While strong formaldehyde-free hair products are gaining popularity as a potentially safer option than formaldehyde-containing counterparts, the new series of medical cases raises doubt on the safety of these alternatives.
Formaldehyde is added to products that smooth hair and hair, as a preservative that helps to extend shelf life and lock hair textures for longer.
However, in recent years, various countries have been moving to ban chemicals from products that strongly cover hair due to health concerns.
When heated during treatment of these hair, formaldehyde is released into the air as a gas. This can cause immediate problems such as skin irritation, coughing, wheezing, and burning eyes. However, especially when it occurs repeatedly, formaldehyde exposure can cause long-term problems, such as fertility issues, asthma, and increased risk of cancers such as leukemia and nasopharyngeal cancer.
Given these issues, formaldehyde-free versions of these products are often touted as a safer option. But that doesn’t mean they’re harmless, according to a new case series published on August 28th in the Journal of Clinical Toxicology. In particular, the report highlights the potential risk of kidney damage associated with glyoxylic acid, a component found in many formaldehyde-free hair tone products that serve as a straightening agent.
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The report details the cases of 13 women and teens who were treated at Sourasky Medical Center in Tel Aviv after exposure to formaldehyde-free hair lighting products. Patients felt sick within 2-72 hours of receiving tension treatment for these hair at various salons.
“Even before these studies were published, our medical toxicology services began receiving similar reports, urging us to visit local hair salons that included illegal salons mentioned by affected patients who discovered the presence of glyoxylic acid in hair tension products.”
Related: Hair tension products contain chemicals that increase the risk of cancer, kidney damage and respiratory problems
Thirteen patients between the ages of 15 and 53 developed symptoms such as vomiting, abdominal pain and scalp rash. Twelve of the patients developed acute kidney injury, as evidenced by the accumulation of waste creatinine in the blood, reduced urine output, and the presence of small crystals in the urine that was expelled.
Those who did not develop kidney damage were treated very quickly. I was admitted to the hospital just six hours after my hair treatment and received thiamine and pyridoxine within two hours of being admitted. This is a B vitamin that helps the body break down glyoxylic acid.
In addition to finding glyoxylic acid-containing products at salons patients visited, the medical centre’s toxicology team also found some of the salons were inadequately ventilated.
The patient stayed in the hospital for 1 to 10 days. None of the patients had to filter the blood through hemodialysis and no death occurred.
It is noteworthy that the case series included a relatively small number of patients, without kidney biopsies, and was performed in part retrospectively. The authors looked back on cases that took place between April 2021 and March 2025, so this is not the first time glyoxylic acid has been linked to kidney problems. Hair products containing ingredients are associated with kidney damage, for example, in one woman’s case of anecdotal reports and repeated kidney damage.
“These findings highlight the potentially unrecognized risk of renal toxicity associated with glyoxylic acid-containing hair products,” the authors concluded. “Fast recognition and early treatment, especially with thiamine and pyridoxine, can reduce the severity of kidney damage. Further research and adjustment measures are needed to better define risks and prevent future cases.”
Meanwhile, in the US, the Food and Drug Administration (FDA) appeared poised in April 2024 to ban hair bangs and formaldehyde in its products that smooth hair. However, the ruling proposed in 2024 was postponed to 2025.
Some experts say glyoxylic acid should also ban hair and smooth products, but there is no movement on the front.
This article is for informational purposes only and is not intended to provide medical advice.
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