Hair Treatment Harms Egyptian Women

10 August 2014

Cairo – Veto – “Waiting for an illness is worse than dealing with the illness itself!” This is how Jihan sums up the psychological pressures she is under from worrying about getting cancer after undergoing Keratin treatment three times to straighten her curly hair.

For years prior to her marriage she had dreamt of owning beautiful hair. However, the hair products she used at the hair salon in Egypt do not clearly indicate that the Keratin formula she underwent also includes formalin which many researchers say causes cancer.

According to research carried out by “Veto” weekly on three samples of keratin available in the market, both locally produced and imported, the percentage of formalin found in the products ranged between 16 times to 41 times more than the 0.2% which is permissible according to the European standards adhered to in Egypt.

Based on a survey by “Veto,” this substance is not only dangerous to those using it but it poses a threat to the employees of beauty salons if they fail to take the necessary precautions.

This investigation also reveals the grey areas in government monitoring of the safety of this product. Generally speaking monitoring lies in the jurisdiction both of the Supply and Vice Police forces as neither oversees the safety aspect of these products. There is also negligence on the part of the Ministry of Health in terms of its inspection of such goods in the Egyptian market. The Supply Police also does not supervise quality control of products manufactured in illegal “basement” factories in the country.

Compounded with all these dangers, doctors warn of an increase in all types of cancer amongst Egyptian women if these practices continue.

Jihan, in her early 20s, says: “I was born with curly hair, which I got from my dad and that has caused me problems ever since I was young. My dilemma increased as my wedding day approached, especially after seeing what traditional hair-styling methods, like using the flat iron, had done to other female members of my family after marriage; their hair deteriorated!”

“That is why,” she says “I responded to the first ad I saw on the use of Keratin for relaxing the hair. The advertisement was clear that I wouldn’t be simply straightening my hair but applying a long-term therapy using Keratin treatment which is a natural substance in the hair. This was a magic solution for me, so I quickly underwent my first treatment, which cost me 2000 Egyptian pounds ($275). The results were amazing and lasted around eight months after which my hair went back to it’s original state.”

When Jihan went back to the hairdressing salon where she had her hair treated, she was told that Keratin “only lasts for a limited period and needs to be reapplied.”

She underwent treatment three times since her marriage three years ago and each time that treatment lasted between 6 and 8 months. However, she became frightened when she saw a warning on television by a dermatologist who said there was a connection between Keratin therapy and cancer. She went for a biopsy test, which came back negative. But her doctor told her that the treatments she had undergone increase her chances of getting cancer due to the formalin substance that is found in Keratin products. Since then she has been living in a constant nightmare, especially after having seen three members of her family suffer from this illness. Cancer success rates in Egypt do not exceed 55% according to Dr. Hussein Khaled, former Dean of the National Institute for Tumours.

This investigative report charts the use of formalin in Keratin that is used in beauty salons without taking any preventative or protective measures.

According to safety regulations, the formalin rate in imported beauty products, which have been implemented by the Ministry of Health in adherence with European standards, should not exceed 0.2%.

Maged George, former director of the beauty section at the Industries Federation says the cosmetics industry in Egypt is worth 6 billion pounds (almost $857 million), whereas imports are estimated at 2.4 billion pounds (almost $343 million), that is 29% of the market.

However the monitoring of such goods is not strict. In accordance with Ministry of Health Law No. 266/2006 a mandatory sample is taken from every initial container of imported products and then the search becomes random.

A Danger to Customers and Employees

This reporter came across a Facebook ad for one of the specialized centres of Keratin therapy in Nasr city. There, I noted the misuse of the product by employees without any protective gear. The customers were also not wearing any masks to protect them from the formaldehyde fumes that are emitted during the straightening process, despite warnings about the necessity of wearing such masks.

The Keratin hair straightening method starts with washing the hair with a pre-Keratin shampoo specifically used to remove all chemicals from it. After the hair is dried with a hair dryer it is parted into several strands and the Keratin substance is applied after shaking. Care is taken to leave one centimetre of the hair from the scalp free of chemicals so as not to harm both the scalp and the roots. Hair is then straightened using a flat iron or hair straightener at a 90-degree angle from the scalp. It is at this point that formalin begins to burn and formaldehyde fumes fill the air causing eyes to bulge in tears and sinuses to fill up. This might eventually lead to lung and larynx cancer, according to reports submitted by doctors and researchers.

Dr. Mustafa Abdul Aal, professor of analytic chemistry at the School of Pharmacy says pharmacy sciences consider formalin to be one of the causes of cancer.

Howayda Sha’baan, one of the employees of the beauty salon in Nasr city, confirms that “the centre carries out between 10 and 20 Keratin treatments per day and this number increases during the festive seasons and in summer”.  She also adds that neither the employees nor the customers wear masks to protect them from the fumes during the process.

The prices of Keratin bottles vary; in large chemist shops the American imported bottle of 300ml is sold at 1055 pounds ($146) whereas other brands can be found in beauty supply stores in low-end areas also from America, but of a lesser quality. Others are from Lebanon, France or Brazil sold at 800 pounds ($110) for every 1000 ml. These large quantities can be divided and resold in smaller quantities after being refilled. Some brands also claim to be free of formalin and they are sold at the cost of 325 pounds ($46.5) for every 100 ml.

Missing Safety Regulations

According to a survey carried out by “Veto” at 14 beauty salons in Shubra Al Kheima, which was chosen as a random housing, lower class area, the result showed that only one did not perform Keratin treatments with the first treatment done 13 years ago. One salon could not determine how many treatments they had carried out due to their large number but the others ranged between 2 and 30 throughout their years of business and that depended on whether they were on a main street or a side street.

Ten owners of the beauty salons were unaware of the dangers associated with using formalin-enriched Keratin, whereas four did admit to knowing. They said they only used formalin free products or made sure that the venue was well ventilated.

I found the names of seven beauty salons on Facebook that carry Keratin treatments and paid a visit to two of them; they were not taking any safety precautions.

“Global Keratin” is one of the biggest American companies producing Keratin treatment formulas, with several pages on Facebook, one of which listed the names of salons that used the product in Egypt. We randomly chose ten centres in the areas of Zamalek, Heliopolis, Nasr city and Mohandiseen to check whether safety precautions were being met; most of the venues had good ventilation.

However, only three out of the ten centres met the safety standards by having their employees wear masks while carrying out the treatment, and only one centre gave a mask to clients. Instructions on the products clearly indicate that customers and employees should both wear special masks and the location should be well ventilated, but there is not authority to enforce such regulations. As mentioned before, the monitoring of beauty salons is carried out by Supply and Vice departments of the police. But neither branch specializes in looking after product safety.

Owners of beauty centres confirmed that the use of Keratin for hair straightening started in Egypt in 2001 when low-priced products came on the market. Most of these salons advertise the use of the “original” product, which claims to be formalin free or includes only the permissible amount.

Analysis results prove the Connection

I chose three samples for analysis, the first from a “Global Keratin” product bought from one of the large chain pharmacies in Al Dokki and does not include any mention of formalin. Instead of formalin the ingredients list a substance known as “glycol methylene” which is a liquid form of formalin, according to the Occupational Safety and Health Agency website affiliated to the US Department of Labour (

The second sample was bought from a hairdressing salon store in Shubra Al Kheima and is similar to many Keratin products that are locally bottled and found in lower-income areas.

The third sample was obtained from the Internet through an ad for “Organic Keratin” that is free from chemicals. The samples were all analysed at a laboratory belonging to Cairo University.

The “Global Keratin” sample showed a result of 8.3% of formalin content, which is 42 times more than the permissible 0.2%. This was refuted by Mohammad Al Azhari the sales representative of SMC, the importing company, who said that the sample tested came from a fake bottle. I confirmed having bought from “Al Azbi” pharmacy, which is listed on Facebook as one of the agents for the product.

At Al Azby pharmacy, we were reassured that they only dealt with “legitimate sources” for their supplies and asked us to send them an email with the questions and an attached copy of the receipt I received when I bought the product. An official request for information was sent to Ahmad Jalal, director of supplies and warehouses on March 4, and to date no response has been given.

The second sample bought from Shubra Al Kheima showed a result of 3.3% of formalin, which is 16 times more than the permissible amount. As to the third sample the result achieved was 7.2% that is 36 times more


Table showing the percentage of formalin content according to analysis results

Medical Warning

The results were shocking to dermatologist and aesthetician Dr. Mona Sabe’, member of the American Academy for Dermatology, who says that such percentages are “catastrophic and hazardous to the health and in contravention with the European standards for formalin levels.”

She also points out beauty salon employees are at risk of inhaling formaldehyde fumes while customers face the danger of formalin entering their blood, which could also lead to skin cancer.

The lie of formalin-free Keratin

Dr. Mona says the “use of the word Keratin in advertisements for these products is misleading, since it is the carcinogenic formalin that actually straightens the hair.”

She goes on to add, “there are no formalin-fee Keratin straightening products”. She considers any ad that touts its product as being free of formalin as simply misleading and untrue. She explains that Keratin is an amino acid that is found in the human body and is primarily located in the hair and nails and it is impossible to introduce it into the body.

Dr. Mona also says “there is nothing called therapeutic Keratin” and considers all the hair products on the market to be hair straightening formulas to which the cancerous formaldehyde has been added, and that is a form of formalin.

She explains that “what the product does is to create a formalin binding on the hair that will keep it from turning curly or frizzy for an extended period of time. It does not treat split ends or hair fall and no such treatment can be received at the beauty salon.

The dangers of using formalin-rich Keratin are on the rise says the doctor and she expects cancer cases among Egyptian women are increasing because of these products. She also warns of other problems that may come about as result of using the Keratin products, namely hair loss and eczema from the contact with formalin. She had already treated two such cases as a result of hair straightening with Keratin.

Poisonous Proteins

We showed our results to Dr. Mustapha Abdul Aal, who is member of the specialized scientific committees at the Ministry of Health. He says they indicate that that the employees and users could possibly suffer from liver damage that may lead to cancer, in addition to lung cancer. He adds “there are much stricter specifications than those complied with in Egypt such as the American standards that restrict formalin content to only 0.1% to avoid lung damage”.

Dr. Abdul Aal also confirms that the main ingredient for hair straightening is the formalin and not Keratin as the ads suggest. He warns of the dangers that the user might incur from the poisonous proteins emitting when formalin mixes with Keratin at high temperatures of 220 degrees. These can be absorbed through the scalp entering into the blood and causing cancers of both that and the brain.

These are the dangers that Jihan is frightened of after three Keratin treatments. The situation is slightly different for Suhaila who underwent six hair-straightening treatments since she got married in 2001.  She explains in an email message sent to us through “Fatakat” forum that she has now stopped using these products after being diagnosed with lung cancer. She says she lost all her hair as a result of the chemotherapy treatment she went through. She had done several hair treatments at different salons in Egypt and none had asked her to wear a mask for protection.

Ministry of Health: Likelihood of smuggling exits

Dr. Maged Sameer, director of the Beauty Products Registration Department at the Ministry of Health stresses that the bottles that were used for the sample test do not carry the name of the importing company or a registration number. That could indicate they were brought into the country illegally, or the samples were not taken from them. If any Keratin bottles are found during the regular customs search to have a large amount of formalin than is permissible the whole shipment is confiscated and destroyed.

The media department at the Ministry of Interior Affairs confirms that customs usually signs off on the shipments after receiving approval from the Ministry of Health.

In the case of market monitoring, the media department says that the supply police carry out random searches and raids on pharmacies and beauty salons asking for receipts and customs release forms. In the case of smuggled goods a report is filed with the police and the owners are made to sign an affidavit saying they would not sell any of the products until the Ministry of Health checks content and signs off on them.

As for beauty salons, the punishment in accordance with Article Two of the Deceit and Fraud Law No. 48/41 which was amended by Law No. 281/1994 is imprisonment for a period not less than one year and not to exceed five and fined no less than 10,000 Egyptian Pounds but not in excess of 30,000 Egyptian Pounds or the cost of the goods whichever is larger.

The official from the media department at the Interior Ministry says it is difficult to determine the amount of violations, as they are “all registered with the supply police and include other smuggling offenses such as wheat in addition to price manipulation and other violations.”

Monitoring by the Ministry of Health is therefore lacking especially with regard to sample inspection. And the supply police do not have records of offenses committed by the so-called “basement” industries manufacturing beauty products. Nor are they able to get a hold of all the smuggled and fake cosmetics in pharmacies.  And if things do not change Keratin-straightening products containing high levels of formalin will continue to be used.


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