A study looking at the use of permanent hair dyes and cancer did
not find an association between such use and hematopoietic cancers (cancers
of the blood or lymph systems). The study, by a team of researchers from
Brigham and Women's Hospital in Boston, involved more than 99,000 women.
The new study's findings differ from the results of at least eight earlier
studies which indicated that women and men who dye their hair frequently
may be at increased risk for hematopoietic cancers. The early studies showed
an association between hair dye use and increased risks for multiple myeloma
(cancer of cells in the bone marrow), non-Hodgkin's lymphoma (cancer of
the lymph system), and leukemia (cancer of blood-forming cells) in both
sexes, and ovarian cancer in women.
Almost all the early studies indicated that increased risk might be restricted
to long-term or frequent hair dye users, particularly users of dark hair
Hair coloring products are widely used in the United States by both men
and women; estimates of current usage range from 20 percent to 60 percent
of the population. These products may contain chemicals that are mutagenic
(altering the structure of DNA) and carcinogenic (cancer-causing) in animals.
The quantity and structure of these chemicals vary by product type and color;
darker dyes tend to have greater amounts than lighter dyes.
Research has shown that some of the substances in hair dyes are readily
absorbed through the skin and scalp during application.
Several studies of cosmetologists and other persons who apply hair dyes
to others as part of their work have shown them to be at increased risk
of non-Hodgkin's lymphoma, multiple myeloma, and leukemia. The International
Agency for Research on Cancer, the research organization that classifies
exposures as carcinogenic to humans, has classified cosmetology as an occupation
entailing exposures that are possibly carcinogenic.
Because the evidence from the studies of personal use of hair dyes is
not conclusive, no recommendation to change hair dye use can be made at
this time. However, because hair dye use is common in the United States,
and because people who apply hair dyes as part of their work have been shown
to be at increased risk of certain cancers, further research is needed to
clarify whether there is a causal association.
The report, published in the Journal
of the National Cancer Institute,1 revealed no greater risk
of hematopoietic cancers among women who had used permanent hair dyes than
among women who had never used the dyes.
Dr. Francine Grodstein, Sc.D., et. al. studied nurses aged 30 to 55 years
when they enrolled in the Nurses' Health Study in 1976. Every two years,
from 1976 to 1990, participants answered questionnaires regarding their
medical history and other health-related variables. From 1976 to 1982, the
questions were designed to determine permanent hair dye use. Other types
of hair coloring products were not studied. In 1982, status of hair dye
use was established for each participant and used for the remaining follow-up.
During the period of the study, 244 newly diagnosed cases of hematopoietic
cancers were identified. The researchers then calculated age-specific incidence
rates and determined the relative risk of developing these cancers from
use of hair dyes.
The findings did not indicate a greater risk for hair dye users. This
was true for hematopoietic cancers as a group and for each specific type.
The findings were not affected by age at first use of hair dyes; duration,
frequency, or time since first use; or cigarette smoking.
An earlier report, published in the February 2, 1994, issue of the Journal
of the National Cancer Institute, shows that women who use permanent
hair dyes do not have an overall increased risk of dying from cancer. However,
women who used black hair dyes for more than 20 years had a significantly
increased risk of dying from non-Hodgkin's lymphoma and multiple myeloma.
Less than 1 percent of women in this study reported that they had used permanent
black hair dyes for more than 20 years.
This study, carried out by Michael J. Thun, M.D., and colleagues at the
American Cancer Society and the U.S. Food and Drug Administration, included
information from 573,369 women enrolled in a cancer prevention study. At
the beginning of the study in 1982, the women answered a questionnaire that
included questions on use of permanent hair dyes. These dyes were the only
type of hair coloring studied. The women were contacted periodically over
the next 7 years, and those who had died were identified and their causes
of death recorded.
Available for study were 437 cases of non-Hodgkin's lymphoma, 246 cases
of multiple myeloma, and 448 cases of leukemia.
Another report, published as an abstract in the October 15, 1993, issue
of the American Journal of Epidemiology, showed that men and women
who used permanent or semipermanent hair dyes for 16 or more years had an
increased risk for leukemia.
Dale Sandler, Ph.D., and colleagues at the National Institute of Environmental
Health Sciences (NIEHS) compared hair dye use among 615 leukemia patients
and 630 people without the disease. The researchers found that those who
had used any type of hair dye had a 50-percent increased risk of developing
leukemia, compared with people who never dyed their hair.
Most of the risk shown in this NIEHS study was associated with permanent
and semipermanent dyes, which increased risk by 60 percent and 40 percent,
respectively. Temporary rinses increased risk by 20 percent. Long-term users,
who used hair dyes for 16 or more years, were 2½ times more likely
to develop leukemia than those who never used hair dyes.
Another study from Italy, published in 1994 in the American Journal
of Epidemiology, also suggested that leukemia might be associated with
the use of hair dyes. The investigators obtained information on hair dye
use from 634 individuals with leukemia and 1,161 controls. For both men
and women, relative risks were slightly elevated for use of dark dyes. The
risks varied by type of leukemia. Among men, the greatest excess (about
two-fold) was for chronic myeloid leukemia, while women experienced a 90
percent excess for acute lymphocytic leukemia and 70 percent excess for
acute myeloid leukemia. Women who used hair dyes more frequently had greater
risks for these types of leukemia than less frequent users.
Lisa Herrinton and colleagues published a report on hair dye use in July
1994 in the American Journal of Public Health. The study included
319 women and 350 men with multiple myeloma. Men using hair dyes experienced
an excess of 50 percent, but women did not.
A Greek study, published in 1994 as an abstract in the American Journal
of Epidemiology, reported a two-fold increase in the risk of non-Hodgkin's
lymphoma associated with use of hair coloring products. Long-term users
of black hair coloring products had an almost five-fold increase in risk.
A study by Anastasia Tzonou, D.M.Sc., and colleagues at the Harvard School
of Public Health and the University of Athens Medical School, reported in
the September 30, 1993,
issue of the International Journal of Cancer, suggested that regular
use of hair dyes might increase the risk of ovarian cancer. The researchers
asked 189 cancer patients and
200 hospital visitors how often they dyed their hair each year. Compared
with women who had never dyed their hair, women who dyed their hair one
to four times a year had a 70percent increased risk for ovarian cancer.
Women who used hair dyes five times or more per year had twice the risk
of developing ovarian cancer than women who never used hair dyes.
Previous National Cancer Institute Studies
Linda Morris Brown, M.P.H., and her colleagues at the National Cancer
Institute (NCI) and the University of Iowa published a report in the December
1992 issue of the American Journal of Public Health that showed a
90-percent increased risk for multiple myeloma in a study of 173 men with
the disease and 650 men without it. More than 8 percent of the men
diagnosed with multiple myeloma reported using hair dyes, compared with
less than 5 percent of the men without the disease. In addition to the overall
risk of multiple myeloma, risk increased among men who had used hair dyes
at least monthly for a year, compared with men who used dyes less frequently
or for a shorter time.
In an NCI study conducted by Shelia Hoar Zahm, Sc.D., published in the
July 1992 issue of American Journal of Public Health, women who used
hair dyes had a 50percent higher risk for developing non-Hodgkin's
lymphoma and an 80percent higher risk of multiple myeloma than women
who never dyed their hair. Among the 373 women in the study with these tumors,
the risk associated with permanent hair coloring products was higher than
that for semipermanent or nonpermanent hair coloring products. Risk was
increased 70 percent in women who used permanent hair dyes and 40 percent
in women who used semipermanent or nonpermanent dyes. Risk did not increase
with frequency of hair dye use, although risk increased with the number
of years of use.
Women who used black, brown/brunette, and red hair coloring products
had a twofold to fourfold increased risk of being diagnosed with these cancers
compared with no increased risk of cancer in women who dyed their hair with
lighter colors. Other cancer risk factors, such as family history of cancer,
cigarette smoking, and herbicide or pesticide exposure, did not change the
risks calculated for hair dye use.
An earlier NCI study published in the May 1988 issue of the American
Journal of Public Health showed that men who had used hair dyes had
a twofold risk for
non-Hodgkin's lymphoma and almost double the risk for leukemia. Kenneth
P. Cantor, Ph.D., and his colleagues at NCI, the University of Iowa, and
the University of Minnesota found this increased risk by interviewing men
622 with non-Hodgkin's lymphoma, 578 men with leukemia, and 1,245 men without
In the United States, about 12,700 new cases of multiple myeloma (6,500
and 6,200 women) were diagnosed in 1994, and about 9,800 people (5,000 men
and 4,800 women) died of the disease.
About 45,000 new cases of non-Hodgkin's lymphoma were diagnosed in 1994
(25,000 men and 20,000 women), and about 21,200 people died of the disease
(11,200 men and 10,000 women).
Leukemias of all kinds accounted for about 28,600 new cases of cancer
(16,200 men and 12,400 women) and about 19,100 cancer deaths (10,500
8,600 women) in 1994.
About 24,000 women were diagnosed with ovarian cancer in 1994, and about
13,600 women died from the disease.
1. Grodstein F, Hennekens CH, Colditz GA, et al: A prospective study of
permanent hair dye use and hematopoietic cancer. Journal of the National
Cancer Institute 86(19):1466-70, 1994
2. Thun MJ, Altekruse SF, Namboodri MM, et al: Hair dye use and risk of
in U.S. women. Journal of the National Cancer Institute 86(3):210-5, 1994
3. Sandler DP, Shore DL, Bloomfield CD, et al: Hair dye use and leukemia.
Journal of Epidemiology 138(8):636-7, 1993
4. Mele A, Szklo M, Visani G, et al: Hair dye use and other risk factors
for leukemia and pre-leukemia: A case-control study. American Journal of
5. Herrinton L, Weiss NS, Koepsell TD, et al: Exposure to hair-coloring
products and the risk of multiple myeloma. American Journal of Public Health
84(7): 1142-4, 1994
6. Linos A, Kiamouris C, Foukanelis T, et al: A case-control study of non-Hodgkin's
lymphoma. American Journal of Epidemiology 139(11):S46, 1994
7. Tzonou A, Polychronopolou A, Hsieh C, et al: Hair dyes, analgesics, tranquilizers,
and perineal talc application as risk factors for ovarian cancer. International
Journal of Cancer 55(3):408-10, 1993
8. Brown LM, Everett GD, Burmeister LF, et al: Hair dye use and risk of
multiple myeloma in white men. American Journal of Public Health 82(12):
9. Zahm SH, Weisenburger DD, Babbitt PA, et al: Use of hair coloring products
and the risk of lymphoma, multiple myeloma, and chronic lymphocytic leukemia.
American Journal of Public Health 82(7):990-7, 1992
10. Cantor KP, Blair A, Everett G, et al: Hair dye use and risk of leukemia
and lymphoma. American Journal of Public Health 78(5):570-1, 1988