Should Doctors Have Beards?

How many of you have ever come across the question: should doctors have beards? From an evolutionary standpoint, it seems that beards have played a rather “healthy” role: in the 1800s, beards were actually prescribed by doctors as a remedy for a sore throat. They believed air contamination could be minimized with natural air filters, or beards. Nowadays, beards are thought to play more of a “dominance” role. A number of studies have found men who have beards appear more mature, confident, and dependent. For instance, most individuals associate an older man’s beard with religious leaders, such as Jesus or Moses. Moreover, a man’s handlebar mustache gives the image the man has a pleasant personality, while a man’s scruffy beard enhances the illusion he is up on the latest trends. Whatever the case, today, beards represent an acceptable form of self-expression. However, is this form acceptable in a hospital setting?

As a doctor, you are well aware infectious viruses and bacteria lurk in hospital settings. There have been a few studies conducted which suggest beards—even those well-trimmed and groomed every day—may harbor infectious microorganisms. For this reason, beards have begun to beg the question: is this personal choice being put ahead of patient safety? This question proves challenging, because it is part of a larger debate. Setting aside beards, shouldn’t ties, bow ties, and white coats also be taken into account? Are white coats being washed thoroughly enough so they do not retain and transmit infectious diseases?

In the year 2014, one of the largest studies on this topic was conducted. It examined over 400 medical staff members and found that bacterial transmission was similar in both male participants with beards and those without. In 2016, a study known as “To Beard or Not to Beard? Bacterial Shedding Among Surgeons” was published. It re-examined the issue of personal hygiene and beards in surgical settings. The researchers sampled ten bearded men and ten clean-shaven men. All participants were given clean disposable surgical caps and scrub tops. They were assessed while masked, unmasked, and masked with a nonsterile surgical hood. The end results showed the bearded participants did not appear to have an increased likelihood of bacterial shedding in comparison to the clean-shaven participants while wearing surgical masks. It remains unknown as to why there was not a vast difference in bacterial shedding, seeing as how previous trends reported bearded participants shed more facial hair while unmasked. Yet, the sample population tested was rather small and did not include broader hospital settings, so an accurate conclusion cannot as yet be determined.

A significant variable may be beard length, as all bearded participants had a full beard and excluded other facial hair variants. While every man’s beard grows at a different rate, beard length is just one variable out of many. Each man’s beard also has its own thickness and strength, and some may be more prone to shedding than others. What’s more, there is even data that hints one’s beard does not play a role in bacterial shedding, but rather personal hygiene, or what is growing on your face. Several doctors have stated the most important thing to do is to keep facial hair neatly trimmed and clean. They also stated that if the facial hair was ever an issue with any patient, they would take it into consideration, as their appearance is considered a reflection on them.

In 1895, a physician by the name of F.A. Colby published a letter in the Boston Medical and Surgical Journal. He illustrated how his beard gave him the confidence to look wise while pondering to make a difficult diagnosis. Today, most doctors would attest to this reference. In fact, they have stated that, in the eyes of several patients, a beard triggers a sense of seniority and wisdom. Most patients feel uneasy being around young doctors, and having a beard seems not only to add a few years, but also gives the illusion of perceived credibility and medical expertise.

Setting aside research studies, surveys, and growing trends, there are also a few health benefits associated with growing a beard. They include:

• Protection from bacterial infections and acne-related skin infections
• Protection from inflammatory conditions often triggered by shaving or accidental cutting while shaving the face
• Protection from skin cancers by blocking the sun’s harmful rays and offering UV protection
• Assistance to those who suffer from asthma by acting as a barrier between the body and toxin exposure
• Assistance to those who suffer from allergies by acting as a filter for pollen and other types of allergens
• Keeping the face moisturized by protecting the skin's natural oils
• Protection for the skin from acne, blemishes, and wrinkles
• Prevention of winter illnesses by providing an extra shield against infectious agents that weaken the immune system
• Prevention of throat diseases by keeping airborne bacteria out of the mouth and throat
• Keeping you warm in the winter by adding a layer of protection
• Helping men feel more attractive and self-confident, thus alleviating self-doubt and negative thoughts that add to stress

The issue that surrounds personal hygiene, especially in a hospital setting, is rather tricky. Certainly, it is standard procedure to wear hair nets and masks when you are exposed to surgical environments. You may even be expected to be extra cautious of your beard to protect patients from bacterial shedding. However, the fact of the matter remains that, because there are thousands and thousands of infectious agents, you cannot always be completely certain as to whether the precautions you take work well in terms of protection against bacterial transmission.

To date, there is very little to no evidence to suggest covering facial hair can fully prevent bacterial transmissions or infectious disease. There is also little evidence to suggest doctors with facial hair are more likely to harbor infectious agents than those with clean-shaven faces. As to whether any type of surgical hat or mask has been linked to bacterial transmission, it is difficult to conduct clinical trials, because this would require potentially exposing patients to the risk of infection from doctors whose hair and skin remain uncovered. Wearing a doctor’s attire is not evidence-based, but rather a recommendation for hospital settings on a national level. After all, the emphasis is on patient safety.

Should doctors have beards is a question that arises in everyday circumstances. On the other hand, different means of transmission must also be taken into consideration—washing hands, wearing white coats, wearing ties, carry stethoscopes, and other sources of possible infection. They have also sparked controversy because of their likeliness to harbor and spread infectious agents, even after being washed with soap and water.

Being a doctor, you have a responsibility to provide your patients with the best possible care, all the while avoiding doing anything to jeopardize their well-being. Certainly, this involves taking good care of your personal hygiene. While having a clean-shaven face is much easier to wash and manage, there is no reason (at least none up to now) as to why you should have to shave off your beard. There are findings that suggest a clean-shaven face is more hygienic and bacteria-resistant, however, until the question of such appearances turns into real medical concerns, to each his own. The issue of the cleanliness of a doctor’s beard, until proven otherwise, is personal. Do you agree? Should doctors have beards in hospital settings?