HYDERABAD: Women often desire silky-smooth straight hair, resorting to various treatments and products such as conditioners and straighteners. Keratin treatment, a popular method, promises frizz-free, smooth, and straight hair. However, it comes with potential side effects, some unexpected and severe. Recently, a startling case emerged where a woman experienced serious kidney injury and scalp burns following keratin treatments. This case prompted a study published in The New England Journal of Medicine, shedding light on the potential kidney damage associated with keratin treatments.
Providing a detailed analysis of the case, Dr Santosh Headu, Consultant Nephrologist and Transplant Physician at CARE Hospitals, explains, “A 26-year-old Tunisian-origin woman underwent keratin treatment in June 2020, April 2021 and July 2022. She had no underlying medical conditions but experienced kidney injuries that were critical in nature coinciding with hair straightening treatments. She started experiencing severe symptoms after each visit to the salon like vomiting, diarrhoea and fever.”
“The kidney injury and symptoms occurred on the same day of hair treatment at the same salon. It was reported that she felt a burning sensation during the treatment and later experienced scalp ulcers. A Computed Tomography (CT) scan was conducted and concluded that blood was present in her urine but no infection was detected. Glyoxylic acid used in the hair treatment process by the salon was absorbed into her skin. This further made its way to the kidney and resulted in serious kidney injury. Prolonged use or high exposure to Glyoxylic acid may lead to health risks, as seen in the case of this woman,” he added.
To understand this case in more depth, experimentation with mice was conducted by the doctors, according to the study. The hair straightening product was applied to the backs of mice and analysis revealed the presence of oxalate crystals. Additionally, there was also an increase in the level of creatinine due to the Glyoxylic acid present in the products.
Referring to the study, Dr Santosh Headu, said that the root cause of the problem is the absorption of Glyoxylic acid into the skin. These derivatives are used in hair straightening creams used for the process of keratin treatment. These were further processed by the liver into oxalate, contributing to the condition of Oxalate Nephropathy. “The study has found that in this case — Glyoxylic acid is the reason causing Calcium Oxalate Nephropathy. It is a medical condition of the kidneys and is caused by the collection of calcium oxalate crystals, which leads to acute kidney damage. Oxalate Nephropathy is a rather rare condition that can also be caused due to certain medications, inflammatory diseases, Ethylene Glycol ingestion, Primary Hyperoxaluria, etc,” informs Dr Headu.
Explaining the behaviour of Glyoxylic acid, Dr Dilip M Babu, Sr Consultant Nephrologist and Transplant Physician at Yashoda Hospitals, says, “The majority hair straightening products contain Glyoxylic acid derivatives, which are considered safe when used topically. Systemic absorption of these products is possible, and anecdotal reports have described kidney toxicity associated with their use. Previous hair products were formaldehyde-based, but formaldehyde was found to be carcinogenic. A series of cases of severe acute kidney injury (AKI) following use of hair-straightening agents has been reported. Glyoxylic acid can be absorbed through the skin, particularly when the product has a low pH and high concentration of Glycolic acid and the exposure time on the skin is prolonged. Usually kidney injury happens after one week of hair straightening process where Glycolic acid containing products are used. The findings strongly suggest that Glyoxylic acid used in hair straightening procedures may be to blame. Most cases recover spontaneously with hydration and supportive treatment but few cases might require dialysis.”