Redheads & Surgery

Back when I was a general surgery resident, one of the sayings passed down from our surgery professors was that “redheads were trouble”, because they seemed to bleed a bit more than the average patient during a typical procedure. It was like a surgical superstition, a part of surgical lore that hadn’t been proven scientifically, and yet was well known by all wise surgeons.

In the last few years, some researchers have started to look at the connection between natural redheads and surgery, and it actually turns out that there ARE some interesting findings – if you are a true redhead, and not just a shade of auburn.

For those that like the technical details, red hair color results from one of several mutations in a hormone receptor known as the melanocortin-1 receptor (MC1-R). The MC1-R plays a key role in determining the type of melanin (eumelanin vs pheomelanin) that is produced within melanocytes (pigment containing cells) – and hence plays a major role in skin and hair color. When the receptor is defective, it’s postulated that melanocortin levels rise – which also seems to make the body more sensitive to pain.

Researchers at the University of Louisville have published 3 separate studies on this topic. They’ve found that red-headed volunteers had:

1. Higher anesthesia requirements, requiring about 20% more inhaled anesthetic agent than brunettes to eliminate responses to noxious stimuli;

2. Higher resistance to lidocaine (a common numbing agent). Subcutaneous injection of lidocaine was less effective in redheads than brunettes, and the redheads were more sensitive to painful hot and cold stimuli.

3. More self-reported bruising after surgery or injury, even though all the usual lab tests for coagulation and platelet function were within the normal range.

So, the surgical lore of our senior surgery professors was right all along – watch out for those red-heads!