Looking Younger:
Why We Go Gray and Is Hair Dye Dangerous?
Robert Filice, M.D.

While certain people are able to accept their graying head with equanimity and grace (Barbara Bush), and others look great with white hair (Sean Connery, although he does color his eyebrows!) or proudly think of it as a sign of increasing wisdom, many people panic at the sight of that first white hair. In general in this youth-oriented society, most of us want to look as young as we can. Maintaining hair color is a very important component of that quest. Graying hair and eyebrows make the face look washed out, and take the vitality away from most people’s appearance. Usually the graying process is gradual, but it is true that in rare cases some people have grayed very quickly when subjected to huge stress. Part of this occurs because the stress made darker hairs fall out, making the gray ones stand out more prominently. Plus the hairs coming out of resting phases come in white. Existing hair does not convert into gray hair. In keeping with the hair cycle, new hair from previously resting follicles grows out with less pigment and shows up as that dreaded gray hair. Stress is the most common cause of hair loss in women. As a general rule in Caucasians, 50% are 50% gray by the age of 50. This varies by ethnicity. It is not unusual for graying to begin in the 30’s, but if I see a patient who is very gray in their 40’s or 50’s I will always ask when the graying process began.

An early start to getting gray hair (often well advance in their 20’s) is a very characteristic feature of the individual with a usually undiagnosed underactive thyroid. This phenonmenon also occurs in families suggesting a genetic component, but there is a familial/genetic component to hypothyroidism also. Other hormonal factors have been definitely implicated in graying. Deficiencies of DHEA, testosterone, and growth hormone, and too much DHT (dihydrotestosterone) are the leading suspects.

DHT is the testosterone metabolite thought to also be responsible for male pattern baldness. In that case there is complete nutritional strangulation of the hair follicle, while with graying there is just a partial interference at the follicle’s root. Stress induced graying may be from depletion of adrenal hormones and the associated trace mineral depletion that can go with it. Whatever the proximate cause, gray hair occurs because of the loss of the pigment called melanin in the keratin producing cells of the hair shaft (keratinocytes). When these cells die they become part of the keratin of the hair shaft, and retain the melanin, thus giving hair its color. Blanching occurs because the melanin producing melanocyte cells decrease or stop producing it, and stop passing it over to the keratinocytes. What you see is actually a transparent hair the natural color of the keratin. There is no white pigment in the hair.

There are some additional known factors that affect the graying rate. Premature graying is 4 times more likely in smokers. General stress and physical illness also accelerate the process. I also believe that anything that increases free radicals or diminishes anti-oxidant defenses is likely to speed up the graying rate. B12 deficiency and associated pernicious anemia are also associated with this problem. Early graying (before 40) is clearly a sign of accelerated aging, and a recent study found an associated increased risk of osteoporosis in such patients later in life.

There is definitely some evidence that the use of commercial hair dyes can be hazardous to your health. I remember thinking when Jacqueline Kennedy Onasis died that her use of dark hair dye might have played a role. Sure enough, Hodgkins disease and multiple myeloma are suspected of being related to the use of such products. And data from the National Cancer Institute suggest that 20 percent of all cases among women of non-Hodgkin’s lymphoma, the disease that killed Jacqueline Kennedy Onassis, are due to women’s regular use of commercial hair dye products. The evidence is also suggestive of an association with breast cancer, as reported in The Breast Cancer Prevention Bible (Macmillan 1997). The dye para-phenylenediamine (PPED), used in virtually every commercial permanent and semipermanent product appears to be the culprit. It was shown in 1986 to be carcinogenic to the breast following oxidation with hydrogen peroxide, precisely as these products are used by women. Further evidence of the cancer risk from hair dye use comes from studies of hairdressers that have provided clear evidence both men and women are at heavily increased risk for bladder and other cancers. Finally, hair dyes may also pose a risk to children whose mothers used them shortly prior to conception or during pregnancy. In fact, the risk of childhood cancer could be increased by as much as tenfold. It appears safe to assume that the darker the color, and the more frequently it is used, the greater the health risk. The fact that the hair color industry is legally exposing millions of women to carcinogenic chemicals without label warnings is, in part, due to legislation governing cosmetics dating to the 1938 Federal Food, Drug, and Cosmetic Act. At that time, intensive special interest lobbying on behalf of the hair dye industry persuaded Congress to exempt the dyes used in these products from government regulation. Under the Act, only an acute health hazard warning is required to be included on the product labels that blindness might result from use on eyelashes and that a preliminary test should be conducted to avoid allergic reactions. This legislation shouldn’t be an excuse for the Food and Drug Administration’s inaction on this issue. The fact is that the FDA has never gone to Congress asking for regulatory authority over hair dyes. Nor has it advocated explicit labeling of hair dyes for their carcinogenic hazard. The FDA has always heeded lobbying pressure from the hair dye industry. The dirty secret behind hair dye’s glamorous façade remains concealed in a complicit unspoken pact between Congress, the beauty industry, and lobbyists. As in other areas of medicine and health, the government and the FDA are not necessarily our friends.

While we are trying to optimize the system by correcting hormonal and nutritional imbalances, and helping to slow and in some cases reverse the problem of graying, I urge my patients to read labels and meticulously avoid all hair dyes and other substances containing para-phenylenediamine.. Aside from its cancer causing potential this substance is also extremely allergenic. Be aware that in some places of the world it is also being substituted for henna for making temporary tattoos. Henna is expensive while PPED is cheap. The resultant allergic reactions can sensitize the patient in such a way that they are then permanently unable to tolerate any topical cosmetics on the skin. A tip-off to the presence of PPED is a cautionary label that reads like this: “Caution: This product may contain ingredients which may cause skin irritation on certain individuals and a preliminary test according to accompanying directions should first be made. This product must not be used for dyeing the eyelashes or eyebrows; to do so may cause blindness.” One of the so called natural products that got a full caution in a safety review in both risk categories (Allergies/Irritants and Cancer) is Antica Herbavita Herbal Permanent Hair Colors. Hennalucent by Ardell got 50% cautions in both categories as well. Both of these were darker colors, however. However, even the lighter shades with some companies are filled with PPED: for example, Clairol Ultimate Blonde and Clairol Ultress Gel Colorant (Dark Blonde.) Clairol Balsam Color Conditioning Shampoo-In Haircolor (palest blonde), and all colors of Clairol’s Nice and Easy.

Thankfully for those that value their color, there are some safer alternatives. Pure henna color like Light Mountain Henna, and Paul Penders “Color Me Naturally” are two. These are herbally based, totally safe, and work extremely effectively without ammonia, peroxide, lead, or sulfur. There is another class of product which definitely works and is more applicable for men because of their shorter hair. These products DO contain lead acetate in minute quantities, and are applied like a hair tonic. Theoretically according to the product literature there is no absorption from the skin or the hair, but there is a caution to wash the hands after application because it can cause skin irritation. Certainly the lead would show up on hair mineral analysis as a component of the hair, in this case an external “contaminant”, but the important question would be whether there is any associated increase in internal lead levels. This has been studied with blood lead levels, and the results showed there was no increase in blood lead as a result of use of these products. This type of “progressive” hair dye product (example Grecian Formula, Youthair, and a Life Extension Brand ) is also endorsed by the Life Extention Foundation, a group of researchers and consumer advocates that I trust and respect. These products work by acting like melanin in the keratinocytes, and wonderfully restore the person’s original hair color, whether brunette of blonde, gradually over time. There are no colors to chose, and the amount of darkening can be controlled by the frequency of application. Some other common sense precautions for those who insist on continuing to use commercial dyes are these suggestions:

• Don't leave the dye on your head any longer than necessary.
• Rinse your scalp thoroughly with water after use.
• Wear gloves when applying hair dye.
• Carefully follow the directions in the hair dye package.
• Never mix different hair dye products because of potentially harmful reactions.

Professional colorists can also lessen their client's exposure considerably by using a more time-consuming process which places color as close to the scalp as possible without actually touching it.

In summary, the person who wishes to do something about safely restoring the color to their hair should obtain a natural medicine evaluation of nutritional and hormonal status as early into the graying process as possible. Supplements and natural hormones can definitely help. Until the FDA requires large scale studies of PPED containing products, their safety is definitely in question and they should not be used, especially by pregnant women. Substitute all natural products which do not contain PPED.
 

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