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

Sora Jung; Heike Richter; Maxim E. Darvin; Sabine Schanzer; Axel Kramer; Alexa Patzelt; Martina C. Meinke; Juergen Lademann

doi:10.18287/JBPE16.02.020303

Authors

Sora Jung 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

DOI:

https://doi.org/10.18287/JBPE16.02.020303

Keywords:

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

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 (t_base) 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 t_base (mean(t_base) ± standard deviation = 2.6 ± 1.27, median ± standard error = 2.6 ± 0.37) to t₂₄ at p_razo_r= 0.05 and p_clipper = 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.

Author Biographies

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

Department of Dermatology, Venerology and Allergology, 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

Department of Dermatology, Venerology and Allergology, 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

Department of Dermatology, Venerology and Allergology, 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

Department of Dermatology, Venerology and Allergology, Center of Experimental and Applied Cutaneous Physiology, Berlin, Germany
Axel Kramer, Institute of Hygiene and Environmental Medicine, University Medicine Greifswald, Germany

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

Department of Dermatology, Venerology and Allergology, 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

Department of Dermatology, Venerology and Allergology, Center of Experimental and Applied Cutaneous Physiology, Berlin, Germany

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