Neuroscience for Kids - Hair Today, Gone Tomorrow

To Shave or Not to Shave...That is the Question!
Shaved heads do not reduce the risk of infection after brain surgery.

August 20, 2001
Brain surgery is a stressful experience, especially for the patient. Surgery, however, is often the only way to treat certain neurological disorders. When planning to operate, surgeons are always concerned about a patient developing an infection after the procedure. To reduce the risk of infection, surgeons shave the hair from the heads of patients. Surgeons know that bacteria may be transferred from the hair to an incision site. Understandably, most patients prefer to keep their hair and many feel embarrassed after their hair is gone. A new study suggests that head shaving may not be necessary to reduce infections.
Neurosurgeons in Bursa, Turkey, compared the infection rate in brain surgery patients whose pre-operative preparation included shaving their heads to that in patients whose heads were not shaved prior to surgery. Patients in the non-shaved group washed their hair with a 4% chlorhexidine shampoo 24 hours before surgery and again immediately before surgery. All patients received antibiotics after surgery.
Researchers found that the infection rate in patients with shaved heads (1.22%; 12 of 980 patients) was not statistically different than that in patients with unshaven heads (1.25%; 13 of 1,038 patients). Patients who were able to keep their hair said that they returned to work sooner because they were not embarrassed about their appearance and were not afraid of what their co-workers might think. These patients also had shorter hospital stays and were in better spirits than those patients with shaved heads.
Many surgeons may still cling to the practice of shaving a patient's hair prior to surgery because it is easier to plan a surgery when the scalp is visible. For example, surgeons must make scalp incisions and open a bone flap to get to the brain. Hair may interfere with the surgeon's ability to do these tasks. Nevertheless, considering the results of this study and the potential benefits to their patients, surgeons may want to rethink their policy and consider leaving their patients' hair untouched.

Reference:

Bekar, A., Korfah, E., Dogan, S., Yilmazlar, S., Baskan, Z and Aksoy, K. The effect of hair on infection after cranial surgery, Acta Neurochir., 143:533-537, 2001.

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