hair dye

For most people concerns about environmental exposures and cancer risks are abstract, something that other people worry about. For this reader the connection between hair dye and bladder cancer is personal.

Q. I have T1 bladder cancer and am being treated with BCG immunotherapy.

I dye my hair dark brown every four weeks, as I have been for 20 years. I heard that hair dye is linked to bladder cancer. Should I stop using color?

A. Your question is surprisingly difficult to answer. For decades epidemiologists have been debating whether hair dye increases the risk of cancer. The problem is that studies are often contradictory.

Epidemiological Research:

One large meta-analysis (Annals of Epidemiology, Feb., 2014) concluded that there was no excess bladder cancer risk from using hair dye.

The Italian authors noted:

“Despite considerable research, the issue of hair dyes and bladder cancer is still open to discussion…Compared with no use, no association was observed for the highest categories of duration of use and lifetime frequency of use of both any type of dyes and permanent dyes. The pooled RR [relative risk] from four studies reporting results for use of dark-colored dyes was 1.29. This meta-analysis allows to definitively exclude any appreciable excess risk of bladder cancer among personal hair dye users.”

The authors characterize the RR (relative risk) of dark-colored hair dyes as hardly “appreciable” though 1.29 represents a 29% increased risk in those four grouped studies. That said, we accept their conclusion that hair dye use by consumers appears not to be related to bladder cancer.

What About Hairdressers?

Hairdressers, on the other hand, had an increased risk for bladder cancer attributed to their exposure to hair dyes (Occupational and Environmental Medicine, May, 2010).

The authors concluded:

“All our results taken into account, we conclude that there is good evidence for an increased risk of bladder cancer among hairdressers, in particular for hairdressers in jobs held >10 years.

“We included 42 studies in our meta-analysis: no indication of publication bias or heterogeneity was found. We found SSRs [summary risk ratios] in the range from 1.25 to 1.70 which were positively associated with duration of employment, rendering a causal association between bladder cancer and job held as a hairdresser likely.”

People’s Pharmacy Note:

A risk ratio (RR or relative risk) of 1.25 to 1.70 represents a 25% to 70% increased risk of bladder cancer. Note that the relative risk of 1.25 (on the low end) in hairdressers is not all that different from the 1.29 RR found in the epidemiology study from Italy.

Finnish Epidemiology Research:

A case-control study of Finnish women reported that the use of hair dye increased the risk for breast cancer (PLOS One, Aug. 11, 2015). The authors discovered:

“After adjusting for potential confounders, the odds of breast cancer increased by 23% (OR [odds ratio]: 1.23) among women who used hair dyes compared to those who did not. In women born before 1950 an increase of 28% was noted (OR: 1.28).”

Their conclusions:

“Our results suggest that use of hair dyes is associated with breast cancer incidence. The impact on public health may be substantial due to vast popularity of hair coloring in modern societies…

“Risk assessment in cosmetic industry is still largely self-regulated and lacks independent evaluation. Safety reports are often provided by the stakeholders of the cosmetic industry. Considering the popularity of hair coloring in the modern societies, the results obtained in our study are worrying…

“Our results suggest that increasingly popular use of hair coloring products may be substantial in the etiology of new breast cancer cases…”

More Epidemiology:

A study published in the journal Cancer Causes Control (online, Jan. 13, 2016) concluded:

“Our results confirm the potential carcinogenic effect of prolonged hair dye use observed in previous investigations. The excess risk could be explained by exposure to a higher concentration of toxic compounds in hair products used in the past.”

These investigators were considering leukemias and lymphomas.

Potential Explanations of a Risk Mechanism:

Two recent studies suggest mechanisms for how dark hair dyes alter cells to make them more prone to cancerous growth (Environmental Toxicology, Jan. 19, 2016). According to the authors of one study (Food Chemistry and Toxicology, Dec., 2015):

“These results point to the hazard of the hair dye exposure to human health.”

People’s Pharmacy Take on Hair Dyes:

Despite the recent research on mechanisms and the epidemiology from Finland and other countries, we would have to say that the risk, if it exists, appears to be relatively small. Nevertheless, this is a controversy that seemingly will not go away. Regulation of the cosmetics industry is somewhat confusing. As authors of one of the studies above described, risk assessment is largely self regulated by the industry. There remains significant confusion about the actual hazards of hair dye.

As for our reader with bladder cancer, our advice is as follows:

Given your diagnosis, you may wish to discuss your concerns with your oncologist and get another opinion from a doctor who is directly involved in your care.

We would appreciate feedback from our visitors. What are you thoughts on the controversial question of hair dye and cancer? Is this a tempest is a teapot? If there were a proven risk would you change your behavior? We only wish there were clear cut answers to guide us.

Please vote on this article at the top of the page.

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  1. Rose

    I started coloring my hair as it began to turn gray, probably in my forties, because I didn’t want to look older. At age 75 , I finally vowed that I was not going to put “that poison” onto my scalp any more!!! I always suspected the hair dye was toxic, because of the strong smell and how it burned my skin. But like so many of the women who commented, I never read or heard OFFICIALLY how really harmful coloring your hair is.. And now we know and I agree with an early suggestion that you (People’s Pharmacy folks) should not hedge around and just say the truth …even if you only say that the chemicals are absorbed into your scalp and that is a dangerous practice. People trust you .

    So , there is enough evidence now to act in our own self interest. I wish I had been more protective of my own health.

  2. Mame
    North Carolina

    Thank you for this conversation. I am struggling with this decision. My hairdresser gave me reasons why all the alternative colorings, including henna, can damage hair or have other unsatisfactory results. The Environmental Working Group’s website warns to be cautious of haircolor that claims not to include harmful chemicals. I appreciate the light that The People’s Pharmacy shines on such topics. Thank you.

  3. JAS

    How do researchers factor in other carcinogens into the studies? Like other possible toxic substances for personal use, like hairsprays, conditioners, shiners, body lotions, antiperspirants, cleansers, etc… If hairdressers have been using gloves while dying hair, how does the toxic sustances get into the body ?

  4. Taylor

    Great article to think about. I have read and heard from second hand stories that Saccharine causes bladder cancer. The only personal knowledge I have is that I had an aunt who used that product from the time it became popular (in the 50’s) until she died of other causes but one of her diagnoses was bladder cancer.

  5. A.X.

    It doesn’t seem worth it to risk it. Is the benefit really that important? My grandmother always said that she had EARNED every last gray hair, and many of them were souvenirs of my father’s childhood, so she refused to dye her hair. I like her attitude.

  6. Amy Ferrell
    Sarasota, Florida

    Because my mother had breast cancer, I have chosen not to color my hair nor to use deodorants (or baking powder) with aluminum. Many of my friends also mid-70’s have made the same decisions. We also avoid sodas and most sugar and we exercise regularly.
    My thought about the hairdressers’ vulnerability is that they are using full-strength chemicals daily or at least frequently and breathing the fumes in the salon, while the clients are only exposed to the full-strength chemicals on their scalp and in the air about once a month. That could certainly make a difference.

  7. Chris

    I have never used hair dye, but have perms approximately 3 times a year and have wondered whether these chemicals are harmful. Any ideas?

  8. BARRY

    Indeed, this is an old controversy. The RR for casual hair-dye users is small, while the RR for hairdressers is significant. But I wonder, regarding the person with T1 bladder cancer: Is – or was – she/he a smoker? The carcinogens in cigarette smoke end up in the urinary bladder, and bladder cancer is much more common in smokers than in never-smokers. Smoking is much more dangerous than using hair dye!

  9. Carol

    I have dyed my hair dark brown for years but I’m starting to get concerned. So much research coming out about the harmful effects of all sorts of chemicals. Common sense tells me that to sit for 30-45 minutes every 3-4 weeks with hair dye on my scalp could be harmful. I have recently been diagnosed with AMD and, in some literature it says that toxins could be one of the causes. I also have concerns about going to bed with eye cream and face cream on and getting it on my pillowcase, etc. More research needs to be done.
    Of course, the hairdressers would want to be in denial and also the cosmetics industry.
    Too many only want to make money regardless of health hazards. Please continue your investigation. We need to know the truth.

  10. Jake

    Don’t help the industry by writing the usual “we just don’t know” posts. ASSUME they’re lying and write accordingly. I used hair dye maybe 5 years more than I would have if somebody had written a convincing argument for not taking the chance. This kind of article, perversely, just gives people the excuse to carry on.

  11. Celia

    There is a substitute for conventional hair dyes. It is henna. I have auburn hair, and reputable suppliers can help you sort through the various plant dyes that can create brown to black hair. I have used the following source for several years and can attest to their stringent quality control.

  12. Tom Clayton, MD

    The article brings out two important points and it is important to keep these concepts separate. First, it takes a long time for cancer of the bladder to develop, meaning repeated exposure over a long period of time. Second is that the the more toxic components of hair dyes used in the past are no longer used. This includes the greater exposure of hairdressers to these toxic chemicals over time. They were repeatedly exposed to fumes that entered the body through the lungs and the skin and were eventually excreted in the urine, hence exposure to the cells lining the ureters and bladder. This is what is meant by aromatic amines, see:

    This article also says the following about prevention: “Hairdressers should protect themselves from dermal uptake by using protective gloves, and perform work where gloves cannot easily be worn (like cutting the hair) before dyeing.” Everyone at home should follow these principles as well. You can never be too safe.

    To the woman with the diagnosis of bladder cancer: Hair is dead tissue; it is not vascularized or innervated (nerves). As long as the hair dye is used properly (as above), there should be minimal to no absorption into the body of the person using it. This has no bearing on your existing bladder cancer so it is my opinion that you should be able to use current hair dyes to look the way that you want. It will not make your bladder cancer worse or in any way adversely affect the treatment. All of this applies to avoiding future events, if any.

  13. Mary
    San Antonio, TX

    I have been covering my grey with a light blonde color for many years. This research seems to speak only to dark colors. Is there less of a safety risk with lighter colors? I use a combination of 8 and 9.

  14. HisGrace
    Houston, TX

    My Mother dyed her hair dark brown for many, many years, and passed away from cancer of the liver when she was only 68. Of course there’s nothing definitive that connects the two, but I’m not willing to take that gamble.

  15. Barbara
    New Mexico

    I have severe multiple chemical sensitivity. In NM we have an MCS Task Force, of which I am a member. We often get phone calls from people who have become chemically sensitive. Some years ago, I made a home visit to a woman who had dyed her hair, in order to present herself better, for a job interview. That seems to have triggered her severe reaction. She started reacting to lots of other things, like cleaning products, perfume, and so on. For a small percentage of people, one such event can change there lives dramatically.

  16. Mari

    I’d like to start coloring my hair, but I’m a bit scared. Are there any safe or safer hair dyes? Does it make a difference if a product is ammonia-free or PPD-free? Are the types sold in health food stores safer than the ones used in salons? There’s always so much “food-for-thought” on this site, which is wonderful!

    • MJ

      Some people use henna to achieve brown or red colors. People who use it typically get it from an Indian grocery or online. The stuff in the “health food” stores may not be as effective. You can do a web search to find out more. But if you are looking for lighter colors, I have not personally heard of any alternative.

  17. BarbP

    We are discovering daily how everything we do effects our lives. Information on aromatherapy would suggest that inhaling hair color fumes, over time, could trigger something. Topical application of dye may have an effect if it is absorbed thru the skin. After 20+ years of coloring my hair, I opted to take advantage of the new look and grew it out. I have less stress over the roots showing and am enjoying many compliments on the natural color and style.

  18. Barbara

    M.D. Anderson Cancer Center in Houston, TX, advises cancer patients to stop coloring their hair. My cousin had a stem cell transplant at M.D. Anderson one year ago for MDS leukemia, and one of the first things they told her when she became a patient was to stop coloring her hair. M.D. Anderson has seen tens of thousands of cancer patient, and their records show that hair dye increases cancer risks. The don’ts are: don’t smoke, don’t dye your hair, don’t eat sugar.

    Do exercise, eat mostly vegetables and fruit, preferably organic, and eat very little, if any, commercial feed-lot raised meat and commercially prepared chicken.

    If you eat chicken and meat, buy from a local farmer who raises the animals without chemicals, corn or any GMO feed. No farm-raised seafood. Wild salmon, trout and cod are considered safe to eat once a week. They advise no fried food, no processed food. Eat natural food that comes out of the ground, not out of a box.

    I was a patient at M.D. Anderson, and they gave me the same advice ten years ago. I follow their advice, and I have stayed in remission. They also told me to read and follow a book titled “Anti-Cancer, A New Way of Life” by David Servan-Schreiber, MD, PhD. Dr. John Mendelsohn, president of M.D. Anderson Cancer Center said the book “Fills an important gap in our knowledge of how patients can contribute to their own care …I recommend this book to anyone interested in preventive medicine and integrative, complementary approaches to patient care.”

    This inspiring, common sense book is easy to follow, it is truly a new way of life.

  19. Barbara

    Spoke with a British Gal who informed me that well in Britain, the Hairdressers where very concerned about **black** hair dyes….she stated they had stories of cancer from the **black** hair dyes?

    We all need to advocate and educate for ourselves with help and in depth knowledge from Folks like yourself….

    Thank you People’s Pharmacy for all you do….( I am also waiting for a reply on the Cinnamon article)….Thank you in advance for your time and consideration…….Enjoy your day…..

  20. Jen

    I am a Cancer survivor and do worry about using hair color dyes. If I could be given a concrete answer as to whether it is harmful, I would stop it immediately. I would like to know just how much dye we really absorb each time we color our hair. I really don’t think most oncologists know the answer so they give approval to dye the hair and leave it to us to decide. I wish research would finally come to a positive conclusion.

    • M. Storms M.D

      Anything put on the skin will be absorbed. That is why many medications are available as patches, gels, creams, etc. Personally, I stopped dying my hair because the toxic fumes and chemicals cannot be healthy for me or the hairdresser, and my scalp skin broke out in a severe rash after hair dye came into contact with it. There is also the concern about what these chemicals are doing to our water supply. It can’t be good.

      We should embrace life in its natural form.

  21. Jane
    Jupiter, FL

    I can’t tell you how I look forward to your emails and your Sunday broadcasts. I am a 64 year old woman who has always sought alternative care over allopathic treatments and am, for all intents and purposes, healthy. I, of course, seek the best treatment for my maladies, as in recently, when I was diagnosed with a-fib , which led to an ablation which was the best thing that I have done for myself in years! In retrospect, I am sure I was symptomatic for some time (extremely tired, anxious, short of breath, brain fog, whirring palpitating heart with an irregular heart beat) but for some reason, I missed the link to my heart. When the cardiologist monitored my heart for 48 hours, I had 17 episodes of very rapid heartbeat (more than 220 heartbeats per minute at times- luckily short in duration) and I was only aware of two. The ablation was successful. My concern is how many, like me, are unaware of a-fib and do not seek treatment.

    The beta blocker that I was prescribed when first diagnosed, was riddled with horrible side effects which led me to the Electro-Physiologist for an evaluation and luckily, I was a candidate for the ablation. I feel better every day and wonder if you might consider a column on a-fib as so many people I have spoken to since I had the ablation are surprised to draw a correlation to the vague symptoms they are feeling. That was what got me to a cardiologist; while on a spiritual retreat, a dear friend was going in and out of fib the entire retreat and I recognized some of his symptoms in myself.
    Thank you again for all of the subjects you tackle and bring to light and for all the help that you give to so many.

  22. Sabrina
    San Diego

    A few years ago and friend (my hairdresser for 30 years) who was a housemate at the time, was being treated for some sort of bladder problems but he never went into too much detail except his doctors had mentions cancer. He left shortly after and we don’t communicate anymore. I had read about this elsewhere and sent him a link. He’s been using hair dyes for close to 40 years. What really surprised me was the link to breast cancer. It’s too important to ignore but if the cosmetic lobby can stifle it, I’m sure they will.
    Thank you for the heads up.

  23. Deborah morgan

    Use henna

  24. Rebecca D
    Lexington, Virginia

    I have been a hair dresser for 20 years, color industry being self regulating , just wondering what that is! I wear gloves and step back when odors are strong! So my comment is concerning the research, i was wondering if some other factors were taken into considerations, from what i have heard the research originally (approximately 20 years ago), was done on female hairdressers only! Did they take into consideration that they typically stand on there feet all day, drink sodas all day and smoke and eat on the run and seem to only pee once a day hence bladder! Our Salone is, from what i can tell is the exception, no smokers, healthy foods, half of the girls have soda at lunch. I have been a people watcher for years! Gathering all kinds of information, not one hair dresser in our small town has had bladder cancer nor breast cancer in 20 years!
    Well any way, my two cents!

    • M. Storms M.D

      It would be nice if hair salons had better air filtration and circulation to remove the fumes. The fumes always bother me. These chemicals are toxic and dangerous to all living things. They need to be regulated and maybe banned because they end up in our water supply.

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