Awareness, prevalence of hair smoothing products that contain formaldehyde and determinants of their harmful effects among women in Saudi Arabia

  • Yara Nasser Hameed
  • Rehab M Elgharabway Pharmacology and Toxicology Department, Faculty of Pharmacy, Qassim University, KSA / Pharmacology and Toxicology Department, Faculty of Pharmacy, Tanta University, Egypt.
  • Amira Saber Ahmed


Individuals who use hair smoothing products at home or in a salon work environment are at risk of exposure to various chemical compounds. Formaldehyde mixed with keratin as a hair straightening product is in common use by women in Saudi Arabia. The high temperatures used during blow-drying can release gas fumes that have several implications to include irritation of the skin, eyes and respiratory complications. Furthermore, formaldehyde is classified as a known human carcinogen. The aim of this study is to assess the source of keratin hair treatment among women, demonstrate the symptoms related to formaldehyde exposure during keratin hair treatment process and determine the practices that can increase the exposure to formaldehyde and to evaluate the level of formaldehyde in the keratin hair treatment products. A national cross-sectional survey was first conducted during March-April 2017 on Saudi Arabian children and women aged between the age of 12 and 50 years old. A standardized, fully confidential questionnaire was provided to participating members. A total of 330 filled questionnaires were obtained within the study location. Moreover, 30 hair salons that used keratin-based products were visited in 3 different cities in Al Qassim province to check the location of keratin hair treatment, ventilation procedures and take samples of hair products that were later analyzed. Most commonly reported symptom was irritation of the eyes reported by 135 people. Other symptoms described include irritation of throat, burning sensation of the nose, headache and nausea. Argan e Ojon was one of the most famous product tested in this study with formaldehyde levels above 0.2% threshold (0.35%). It is worrying thatArgan e Ojon does not comply with GSO 1943 and SASO 1953 standards. A majority of salons demonstrated poor ventilation measures and failed to isolate their clients from the general public and salon workers. With the evident complications, more should be done to make people aware of the formaldehyde risks and prevent salons from using these products.


1. Gattuso DJ. (2011): The true story of cosmetics. Exposing the Risks of the Smear Campaign. Competitive Enterprise Institute, Issue Analysis 6, P 1-38.
2. Dahlgren J, Roback R, Dominguez M, et al. (2013): Case Report: Autoimmune Disease Triggered by Exposure to Hair Straightening Treatment Containing Formaldehyde.OJRA, 3(1):1-6.
3. Coulombe PA and Omary MB (2002): ‘Hard’and ‘soft’principles defining the structure, function and regulation of keratin intermediate filaments. Current opinion in cell biology, 14: 110-122.
4. Miranda‐Vilela A, Botelho A and Muehlmann L (2014): An overview of chemical straightening of human hair: technical aspects, potential risks to hair fibre and health and legal issues. International journal of cosmetic science, 36: 2-11.
5. Mirabelli MC, Holt SM and Cope JM (2011): Anatomy laboratory instruction and occupational exposure to formaldehyde. Occupational and environmental medicine, 68: 375-378.
6. Songur A, Ozen OA and Sarsilmaz M (2010): The toxic effects of formaldehyde on the nervous system. Reviews of environmental contamination and toxicology, 203: 105-118.
7. Zhang L, Freeman LEB, Nakamura J, et al. (2010): Formaldehyde and leukemia: epidemiology, potential mechanisms, and implications for risk assessment. Environmental and molecular mutagenesis, 51: 181-191.
8. Marsh GM, Morfeld P, Collins JJ, et al. (2014): Issues of methods and interpretation in the National Cancer Institute formaldehyde cohort study. Journal of Occupational Medicine and Toxicology, 9: 22.
9. Fenech M, Nersesyan A and Knasmueller S. (2016): A systematic review of the association between occupational exposure to formaldehyde and effects on chromosomal DNA damage measured using the cytokinesis-block micronucleus assay in lymphocytes. Mutation Research/Reviews in Mutation Research, 770: 46-57.
10. SFDA. (2016): SFDA Warns from using Five Hair Straightening Products as they Contain High Percentage of Formaldehyde. Available at:
11. Pierce J, Abelmann A, Spicer L, et al. (2011): Characterization of formaldehyde exposure resulting from the use of four professional hair straightening products. Journal of occupational and environmental hygiene, 8: 686-699.
12. Tsigonia A, Lagoudi A, Chandrinou S, et al. (2010): Indoor air in beauty salons and occupational health exposure of cosmetologists to chemical substances. International Journal of Environmental Research and Public Health, 7: 314-324.
13. Salthammer T, Mentese S and Marutzky R (2010): Formaldehyde in the indoor environment. Chemical reviews, 110: 2536-2572.
14. Garcia JS and Harbison RD (2015): Aldehydes and Ketones. Hamilton & Hardy's Industrial Toxicology. John Wiley & Sons, Inc., 445-490.
15. Gaffney S. (2013): Formaldehyde Exposure During Simulated Use of a Hair Straightening Product. Journal of occupational and environmental hygiene, 10(8):D104-110.
16. Dar A and Naseer A (2016): A simple spot test quantification method to determine formaldehyde in aqueous samples. Journal of Saudi chemical society, 20: s352-356.
17. McCarthy, K., D. McLaughlin, D. Montgomery, P. Munsell, M. Schuster, and M. Wood (2010): Keratin-Based Hair Smoothing Products and the Presence of Formaldehyde. Portland, Ore: Oregon Occupational Safety and Health Administration (OSHA), Center for Research on Occupational and Environmental Toxicology (CROET). Available at:
18. Cardarella J (2014): Formaldehyde Vapors and Keratin Treatments. Available at: [Accessed 20 Apr. 2017].
19. Health Canada (2013): Several Professional Hair Smoothing Solutions Contain Excess Levels of Formaldehyde. Available at:
20. Agency for Toxic Substances and Disease Registry (ATSDR), (2014): Toxic Medical Management Guidelines for Formaldehyde. In Toxicological Profiles. Atlanta, Ga.: U.S. Department of Health and Human Services.
21. Mathur N and Rastogi SK (2007): Respiratory effects due to occupational exposure to formaldehyde: Systematic review with meta-analysis. Indian J Occup Environ Med. 11(1):26-31.
22. Morrill, Jr and EE (1961): Formaldehyde exposure from paper process solved by air sampling and current studies. Air Cond Heat Vent, 58:94-95.
How to Cite
HAMEED, Yara Nasser; ELGHARABWAY, Rehab M; AHMED, Amira Saber. Awareness, prevalence of hair smoothing products that contain formaldehyde and determinants of their harmful effects among women in Saudi Arabia. International Archives of Medicine, [S.l.], v. 10, oct. 2017. ISSN 1755-7682. Available at: <>. Date accessed: 21 nov. 2019. doi:

Most read articles by the same author(s)