Another common sharp hair fragment disease – barbers’ anterior disease (BAD)

barbers’ anterior disease

  • Dietrich Doll Marienhospital Vechta
  • Katharina Maier
  • Kristina Albers
  • Jessica Runden
  • Ioannis Massalis
  • Philipp Moersdorf
  • Markus M Luedi
Keywords: barbers’ disease, sharp cut hair, pilonidal sinus disease, scalp, electron microscopy, pathogenesis


Introduction: There is suspicion that sharp cut hair fragments cause intergluteal pilonidal sinus disease. Barbers, exposed daily, have not been systematically investigated for risk.

Methods: One hundred barbers in Northern Germany were interviewed regarding site and incidence of hair penetration as well as methods/frequency of self-epilation, using a structured questionnaire.

Results: Ninety-two percent of barbers experience foreign hair penetration, mostly when cutting short dry hair. Despite daily showering and changes of clothing, 43% need monthly and 25% weekly hair removal using forceps. Left index and middle fingers as well as palms are prone to penetration, followed by feet, anterior chest and elbow groove. While 12 barbers reported intergluteal pilonidal sinus disease within their families, none had it themselves. Self-epilation was not linked to a higher incidence of hairs in the axilla, arms, legs or genital region.

Conclusion: The overwhelming majority of barbers need to remove penetrating foreign hair fragments regularly, despite changing clothes and daily showering after work. Fingers, hands, feet and the anterior chest are particularly at risk. The term “Barbers’ Anterior Disease” could be used to describe sharp hair fragments affecting hair care professionals. Anterior hair exposure is not linked to posterior pilonidal hair disease.


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