Immediate cut hair translocation to the intergluteal fold in the hairdressers shop – another link to pilonidal sinus disease

Cut hair translocation and PSD

  • Dietrich Doll Marienhospital Vechta
  • Dirk Wilhelm
  • Andreas Ommer
  • Kristina Albers
  • Hanna Mordhorst
  • Igor Iesalnieks
  • Pantelis Vassiliu
  • Marcus Luedi
Keywords: pilonidal sinus, sharp cut hair, intergluteal pilonidal sinus disease, axial hair strength, occipital hair,, barber, pathogenesis


Introduction: The genesis of pilonidal sinus disease is still disputed, but there is mounting evidence that occipital cut hair may play a major role, with the folliculitis theory losing ground. Translocation of cut hair from the head to the lower back has not been proven so far.

Methods: Eight men were asked to undress their upper body immediately following a dry haircut. A large layer of sticky transparent plastic sheeting was applied to their chest and back, then removed and placed on millimeter scale paper, fixing all hairs in position. Cut hairs were counted and the totals were transferred to Excel matrix datasheets.

Results: Despite protective measures taken during haircuts, all customers had cut hair on their upper body (chest and back) (38-630 hair fragments; median 325), with the majority of hairs (62%) located on the back. Cut fragments were mostly found close to or within the sweat crest, and were also present in the lower back.

Conclusion: Any haircut results in large numbers of sharp hair fragments on the upper body despite the use of a protective gown and an elastic paper collar. This sharp hair slides down the posterior sweat crest towards the nates and into the intergluteal fold, where it can inject itself into the healthy skin. Young patients should shower or take a bath following a haircut to reduce their intergluteal hair load. It is highly likely, but not yet proven, that the frequent exposure to a large number of cut hair fragments at a certain age leads to pilonidal sinus disease. If we solve this question, then prevention of pilonidal sinus would be possible.

Author Biographies

Dirk Wilhelm

Klinik und Poliklinik für Chirurgie, Klinikum rechts der Isar der TU München, Germany


Andreas Ommer

End-und Dickdarm-Zentrum Essen, Essen, Germany

Kristina Albers

Pilonidal Research Group, Vechta, Germany

Hanna Mordhorst

Pilonidal Research Group, Vechta, Germany

Igor Iesalnieks

Städtisches Klinikum Bogenhausen, München, Germany

Pantelis Vassiliu

4th Surgical Clinic, Attikon University Hospital, Athens, Greece

Marcus Luedi

Department of Anaesthesiology and Pain Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland


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