Study warns of blood-borne infection risks from barbershop haircuts

A recent study by South African academic Professor Nonhlanhla P. Khumalo has raised alarm over the risk of exposure to blood-borne viral infections during haircuts at public barbershops, a concern that extends beyond South Africa to similar settings across Africa, including Zimbabwe.

Professor Khumalo, Head of Dermatology at the University of Cape Town, published the study in the South African Medical Journal in November 2025. The research examined the potential transmission of blood-borne viruses such as HIV, Hepatitis B (HBV) and Hepatitis C (HCV) through haircutting practices, particularly the popular clean-shave hairstyle commonly known as chiskop.

The study also explored the relationship between haircut-related bleeding and Folliculitis Keloidalis Nuchae (FKN), a chronic condition characterised by keloid-like scars at the back of the head, which predominantly affects men of African descent.

The findings show that men who regularly experience visible bleeding during haircuts are significantly more likely to be HIV-positive, with an odds ratio of 2.51. Among a cohort of more than 1 100 men, the overall seroprevalence was recorded at 17.2% for HIV, 6.9% for HBV and 0.4% for HCV.

While FKN itself was not directly linked to higher rates of these infections, the study confirmed that bleeding caused by haircutting is a clear risk factor for exposure to blood-borne viruses.

As part of the investigation, researchers collected one clipper from each barber immediately after it had been used for a clean-shave haircut. The clippers were rinsed with phosphate-buffered saline, submerged in viral medium and subjected to polymerase chain reaction (PCR) testing to detect haemoglobin beta - a blood-specific RNA marker - as well as HIV and HBV.

The clean-shave haircut was found to be the most popular style, accounting for 78% of clients. Of the clippers tested, 42% were positive for haemoglobin beta, confirming the presence of blood. None tested positive for HIV in this sample, but four clippers - representing 8% - tested positive for Hepatitis B virus.

Further analysis revealed that two of the clippers were positive on qualitative HBV PCR testing. Genetic sequencing showed that one sample clustered with genotype A sequences from South Africa, India, Brazil and Martinique, while another clustered with South African genotype D sequences identical to a subtype previously identified in Gauteng province.

Although HIV was not detected on the clippers in this particular study, researchers noted that the HBV DNA copies found were sufficient to pose a real transmission risk.

"This study confirms that there is significant contamination of barber hair clippers with blood and blood-borne viruses," the study states. "Hepatitis B was detected with enough DNA copies to pose a risk of transmitting infection. Although HIV was not detected in this small study, the risk of transmission should be quantified."

Professor Khumalo has spent more than a decade researching haircut-associated viral risks. Her earlier work includes studies on blood and virus detection on barber clippers (2018), invisible bleeding from clean-shave haircuts (2013), and the potential link between FKN, haircut bleeding and HIV transmission (2008).

One of her most significant contributions is the identification of "invisible bleeding." Using highly sensitive RNA markers, Khumalo's team demonstrated that blood is often present on the scalp after a clean-shave haircut even when no cuts or injuries are visible. This suggests that routine barbering practices can allow blood-to-tool-to-blood contact without the awareness of either the barber or the client.

In her recommendations, Khumalo called for increased public awareness of infection risks, improved training for barbers, and stricter enforcement of clipper sterilisation and hygiene protocols to reduce the spread of Hepatitis B and other blood-borne infections in barbershops.