In view of the difficult cases: everything that is important to verify before doing hair straightening

Yesterday (Sunday) we reported on a 14-year-old girl who was hospitalized for acute kidney failure after having her hair straightened. It turned out that her parents actually did what was expected to avoid risks: they asked in advance about the material they were going to use, and at the hair salon they were told that it was approved by the Ministry of Health. Despite this, hours after the slide, their daughter began to suffer from typical symptoms and the next day she was hospitalized for acute kidney failure.

Following this case, and in light of other cases that have been reported in recent years, we spoke with Dr. Ofir Levon, director of the clinical pharmacology and toxicology unit at the Carmel Medical Center of the Klalit Group. He explains that when examining the risk that may involve a chemical substance, it is not enough to know what it contains. Therefore, it is not enough to know what is in the material, but also how the body was exposed to it,” he clarifies.

In recent years dozens of cases of kidney damage after hair straightening have been recorded in Israel. According to Dr. Levon, in the investigation of the cases, the name of glyoxylic acid came up again and again, which can lead to the formation of oxalate crystals that sink into the kidneys – and harm their function. There were women who went so far as to have a biopsy of the kidney – and there they saw the oxalate crystals.”

Dr. Yael Borowitz, a senior nephrologist at the Schneider Pediatrics Center of the Klalit Group, is also well aware of the phenomenon. According to her, in the investigation of the first cases, the parents themselves helped the doctors understand what caused the injury. “The parents brought the boxes of the materials or photographs of the components from the hairdressers,” she says. “In some cases, there was evidence that they were used even though they were not authorized.”

As mentioned, the 14-year-old’s family claims that they inquired in advance and were told that the substance is approved by the Ministry of Health. “Does the fact that they were told that there is no glyoxylic acid – really mean that there is not?”, asks the doctor, referring to the case. According to her, if it turns out that the substance they used was indeed licensed and did not contain the acid, it will be necessary to find out what caused the kidney damage after all, for example if the contents of the product did match what was written on it.

It was only in August that the Ministry of Health warned against a series of hair products that were found during an inspection operation in nine branches of the “Sliding Center” chain. The inspections found smoothing products and shampoos that were not registered in the office’s databases. In one product it was stated on the label that it contains glyoxylic acid, in other products there was concern about their origin, composition and safety, and in additional smoothing products that were not marked as required, the presence of formaldehyde was found – a carcinogenic substance prohibited for use in perfumes.

Contact with the scalp should be reduced as much as possible

“The main thing is professionalism – to use the right materials in the right way,” says Dr. Levon. According to him, the contact of the material with the skin of the scalp and the duration of exposure to it should be reduced as much as possible. However, as far as we know, this recommendation is not really applicable in practice, since the material is liquid and in any case it comes into contact with the scalp, even if you try to keep a distance between them.

Ask to see the packaging with your own eyes

Don’t be satisfied with being told that the material is “approved”. Ask to see the product itself, check the label on the packaging and read the list of ingredients. “What I recommend is to ask to see the product, make sure it says that it is approved by the Ministry of Health and carefully read the ingredients listed in the fine print,” says Dr. Borowitz.

“It’s also a good idea to take a photo of the packaging and the list of ingredients on your phone before you start skating. If a medical reaction later develops, the photo can help doctors understand what substance you were exposed to,” she recommends.

Look for two names: glyoxylic acid and formaldehyde

“You have to specifically ask what materials are used and make sure there is no formaldehyde and no glyoxylic acid,” adds Dr. Levon.

According to him, even if the chance of injury for someone who goes through a single slip is not high, it exists. Therefore, from a medical point of view, the recommendation is to avoid exposure to these substances. However, he emphasizes that even their absence does not automatically make any other substance safe: “There are many substances in the world of cosmetics, and we do not have complete information on each and every substance.”

Do not try to identify a dangerous substance by smell

A pungent smell can certainly arouse suspicion, but on the other hand, the absence of a smell does not mean that the substance is safe. “Smell is not a measure,” emphasizes Dr. Levon. According to him, cosmetic products can contain fragrances designed to make them more pleasant to use. “Even a dangerous substance will not necessarily cause a suspicious smell. This is not a way to know if a substance is dangerous or not.”

Check your scalp before you start

Scratches, wounds or irritation of the scalp are not a minor issue in case you plan to go through shaving. According to Dr. Levon, the more damaged the skin, the more substance it may absorb. “The main risk is not the hair. The question is to what extent the skin of the scalp comes into contact with the substance,” he explains. “If the scalp is injured or irritated, there is another reason to stop before the treatment and not expose it to the substance.”

Be careful inhaling the fumes

It is important to remember that the skin is not the only possible route of exposure. “There is another dangerous source – the vapors that are caused by the heating of the material and the customer may inhale it,” says Dr. Levon. According to him, this exposure is particularly relevant to barbershop workers, who, unlike customers, may repeatedly come into contact with the materials as part of their work.

Nausea, vomiting or shortness of breath after treatment should turn on a red light. In such a case, Dr. Borowitz recommends seeking medical help and not waiting for the symptoms to go away on their own. According to her, the sooner an injury is detected, the sooner supportive treatment can be started.

“When you arrive for the examination, it is important to tell the medical staff that the girl has had her hair straightened. If you took a photo of the packaging or the list of ingredients, present them as well. As mentioned, as the experience from the previous cases shows, this information may help the doctors understand what they used and what substance the patient was exposed to.”

This is perhaps the most important point: hair straightening is not a medical operation, and some of the substances used in the cosmetics industry may be allowed to be used – but they are not necessarily risk-free. “Any substance can have the potential for toxicity,” says Dr. Levon. “As mentioned, the dose and form of exposure have a great effect.”

Therefore, if it is not clear to you what material is being used, if it is impossible to see the packaging or the list of ingredients, or if something in the process arouses doubt in you – there is no reason to take the risk. “The message in medicine is that prevention is always better,” concludes Dr. Levon. “Even in the best professional hands there is potential for injury. Why take a risk?”