To shave or not to shave? How beards may affect COVID-19 risk

To shave or not to shave? How beards may affect COVID-19 risk

Growing a beard may seem as harmless as committing to elastic waistbands, as far as pandemic trends go. But for some, choosing to forego shaving could impact one crucial method for ending the pandemic.

An important part of wearing face masks to reduce the risk of contracting or spreading coronavirus is that the mask fits snugly.

Depending on a beard’s length and thickness, experts have said it may reduce the effectiveness of mask-wearing by creating more space between your face and the mask.

Any opening “increases the chance that there is a virus that will get to the orifices, which can then obviously give you the disease,” said Dr. Mona Gohara, an associate clinical professor of dermatology at Yale School of Medicine.

Mask-wearing doesn’t totally prevent infection, but it can help limit the spread of potentially virus-laden respiratory droplets among people.

Mask use can reduce the number of new coronavirus infections by nearly 50%, according to a December 2020 study.

Is now the time to give up beards, then?

The answer isn’t simple. Shaving may be a blow to your self-expression, self-esteem, religious or cultural beliefs, or any skin conditions that are helped by letting your facial hair grow.

Here’s what people with beards should know and do during the pandemic — including some possible ways your whiskers and masks could coexist safely.
What research does and doesn’t tell us

There have been studies on whether beards accumulate, harbor or shed more or less bacteria than bare faces. But that research was inconclusive and on bacteria.

There appears to be very little, if any, research on whether beards accumulate, harbor or shed more or less virus than bare faces.

However, given the evidence that “not being protected adequately with masks and social distancing does increase your risk of coronavirus,” Gohara said, “if your mask isn’t fitting properly, then you are increasing your risk.”

Health care workers often wear masks, and they have known that facial hair is an impediment to proper mask-wearing since long before the pandemic. What commonly reveals the problem is when medical professionals’ fittings for N95 masks are unsuccessful because of facial hair.

Some facial hair styles aren’t recommended, because they likely interfere with a respirator’s seal (which presses to the face), or because the hair might interfere with the exhalation valve (which makes breathing easier), according to a 2017 infographic by the US Centers for Disease Control and Prevention.

“For a mask to have any chance of fitting properly, it needs to be mask to skin, not mask to hair,” Gohara said.

“If a mask can completely cover a beard, there (shouldn’t) be any problem. If not, a beard is very likely to create a small gap between facial skin and mask unless one fastens the mask tightly,” said Qingyan Chen, a professor of mechanical engineering at Purdue University in Indiana, via email.

“The small gap would create a leakage for air to enter (the) nose when inhaling and for air with virus to go to the surroundings when one exhales.”

For example, a gap “of only 0.2-millimeter height can cause 2% to 8% of the inhaled air (containing virus-transporting droplets) to enter the mask unfiltered,” said Robinson Peric, a post-doctoral researcher at Hamburg University of Technology in Germany, via email.

The greater the gap, he said, the higher the percentage of inhaled air entering the mask unfiltered.

Why beards are tough to part with

Some people with beards may have worn the same style for years, finding their facial hair an important part of self-expression or image.

Keeping a beard, however, isn’t always a matter of personal style or preference. Beards can be extensions of pillars of certain religious faiths, which might make the decision to shave them even harder.

Two doctors of the Sikh faith, for example, sparked controversy by making a difficult call that would allow them to treat Covid-19 patients more safely. They sacrificed Kesh — the Sikh practice of allowing hair to grow to respect God’s creation — by shaving off their beards to fulfill Seva, service to mankind.

Some followers of Islam, some sects of Judaism and Rastafarianism also have religious practices or cultural beliefs that prohibit cutting hair.

Skin issues can also be a factor in facial hair decisions. Men of color, particularly Black men, are more likely to experience inflammation, razor bumps and ingrown hairs after shaving, Gohara said.

And the friction of masks against bare skin can cause irritation, which can result in hyperpigmentation, she added.

“Many infectious disease experts will say that if you can eliminate facial hair, or if you can at least trim it just so it fits within the confines of the mask, then that’s advisable,” Gohara said. “There have to be solutions for people where that’s not an option. And that’s something that, as medical providers, we need to address.”

How masks and facial hair can coexist

If completely shaving off your beard isn’t right for you, there are alternatives that may not compromise safety.

Trimming your beard or wearing a different style, like a goatee, is one option.

Some online small businesses sell extra-large masks that fit over a beard and against one’s neck.

If you’re a medical professional, you could request a controlled air purifying respirator or a powered air-purifying respirator, which are designed to accommodate facial hair while protecting you and others.

Lastly, you could join the double-masking trend, starting by wearing an N95 mask or masks with ties “that kind of create a bit more security and tightness,” Gohara said.

Follow up with another mask that you put over your beard, fit snugly against your jaw or neck, and secure by looping the straps behind your ears or by tying them behind your head.

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