Changes of the skin barrier and bacterial colonization after hair removal by clipper and by razor

Sora Jung (Login required)
Department of Dermatology, Allergology and Venerology, Charité – Universitätsmedizin, Center of Experimental and Applied Cutaneous Physiology, Berlin, Germany

Heike Richter
Department of Dermatology, Allergology and Venerology, Charité – Universitätsmedizin, Center of Experimental and Applied Cutaneous Physiology, Berlin, Germany

Maxim E. Darvin
Department of Dermatology, Allergology and Venerology, Charité – Universitätsmedizin, Center of Experimental and Applied Cutaneous Physiology, Berlin, Germany

Sabine Schanzer
Department of Dermatology, Allergology and Venerology, Charité – Universitätsmedizin, Center of Experimental and Applied Cutaneous Physiology, Berlin, Germany

Axel Kramer
Institute of Hygiene and Environmental Medicine, University Medicine Greifswald, Germany

Alexa Patzelt
Department of Dermatology, Allergology and Venerology, Charité – Universitätsmedizin, Center of Experimental and Applied Cutaneous Physiology, Berlin, Germany

Martina C. Meinke
Department of Dermatology, Allergology and Venerology, Charité – Universitätsmedizin, Center of Experimental and Applied Cutaneous Physiology, Berlin, Germany

Juergen Lademann
Department of Dermatology, Allergology and Venerology, Charité – Universitätsmedizin, Center of Experimental and Applied Cutaneous Physiology, Berlin, Germany


Paper #2997 received 2016.03.31 revised manuscript received 2016.05.27; accepted for publication 2016.05.30; published online 2016.06.14.

DOI: 10.18287/JBPE16.02.020303

Abstract

Background: Inappropriate hair removal increases the risk of surgical site infections which are associated with a higher morbidity and mortality of surgical patients. Here, the effects of a clipping device and a disposable razor on the skin barrier, microbial burden and surface structure were compared. Methods: Changes in bacterial colonization, transepidermal water loss, antioxidant status and the skin surface structure were investigated on the calves of 12 healthy volunteers. Measurement time points were at baseline (tbase) and 24 hours after hair removal (t24). Results: Both, the disposable razor and the clipper showed a decrease in log colony-forming units count from tbase (mean(tbase) ± standard deviation = 2.6 ± 1.27, median ± standard error = 2.6 ± 0.37) to t24 at prazo r= 0.05 and pclipper = 0.06 respectively. At t24 clipping resulted in a higher reduction of log colony-forming units (mean(t24) = 1.76 ± 0.8, median = 1.69 ± 0.23) compared to the use of the disposable razor (mean(t24) = 1.84 ± 0.85, median = 1.91 ± 0.24). Furthermore, the razor-treated group showed an increase in colony-forming units from t0 to t24, whereas clipping lead to a continuous decrease in colony-forming units from t0 to t24. An enhanced appearance of microlesions and a significant increase of transepidermal water loss after shaving using the disposable razor (p = 0.005) were found indicating skin barrier disruptions. Clipping showed no significant effect on transepidermal water loss. Conclusion: Hair removal using the clipping device results in less disruption of the skin barrier compared to the razor, avoiding the development of microlesions. This could be favorable for the prevention of surgical side infections and postoperative wound management.

Keywords

preoperative hair removal; skin barrier disruption; post-operative; postsurgical infection; clipping

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