, Montserrat
AU - Brinton, Louise A.
AU - Trabert, Britton
N1 - Publisher Copyright:
© 2022, This is a U.S. government work and not under copyright protection in the U.S.; foreign copyright protection may apply.
PY - 2023/3
Y1 - 2023/3
N2 - 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.
AB - 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.
KW - Endogenous estrogens
KW - Ghana
KW - Hair relaxer use
KW - Postmenopausal women
KW - Skin lightener use
UR - http://www.scopus.com/inward/record.url?scp=85122319993&partnerID=8YFLogxK
U2 - 10.1038/s41370-021-00407-4
DO - 10.1038/s41370-021-00407-4
M3 - Article
C2 - 34992224
AN - SCOPUS:85122319993
SN - 1559-0631
VL - 33
SP - 301
EP - 310
JO - Journal of exposure science & environmental epidemiology
JF - Journal of exposure science & environmental epidemiology
IS - 2
ER -
