Colorful Images to Help Illuminate the Brain

The experts are definitely getting closer: the last few decades have produced an explosion of new techniques for probing the blobby, unprepossessing brain in search of the thinking, feeling, suffering, scheming mind.

But the field remains technologically complicated, out of reach for the average nonscientist, and still defined by research so basic that the human connection, the usual“hook” by which abstruse science captures general interest, is often missing.

Carl Schoonover took this all as a challenge. Mr. Schoonover, 27, is midway through a Ph.D. program in neuroscience at Columbia, and thought he would try to find a different hook. He decided to draw the general reader into his subject with the sheer beauty of its images.

So he has compiled them into a glossy new art book.“Portraits of the Mind: Visualizing the Brain From Antiquity to the 21st Century,” newly published by Abrams, includes short essays by prominent neuroscientists and long captions by Mr. Schoonover— but its words take second place to the gorgeous imagery, from the first delicate depictions of neurons sketched in prim Victorian black and white to the giant Technicolor splashes the same structures make across 21st-century LED screens.

Scientists are routinely seduced by beauty. Mr. Schoonover knows this firsthand, as he acknowledged in an interview: for a while his wallet held snapshots not of friends or family, but of particularly attractive neurons. Sometimes the aesthetics of the image itself captivate. Sometimes the thrill is the magic of a dead-on fabulous technique for getting at elusive data.

Consider, for instance, a blurry little black-and-white photograph of a smiley-face icon, so fuzzy and ill-defined it looks like a parody of the Shroud of Turin. The picture is actually a miracle in its own right: the high-speed video camera that shot it was trained on the exposed brain of a monkey staring at a yellow smiley face. As the monkey looked at the face, blood vessels supplying nerve cells in the visual part of the monkey’s brain transiently swelled in exactly the same pattern. We can tell what was on the monkey’s mind by inspecting its brain. The picture forms a link, primitive but palpable, between corporeal and evanescent, between the body and the spirit. And behind the photo stretches a long history of inspired neuroscientific deductions and equally inspired mistakes, all aiming to illuminate just that link.

It’s only fitting that the story should be a visual one, for the visuals had the ancients fooled for millenniums. The brain was so irredeemably ugly that they assumed the mind was elsewhere.

Aristotle, for example, concluded that the brain’s moist coils served only to cool the heart, the obvious home of the rational soul. The anatomistGalenpointed out that all nerves led to the brain, but medieval philosophers figured that most of the important things happened within the elegantly curved fluid-filled ventricles deep inside.

Only when the long ban on dissection petered out in the Renaissance did the ventricles prove to be so much empty space— poke the brain around a little, and they collapse and disappear. The gelatinous brain moved into the spotlight, as resistant to study as a giant mass of tightly packed cold spaghetti.

The challenge was twofold: what did that neural pasta really look like, and how did it do what it did?

In 1873 the Italian scientist Camillo Golgi developed a black stain to highlight the micron-thin neural strands. Fifteen years later the Spanish scientist Santiago Ramón y Cajal, deploying the stain with virtuoso dexterity, presented the world for the first time with visible populations of individual neurons, looking for all the world like burnt scrub brush in a postapocalyptic Dalí landscape. The roots, or dendrites, of these elongated nerve cells gather information. The trunks, or axons, transmit it.

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In South Korea, Children Ease Alzheimer’s Bite

“Oh, it hurts,” said Noh Hyun-ho, sinking to the ground.

“I thought I was going to die,” said Yook Seo-hyun.

There was surprisingly little giggling, considering that Hyun-ho, Seo-hyun and the others were actually perfectly healthy 11- to 13-year-old children. But they had strapped on splints, weighted harnesses and fogged-up glasses, and were given tasks like“Doorknob Experience” and“Bathroom Experience,” all to help them feel what it was like to be old, frail or demented.

“Even though they are smiling for us, every day, 24 hours, is difficult for them,” Jeong Jae-hee, 12, said she learned.“They lose theirmemoryand go back to childhood.”

It is part of a remarkable South Korean campaign to cope with an exploding problem:Alzheimer’s diseaseand other dementias. As one of the world’s fastest-aging countries, with nearly 9 percent of its population over 65 already afflicted,South Koreahas opened a“War onDementia,” spending money and shining floodlights on a disease that is, here as in many places, riddled with shame and fear.

South Korea is training thousands of people, including children, as“dementia supporters,” to recognize symptoms and care for patients. The 11- to 13-year-olds, for instance, were in the government’s“Aging-Friendly Comprehensive Experience Hall” outside Seoul. Besides the aging simulation exercise, they viewed a PowerPoint presentation defining dementia and were trained, in the hall’s Dementia Experience Center, to perform hand massage innursing homes.

“‘What did I do with my phone? It’s in the refrigerator,’” said one instructor, explainingmemory loss.“Have you seen someone like that? They may go missing and die on the street.”

In another striking move, South Korea is also pushing to make diagnoses early, despite there being scant treatment.

“This used to be hidden” and“there is still stigma and bias,” said Kim Hye-jin, director of senior policy for the Health and Welfare Ministry. But“we want to get them out of their shells, out of their homes and diagnosed” to help families adjust and give patients“a higher chance of being taken care of at home.”

Hundreds of neighborhood dementia diagnostic centers have been created. Nursing homes have nearly tripled since 2008. Other dementia programs, providing day care and home care, have increased fivefold since 2008, to nearly 20,000. Care is heavily subsidized.

And a government dementia database allows families to register relatives and receive iron-on identification numbers. Citizens encountering wanderers with dementia report their numbers to officials, who contact families.

To finance this, South Korea created a long-term-care insurance system, paid for with 6.6 percent increases in people’s nationalhealth insurancepremiums. In 2009, about $1 billion of government and public insurance money was spent on dementia patients. Still, with the over-65 population jumping from 7 percent in 2000 to 14 percent in 2018 to 20 percent in 2026, dementia is straining the country, socially and economically.

“At least one family member has to give up work” to provide caregiving, said Kwak Young-soon, social welfare director for Mapo District, one of Seoul’s 25 geographic districts. Because South Korea encourages people to work well past retirement age, families may also lose dementia sufferers’ incomes.

Most families no longer have generations living together to help with caregiving, and some facilities have long waiting lists, but“we can’t keep building nursing homes,” Mr. Kwak said.“We call it a ghost. It’s basically eating up the whole house.”

Dementia Epidemic

South Korea is at the forefront of a worldwide eruption of dementia, from about 30 million estimated cases now to an estimated 100 million in 2050. And while South Korea’s approach is unusually extensive, even in the United States, the National Alzheimer’s Project Act was introduced this year to establish a separate Alzheimer’s office to create“an integrated national plan to overcome Alzheimer’s.” Supporters of the bill, currently in committee, includeSandra Day O’Connor, whose late husband had Alzheimer’s.

South Korea also worries that dementia, previously stigmatized as“ghost-seeing” or“one’s second childhood” could“dilute respect for elders,” Mr. Kwak said.“There’s a saying that even the most filial son or daughter will not be filial if they look after a parent for more than three years.”

So the authorities promote the notion that filial piety implies doing everything possible for elders with dementia, a condition now called chimae (pronounced chee-may): disease of knowledge and the brain which makes adults become babies. But South Korea’s low birth rate will make family caregiving tougher.

“I feel as if a tsunami’s coming,” said Lee Sung-hee, the South Korean Alzheimer’s Association president, who trains nursing home staff members, but also thousands who regularly interact with the elderly: bus drivers, tellers, hairstylists, postal workers.“Sometimes I think I want to run away,” she said.“But even the highest mountain, just worrying does not move anything, but if you choose one area and move stone by stone, you pave a way to move the whole mountain.”

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Su-Hyun Lee contributed reporting from Seoul, South Korea.

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Epilepsy’s Big, Fat Miracle

We never make exceptions when it comes to Sam and food, though, which means that when temptation takes hold of Sam and he is denied, things can get pretty hairy. Confronted with a gingerbread house at a friend’s party last December, he went scorched earth, grabbing parts of the structure and smashing it to bits. Reason rarely works. Usually one of us has to pry the food out of his hands. Sometimes he ends up in tears.

It’s not just cookies and candy that we forbid Sam to eat. Cake, ice cream, pizza, tortilla chips and soda aren’t allowed, either. Macaroni and cheese used to be his favorite food, but he told Evelyn the other day that he couldn’t remember what it tastes like anymore. At Halloween we let him collect candy, but he trades it in for a present. At birthday parties and play dates, he brings a lunchbox to eat from.

There is no crusade against unhealthful food in our house. Some might argue that unhealthful food is all we let Sam eat. His breakfast eggs are mixed with heavy cream and served with bacon. A typical lunch is full-fat Greek yogurt mixed with coconut oil. Dinner is hot dogs, bacon, macadamia nuts and cheese. We figure that in an average week, Sam consumes a quart and a third of heavy cream, nearly a stick and a half of butter, 13 teaspoons of coconut oil, 20 slices of bacon and 9 eggs. Sam’s diet is just shy of 90 percent fat. That is twice the fat content of a McDonald’s Happy Meal and about 25 percent more than the most fat-laden phase of the Atkins diet. It puts Sam at risk of developingkidney stonesif he doesn’t drink enough. It is constipating, so he has to take daily stool softeners. And it lacks so many essential nutrients that if Sam didn’t take a multivitamin and acalcium-magnesium supplement every day, his growth would be stunted, his hair and teeth would fall out and his bones would become as brittle as an 80-year-old’s.

Evelyn, Sam’s twin sister Beatrice and I don’t eat this way. But Sam hasepilepsy, and the food he eats is controlling most of hisseizures(he used to have as many as 130 a day). The diet, which drastically reduces the amount ofcarbohydrateshe takes in, tricks his body into a starvation state in which it burns fat, and not carbs, for fuel. Remarkably, and for reasons that are still unclear, this process— called ketosis— has an antiepileptic effect. He has been eating this way for almost two years.

Curiosity bordering on alarm is the only way to describe how people receive this information.“In-teresting,” one acquaintance said.“Did you make this up yourself?” Another friend was more direct:“Is this a mainstream-science thing or more of a fringe treatment?” We are not surprised by these reactions. What we are doing to Sam just seems wrong. The bad eating habits of Americans, especially those of children, are a national health crisis. Yet we are intentionally feeding our son fatty food and little else.

But what we are doingismainstream science. Elizabeth Thiele, the doctor who prescribed and oversees Sam’s diet, is the head of the pediatric epilepsy program atMassachusetts General Hospitalfor Children, which is affiliated with Harvard Medical School. In fact, the regimen, known as the ketogenic diet, is now offered at more than 100hospitalsin the United States, Canada and other countries. We’re not opposed to drugs; we tried many. But Sam’s seizures were drug-resistant, and keto, the universal shorthand, often providesseizurecontrol when drugs do not.

The idea of food as medicine has been a controversial topic in this country in recent years. For decades the fight that the lateRobert Atkinsand his low-carb acolytes had with mainstream medicine has been as vitriolic as a religious war. There are food cures for everything fromcancerand heart disease tocataracts. Doctors talk about diet as a part of basic good health all the time. But talk to them about a diet instead of drugs to stop an infection or treat atumorand most would be visibly alarmed, and in many cases, they would have good reason to be. A decade ago most doctors held the same contempt for keto. An Atkins-like diet that worked as well— and often better— than antiepileptic drugs? Common sense suggests that’s crazy.

But when it comes to keto’s impact on pediatric seizures, there is wide acceptance. There are about two dozen backward-looking analyses of patient data suggesting keto works, and, more significant, two randomized, controlled studies published in 2008. One of the trials, by researchers at University College London, found that 38 percent of patients on the diet had their seizure frequency reduced more than 50 percent and that 7 percent had their seizure frequency reduced more than 90 percent.

Those numbers may look low, but they’re not. These were patients for whom antiepileptic drugs had already failed. For children with certain kinds of drug-resistant seizures, Thiele’s clinical data show an even better response: 7 out of 10 were able to reduce their count more than 90 percent with the diet. Those statistics are as good as those for any antiepileptic drug ever made. Other pediatric neurologists get similar results. The diet has cut Sam’s seizures by 75 percent.

That is a big deal. There are dozens of antiepileptic drugs on the market, many approved in the last 15 years. The newer ones work with fewer side effects, and that’s important. But the percentage of patients who take drugs and still have seizures hasn’t changed meaningfully in decades. About a third of the nearly 3 million epileptics in the United States have drug-resistant seizures, and doctors estimate that at least 250,000 of those drug-resistant patients are children. Since keto often works when drugs do not, neurologists finally see a way to fix that problem.

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Fred Vogelstein, a contributing editor for Wired, is writing a book about the intersection of technology and media in Silicon Valley.

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Really? - Can Cellphones Cause an Allergic Reaction?

In recent years, dermatologists have seen a small but growing number of people with itchyrashesalong their jaw lines, face and ears which go away when cellphone use is discontinued.

The reason, studies suggest, is an allergy to metals in the phones, most often nickel.

Nationwide, nickel allergy afflicts about 3 percent of men and nearly 20 percent of women. Women are more likely to be affected because they are often sensitized to it by ear piercings and metal jewelry, said Dr. Clifford W. Bassett a New York City allergist and fellow of the American College of Allergy,Asthmaand Immunology, who has treated the condition.

It’s unclear how many people developallergic reactionsto their phones. But the medical literature is rife with case studies. In a typical case, described by researchers atBrown Universityandpublished in the journal CMAJin 2008, an 18-year-old developed a strange rash on the right side of his face. When his cellphone headset tested positive for nickel, he switched to a nickel-free phone, and the eruption cleared up. The researchers later tested 22 popular models of cellphones and found nickel in 10 of them, mostly in the headsets and menu buttons.

For those who suspect a metal allergy, a patch test at an allergist’s office can provide confirmation, Dr. Bassett said, and a simple swab test can reveal the presence of nickel in a phone or other product.

THE BOTTOM LINEIn people with nickel allergies, cellphones can cause an allergic reaction.ANAHAD O’CONNORscitimes@nytimes.com

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In Cybertherapy, Avatars Assist With Healing

“When I saw that, I slowed down and then stopped what I was saying,” said the speaker, a 47-year-old public servant named Gary, who last year took part in an unusual study of social anxiety treatment at the University of Quebec.

The anxiety rose in his throat—What if I’m not making sense? What if I’m asked questions I can’t answer?— but subsided as his therapist, observing in the background, reminded him that the audience’s reaction might have nothing to do with him. And if a question stumped him, he could just say so: no one knows everything.

He relaxed and finished the talk, and the audience seemed to settle down. Then he removed a headset that had helped create an illusion that the audience was actually there, not just figures on a screen.“I just think it’s a fantastic idea to be able to experience situations where you know that the worst cannot happen,” he said.“You know that it’s controlled and gradual and yet feels somehow real.”

For more than a decade, a handful of therapists have been using virtual environments to help people to work throughphobias, like a fear of heights or of public spaces. But now advances in artificial intelligence and computer modeling are allowing them to take on a wider array of complex social challenges and to gain insight into how people are affected by interactions with virtual humans— or by inhabiting avatars of themselves.

Researchers are populating digital worlds with autonomous, virtual humans that can evoke the same tensions as in real-life encounters. People with social anxiety are struck dumb when asked questions by a virtual stranger. Heavy drinkers feel strong urges to order something from a virtual bartender, while gamblers are drawn to sit down and join a group playing on virtual slot machines. And therapists can advise patients at the very moment those sensations are felt.

In a series of experiments, researchers have shown that people internalize these virtual experiences and their responses to them— with effects that carry over into real life.

The emerging field, called cybertherapy, now hasannual conferencesand a growing international following of therapists, researchers and others interested improving behavior through the use of simulations. The Canadian military has invested heavily in virtual-reality research; so has theUnited States Army, which has been spending about $4 million annually on programs with computer-generated agents, for training officers and treating post-traumatic stress reactions.

The trend has already generated a few critics, who see a possible downside along with benefits.

“Even if this approach works, there will be side effects that we can’t anticipate,” said Jaron Lanier, a computer scientist and author of“You Are Not a Gadget: A Manifesto” (Knopf, 2010).“And in some scenarios I would worry about defining humans down: defining what’s normal based on what we can model in virtual environments.”

But most researchers say that virtual therapy is, and will remain, no more than a therapist’s tool, to be used only when it appears effective.“There’s a real and understandable distrust of technology as a shortcut for good clinical skills,” said Albert Rizzo, a psychologist at theUniversity of Southern California,“but I think, deep down, most therapists will want any tool that can help them do their work, and they’ll be open to using virtual approaches.”

Virtual Humans, Real Therapy

“My abilities are somewhat limited,” says a female voice.“For example, I can speak and listen to what you say, but I can’t do anyphysical activity.”

In an office at theInstitute for Creative Technologiesat the University of Southern California, a virtual woman named Angelina is addressing a college student from a computer screen.

Angelina looks to be about 30 or so, a pretty, athletic figure with an open, intelligent face framed by short black hair. Her eyes and expression, guided by video cameras and microphones, stay in sync with the student’s, as an empathetic therapist’s would.“What are some of the things you hate about yourself?” asks the voice.

The student stalls for a moment.“Well,” she says, ina video of the exchange,“I don’t like that I can be really quiet in social situations. Sometimes people take that as me being rude, but it’s just me being quiet.”

Angelina nods sympathetically and then asks another question, about what the student fears most.

Interacting with a virtual human programmed to be socially sensitive in this way is oddly liberating. The figures are clearly not human; some are balky with language, others mute. Many have a two-dimensional graphic-arts quality.

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Exercise in Small Increments - Personal Health

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AIDS Risk Greatly Lowered by Daily Pill, Study Finds

Inthe study, published Tuesday by theNew England Journal of Medicine, researchers found that the men taking Truvada, a common combination of two antiretroviral drugs, were 44 percent less likely to get infected with the virus that causes AIDS than an equal number taking a placebo.

But when only the men whose blood tests showed that they had taken their pill faithfully every day were considered, the pill was more than 90 percent effective, said Dr.Anthony S. Fauci, head of theinfectious diseasesdivision of theNational Institutes of Health, which paid for the study along with theBill and Melinda Gates Foundation.

“That’s huge,” Dr. Fauci said.“That says it all for me.”

The large study, nicknamed iPrEx, included nearly 2,500 men and was coordinated by theGladstone Institutesof theUniversity of California, San Francisco.

The results are the best news in the AIDS field in years, even better than this summer’s revelation that a vaginal microbicide protected 39 percent of all the women testing it and 54 percent of those who used it faithfully.

Also,Truvada, a combination of tenofovir and emtricitabine that prevents the virus from replicating, is available by prescription in many countries right now, while the microbicide gel is made in only small amounts for clinical trials.

The protection, known as pre-exposure prophylaxis, is also the first new form available to men, especially men who cannot usecondomsbecause they sell sex, are in danger of prisonrape, are under pressure from partners or lose their inhibitions when drunk or high.

It“does not involve getting permission from the other partner, and that’s important,” said Phill Wilson, president of the Black AIDS Institute, which focuses on the epidemic among blacks.

Michel Sidibé, the head of theUnited Nationsagency that fights AIDS, called it“a breakthrough that will accelerate the prevention revolution.”

AIDS experts and the researchers issued several caveats about the study’s limitations, emphasizing that it looked only at gay men and Truvada. More studies, now under way, are needed to see whether the results can be duplicated, whether other antiretroviral drugs will work and whether they will protect heterosexual men and women, prostitutes and drug users who share needles.

There is no medical reason to think the pill would not work in other groups, since it attacks the virus in the blood, not in the vaginal wall as a microbicide does. Pre-exposure prophylaxis became possible only in recent years as newer, less-toxic antiretroviral drugs were developed.

Some scientists fear that putting more people on the drugs will speed the evolution of drug-resistant strains, though that did not occur in the study.

Because Truvada is available now, some clinicians already prescribe it for prophylaxis, Dr. Fauci said, but whether doing so becomes official policy will depend on discussions by theCenters for Disease Control and Prevention, theFood and Drug Administration, medical societies and others, which could take months.

Although the C.D.C. would prefer that doctors wait for further studies, more will probably prescribe the drugs now that this study is out, said Dr. Kevin Fenton, chief of the agency’s AIDS division, so the C.D.C. will soon release suggested guidelines.

The agency will suggest that the drug be prescribed only with close medical supervision and used only with other safe-sex practices.

“The results are encouraging, but it’s not time for gay men to throw away their condoms,” Dr. Fenton said.

AIDS advocacy groups were very excited by the results.

“If you comply with it, this works really well,” said Chris Collins, policy director of amfAR, the Foundation for AIDS Research.“This is too big to walk away from.”

Mitchell Warren, executive director of AVAC, an organization that lobbies for AIDS prevention, called the study“a great day for the fight against AIDS” and said gay men and others at risk needed to be consulted on the next steps.

In the study, 2,499 men in six countries— Brazil, Ecuador, Peru, South Africa, Thailand and the United States— were randomly assigned to take either Truvada or a placebo and were followed for up to three years. For ethical reasons, they were also given condoms, treatment forvenereal diseasesand advice on safe sex. There were 64 infections in the placebo group and 36 in the group that took Truvada, a 44 percent risk reduction.

Two in the Truvada group turned out to have been infected before the study began. When the remaining 34 were tested, only 3 had any drug in their blood— suggesting that the other 31 had not taken their pills.

Different regimens, like taking the pills not daily but only when sex is anticipated, also need testing.

Also, many men in the study failed to take all of their pills, and some clearly lied about it. For example, some who claimed to take them 50 percent or 90 percent of the time had little or no drug in their bloodstreams.

The pills caused no major side effects, though men who began to show signs of liver problems were taken off them quickly. Some men stopped taking the pills because they disliked relatively minor side effects like nausea and headaches. Also, some stopped bothering once they suspected that they might be taking a placebo.

“People have their own reasons,” Mr. Collins said.“People don’t take theirLipitorevery day either.”

A major question now is who will pay for the drug.

In the United States, Truvada, made by Gilead Sciences, costs $12,000 to $14,000 a year. In very poor countries, generic versions cost as little as 40 cents a pill.

Globally, only about 5 million of the 33 million people infected with the AIDS virus are on antiretroviral drugs, and in an era of tight foreign-aid budgets, that number is not expected to rise quickly.

Hundreds of millions of Africans, Eastern Europeans and Asians are at risk and could benefit from prophylaxis, but that would cost tens of billions of dollars.

In this country, insurers andMedicarenormally pay for the drugs, and the Ryan White Act covers the cost for the poor, but none of these payers yet have policies on supplying the drugs to healthy people.

No participant in the study developed resistance to tenofovir. Three were found to have strains resistant to emtricitabine, but investigators believe that all three were infected before the study began at levels low enough to have been missed by their first H.I.V. tests.

Another concern was that the participants would become so fearless that they would stop using condoms, but the opposite effect was seen— they used condoms more often and had fewer sex partners. But that can also be a result of simply being enrolled in a study and getting a steady diet of advice on safe sex and free condoms, the investigators said.

Other trials of pre-exposure prophylaxis have about 20,000 volunteers enrolled around the world. Their results are expected over the next two years.

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A Safety Kink in Hair Relaxing? - Skin Deep

Mark Garrison, the owner of a salon on the Upper East Side of Manhattan that bears his name, set aside a floor for the treatment, equipped it with special ventilators and began providing industrial-strength respirators to his clients and stylists. And a West Hollywood salon, John Frieda, relegated its straightening treatments to an open-air courtyard.

Just like the permanents that were once the height of fashion, the lucrative process of converting frizzy or kinky hair into smooth locks produces unpleasant odors. But is it dangerous, especially to the operators who apply the product repeatedly?

Last month, the beauty world was rattled when the occupational health agency in Oregon found significant levels of formaldehyde in the hair-smoothing solution sold under the name Brazilian Blowout. (A common ingredient found in many products, formaldehyde is a recognized carcinogen if it is present at high levels.) The agency said it had conducted lab tests after receiving numerous complaints from stylists citing nosebleeds, breathing problems and eye irritation after applying the product. Last Friday, Oregon authorities broadened their warning to include other hair-smoothing products, particularly those described as“keratin-based,” and said employers should take steps to protect their workers.

The report came soon after a warning from Canadian health authorities about the potential dangers of Brazilian Blowout. Subsequently, the United StatesFood and Drug Administrationannounced that it was working with state and local authorities to determine if Brazilian Blowout and similar products, known generically as Brazilian or Keratin treatments, are safe. The F.D.A. does not approve cosmetics other than color additives in advance, but will respond to consumer complaints, said a spokeswoman, Siobhan Delancey.

Brazilian Blowout, also the name of the company based in Los Angeles that distributes the solutions by that name— which it says are manufactured in Brazil by Cadiveu— initially repudiated the Oregon findings. But in response to the most recent report, it said that the Oregon tests showed that formaldehyde exposure from Brazilian Blowout was“safely below” permissible levels.

The warnings have prompted various responses from salon owners. Some, like the Sally Hershberger salons in Los Angeles and New York and the John Barrett Salon at Bergdorf Goodman in New York, decided to ban the brand Brazilian Blowout, but continue to use products from other companies. Some manufacturers acknowledge that their products contain formalin, a substance made up in part of formaldehyde, but say the amounts are insignificant.

Michael Angelo’s Wonderland Beauty Parlor in the meatpacking district of Manhattan stopped doing Brazilian treatments years ago because of the presence of formalin. Michael Angelo, the owner, said he began offering the Brazilian Blowout solution again when the company assured him the product was formaldehyde-free, but has now ceased altogether.“A lot of money went out the door,” he said.

Other salon owners believe the health agencies are overreacting.“I say, you putBotoxin your face, lead in your lipstick, and you smoke,” said Mr. Weisberg of the Neil George salon.“Pick your poison.” He said his salon does up to 20 treatments a week, mostly using Brazilian Blowout, and has no intention of stopping.

At Studio Noi, a small Los Angeles salon, Mar Fujimoto, the owner, said she had personally performed the Brazilian Blowout 300 times in six weeks after discounting the price to $125 from $300. She said the company had assured her that the product was not harmful.“I trust their claims that it is formaldehyde-free,” she said.

Questions about the safety of Brazilian treatments have been raised for years, most notably in a widely read 2007 article in Allure magazine. Yet for many salon owners and stylists, who are usually independent contractors, it is hard to contemplate eliminating such a profitable procedure.“It’s one of the most popular services we’ve had in years,” said the salon owner John Barrett.“People think it’s an absolute godsend.”

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Antibiotics Research Subsidies Weighed by U.S.

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