As research stacks up pointing to the long-term health risks of chemical hair relaxers, aka “creamy crack,” many Black women have long ditched the lye and are sticking with their natural hair textures.

The U.S. Food and Drug Administration’s recent proposed ban on cancer-causing formaldehyde, a key ingredient in some products, has been called a public health win. It’s even more pivotal as 95% of Black women have used chemical relaxers over their lifetimes, research suggests. Yet, many Black hair stylists say women have already moved on from a dependence on chemical hair straighteners. So, what would a potential ban mean now, and where did the push start to fight anti-Black hair sentiment?

“There have been alternatives to chemical straighteners forever,” said Jasmine Cobb, author of New Growth: The Art and Texture of Black Hair. Hot combs, flat irons, and blow dryers came right to mind for her, but she acknowledges that those are temporary fixes. She thinks a move to ban chemicals like formaldehyde might encourage more Black women to wear their natural hair. Hair relaxers’ necessity might continue to decline, she said.

In 2019, California became the first state to pass the CROWN Act banning race-based hair discrimination, and since then more than 20 states have followed suit. More recent efforts by U.S. Reps. Ayanna Pressley of Massachusetts and Shontel Brown of Ohio have called on the FDA to investigate chemical hair straightening products, like relaxers.

Since then, the agency has announced the new proposal. Here’s what you should know, according to experts:

What do we know about the link between chemical relaxers and Black women's health?

For years, research has linked the toxic chemicals in chemical hair straighteners to disruptions in menstruation and menopause, and increased risk of uterine cancer and fibroids. The range of health consequences goes from somewhat benign, like skin irritation and small scalps burns, to life-threatening diagnoses like uterine cancer.

“We’ve all kind of accepted that the pain is the price of the beauty,” said Cobb. She sees chemical hair products kind of like cigarettes a few decades ago.

“We know that they are toxic and that there are negative consequences associated,” she said. “The question is how great are those consequences and do we think they are worth doing something about.”

Research from 2022 found that several of the chemicals found in straighteners — such as parabens, metals, and formaldehyde — could be contributing to increased uterine cancer risk among the women being studied. It is unclear exactly what products or brands were used. But, in the research, Black women used the products more frequently.

This year, a new study looked at the use of relaxers among more than 44,000 Black people ages 21 to 69. What the researchers found affirmed previous findings. Compared to women who never or rarely used hair relaxers, those who reported using the products more than twice a year or for more than five years had a more than 50% increased risk of uterine cancer.

But Black experts say the context is important. For example, if the probability of getting uterine cancer starts at 1% and the risk changes by 50%, there’s still a very low probability of getting cancer.

It’s also important to note that not all relaxers contain the same chemicals, said Dr. Cheri Frey, chair of the National Medical Association’s dermatology section. The FDA ban is specific to formaldehyde, which is known to cause cancer and should be avoided, she said. Some products may or may not use formaldehyde or formaldehyde-releasing chemicals, and because science is evolving, she expects what we know about all the ingredients in relaxers and their health risks will grow.

As the severity of the consequences related to these treatments is being debated and researched, the incidence of the disease is on the rise, especially among Black women.

What’s driving this move by the FDA? Why has it taken so long if the risks have long been documented?

In recent years, the FDA has gotten more pressure from politicians, researchers and health organizations to look into these health risks. Earlier this year, lawmakers Pressley and Brown urged the FDA to investigate whether the products pose a public health threat.

“The increased risk disproportionately impacts Black women and contributes to national racial health disparities. The FDA has a mandate to review the latest research and reevaluate the safety of these products,” the representatives wrote. “Consumers need to be reassured that the cosmetic products they use do not threaten their health.”

Experts also hypothesize that the mounting evidence and increased attention on the links between relaxers and hormone-related cancers has heightened the urgency for the FDA to take action.

What is the likelihood a ban will actually be implemented?

In its investigation, the FDA will evaluate the research that exists on the topic and eventually make a determination on whether the chemicals in hair relaxing products are too dangerous to be available over the counter for customers.

Frey believes a formaldehyde ban will likely take place. Its association to cancer has been established. And, she said, “there’s a lot of pressure for our government to take action.” But it’s too early to know exactly what decision the FDA will land on.

What will this process look like? Could relaxers be off of store shelves soon?

The FDA is in the beginning of the process, and bans can take years to be implemented from the time they are proposed. For example, the agency proposed a ban on menthol cigarettes — which are easier to smoke and harder to quit than unflavored products and disproportionately marketed by Big Tobacco to Black communities — in the spring of 2022, and it has yet to take effect. The rule was sent for final review earlier this month.

Read more: A Nationwide Ban on Menthol Cigarettes Could Be Coming, and It’s Dividing Racial Justice Advocates

And because this ban is specific to the chemical formaldehyde, and not specific products or brands, it may not apply to all hair straightening products.

Margo Snipe is a health reporter at Worldacad. Twitter @margoasnipe