Despite widespread use of hair products globally, little is known about the prevalence and patterns of use in populations outside the United States. As some hair products contain endocrine-disrupting chemicals (EDCs) and EDCs have been linked to breast cancer, which is increasing globally, in this study, we addressed key knowledge gaps about hair product use and practices, and perceptions of use among women in two counties in Kenya. Using community-engaged approaches in Embu and Nakuru, Kenya, we recruited women aged 15–50 years to complete a questionnaire that ascertained hair product use in the last 7–14 days, ever using hair dyes and chemical relaxers, and participants’ perceptions or harm around hair product use. In multivariable-adjusted regression models, we evaluated associations between participants’ sociodemographic characteristics and perceptions of hair product use in relation to if they have ever used hair dyes and relaxers. In our sample of 746 women (mean age, 30.4 ± 8.1 years), approximately one-third of participants reported ever using permanent and/or semi-permanent hair dyes, with approximately one-fifth reporting current use. Almost 60% reported ever using chemical relaxers, with a little over one-third reporting current use. Increasing age and having an occupation in the sales and service industry were statistically significant predictors of hair dye use (OR 1.04, 95% CI: 1.02–1.06 and OR 2.05, 95% CI: 1.38–3.03, respectively) and relaxer use (OR 1.03, 95% CI: 1.01–1.06 and OR 1.93, 95% CI: 1.30–2.87). On average, participants reported moderate-to-high levels of concern about exposures and general health effects from using hair products, and relatively high levels of perceived risk of breast cancer related to hair product use. However, in contrast to our hypotheses, we observed mixed evidence regarding whether higher levels of perceived risk were associated with lower odds of ever using hair dyes and relaxers. These findings add new knowledge to the extant literature on hair product use among women in Kenya, where breast cancer incidence rates are increasing. Improving the understanding of patterns of use of specific products and their chemical ingredients—which may be hormone disruptors or carcinogens—and exploring the role of environmental health literacy are critical for developing interventions to reduce potentially harmful exposures found in these products.

Breast cancer (BC) is the leading cancer among women, with rising incidence in sub-Saharan Africa. Personal care products (PCPs), including hair products, contain endocrine-disrupting chemicals and carcinogens implicated in BC risk, yet evidence is largely from Western populations. We examined perceived BC risk and its association with hair product use among women in Embu and Nakuru Counties, Kenya. A cross-sectional survey of 744 women aged 15–50 years conducted in May–July 2023 assessed perceived BC risk related to hair product use. Latent class analysis (LCA) identified risk profiles, and multivariable logistic regression examined associations between risk class and PCP use in the prior 7–14 days. LCA identified three risk classes: no/low (11.0%), high (42.7%), and very high (46.2%). Classes differed in concern, behavioral intentions, and information-seeking about hair product ingredients, with the very high-risk class reporting the greatest concern and intention to change practices. However, perceived risk was not associated with lower hair product use after correction for multiple comparisons. Perceived BC risk was associated with greater concern and intention to change hair product practices, but not lower product use. Culturally responsive interventions are needed to translate risk awareness into behavior change and safer PCP use.