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Dermatology. 2013;227(3):197-201. doi: 10.1159/000353529. Epub 2013 Oct 16.

Invisible bleeding from clean-shave haircuts: detection with blood specific RNA markers.

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  • 1Division of Dermatology, Groote Schuur Hospital, University of Cape Town, Cape Town, South Africa.



'Haircut-associated bleeding' is a newly recognized entity that affects at least a quarter of African men who wear shiny clean-shave ('chiskop') haircuts.


This pilot study aimed to elucidate whether invisible haircut-associated bleeding was detectable using blood specific RNA markers (16 participants, 5 with unknown HIV status) and whether surface virus could be detected using PCR from scalp swabs (of 11 known HIV-positive participants).


Haircuts were performed professionally and scalps examined by a dermatologist to exclude injury. Serum samples for viral loads were also collected at the same time.


In all, 6/16 (37%) samples tested positive (>100 relative fluorescent units) for hemoglobin beta and albumin, confirming evidence of blood; of these, only 1/11 was HIV-positive but had an undetectable serum viral load. No surface HIV was detected from any scalp samples.


This study confirms the entity of haircut-associated bleeding but goes further to show for the first time that invisible bleeding from clean-shave haircuts is also common. Both a high serum viral load and evidence of bleeding should ideally be present prior to surface HIV detection. Future investigations for potential HIV (and hepatitis B) transmission through clean-shave haircuts are warranted but should not delay public education for disease prevention.

© 2013 S. Karger AG, Basel.

[PubMed - indexed for MEDLINE]
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