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Editorial / Featured Articles / Industry News / Oncology Aesthetics

Treating Clients with Red Hair – Risks + Precautions

Redheads carry mutations in the gene known as Melanocortin 1 receptor (MC1R). Those with only a hint of red, including strawberry blond or auburn hair, may carry just a few MC1R mutations, while those with vibrant red hair may carry numerous mutations in the gene.

MC1R is responsible for producing the skin pigment melanin, which redheads can’t produce because of the mutation.  In order for a person to have red hair, both parents need to pass along a recessive genetic trait. To iterate, redheads inherit mutations in the melanocortin 1 receptor, or MC1R, on chromosome 16. 

The human MC1R is expressed on the surface of melanocytes and is a key regulator of intracellular signaling to the melanin biosynthetic pathway governing pigment formation.

The red hair phenotype results from excess pheomelanin production. Production of this yellow-red pigment results from well-described mutations of the MC1R.

In contrast, when a normal MC1R is expressed, the predominant pigment produced by melanocytes is eumelanin (dark brown) and the typical eumelanin to pheomelanin ratio is high.

This same gene is responsible for hair and skin color, but also for the midbrain function that determines pain response.

Who is This Type – Fitzpatrick Scale – Type 1

The red hair phenotype is characterized by fair skin color, freckles, and increased UV sensitivity.

Temperature changes

Redheads can easily detect changes in hot and cold temperatures.  Redheads are shown to be more sensitive to cold pain perception, cold pain tolerance, and heat pain.

Hair on Redheads

People with red hair have fewer strands of hair on their heads, just about 90,000 to the 110,000 for blonds and the 140,000 for dark-haired people. However, the individual strands are thicker, making their hair easier to style. Plus, redheads don’t go gray. The coppery color simply fades as the years wear on and eventually turns white.


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Bruising

People with red hair color and red-haired women are more slightly more prone to post-op bruising but have normal coagulation tests. Estheticians may need to note this when performing more invasive salon/spa services.

Risk of Skin Cancers

Redheads, according to skincancer.org, are one and a half times as likely to develop basal cell carcinomas; twelve times more likely develop squamous cell carcinomas and the risk for melanoma can vary from 10 to 100 times that of people without the gene variant.  That is why sun protection from an early age is crucial for redheads. 

Because MC1R affects the body systemically, the mutation also dictates other differences in the redheads. While it makes redheads more susceptible to sunburn, that very sensitivity to ultraviolet rays also allows their bodies to produce more vitamin D, which is essential to bone development and good health.

Because their bodies don’t produce melanin, which helps to protect the skin from damaging UV rays, this leaves this population very vulnerable to sunburn, and ultimately developing skin cancer.

If, in fact, we have clients with red hair and they are experiencing these issues, we need to be aware and to modify services for them.  This includes redhead clients diagnosed with cancer.  Some of these issues can be exacerbated if ignored.

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Anesthesia and Pain Killers During Surgery

Anesthetic via inhalation is usually the same for everyone, however, some anesthesiologists have mentioned that people with natural red hair require more anesthesia than people with other hair colors.

Study results plus anecdotal evidence indicates that people with red hair require significantly more desflurane (anesthesia) than those with dark hair. This represents an increase of 19% in the desflurane partial pressure so more anesthesia is needed in order to sedate the person.

Besides an increase of 19-20% in anesthesia, redheads also need more local topical anesthetics, such as lidocaine or Novocain. Subcutaneous lidocaine was also found to be significantly less effective in redheads.

Red heads though need lower doses of pain-killing analgesics, such as opioids.

Red heads may also be less sensitive to electric shock, needle pricks and stinging pain on the skin.

https://www.skincancer.org/blog/red-alert/

https://www.ucihealth.org/blog/2018/04/redheads-pain

https://practicaldermatology.com/articles/2014-mar/beware-the-redheaded-patient-fact-or-fiction-in-cosmetic-and-surgical-dermatology

https://www.medicaldaily.com/8-ways-having-red-hair-affects-persons-health-pain-sex-348198

References:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1362956/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1351323/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1692342/



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