This article is over 3 years old 
 
 What do beards and toilets have in common? Fortunately, for fans of facial growth, the answer, and the good news, is nothing 
 
 No need for men to get flush-faced about faeces in beards 
 
 According to multiple news sites, beards can contain more poo than a toilet. Here are a few of the headlines: 
 
 “Some beards contain more poo than a toilet shocking study reveals” – the Mirror 
 
 
 
 “Shock new research reveals some beards contain more poo than a toilet” – news.com.au 
 
 
 
 “Some beards are so full of poo they are as dirty as toilets” – metro.co.uk 
 
 
 
 I was curious to read the original study to see what the basis was for the investigation and the actual results. 
 
 
 
 However, as far as I can tell there was no proper study, no team of microbiologists and no poo in beards. The origin of the story appears to be this segment from a TV news network in New Mexico, which involved a reporter swabbing a “handful” of men’s beards and then sending the swabs to a microbiologist in a lab to culture any microbes present. 
 
 
 
 The reporter then interviewed the microbiologist, John Golobic, who identified a few of the bacteria present as “enterics”, that is they are bacteria that normally live in the intestines. 
 
 
 
 “Those are the types of things you’d find in faeces,” he said. 
 
 
 
 And that’s all. Somehow, from this story other media organisations have managed to get poo in beards. 
 
 
 
 While it is true that human faeces are partially composed of gut bacteria, it’s not accurate to describe those bacteria on their own as faeces. 
 
 
 
 Further, even if this was a properly conducted scientific study with a large number of samples and published in a reputable journal, there wouldn’t necessarily be any cause for concern. 
 
 Human skin is home to great diversity of microbes, and it’s not unheard of for types of bacteria normally found in the gut, such as E. coli, to be also found on the skin. 
 
 
 
 So, if the stories aren’t right, are there any actual proper studies into microbes in beards? 
 
 
 
 I could only find a couple in a short amount of time, but there was one study in the journal Anaesthesia which looked at whether facial hair had any effect on the ability of surgical face masks to prevent transmission of bacteria. 
 
 
 
 The study found that bearded men shed more bacteria than clean-shaven men. The study did have a relatively small sample size though, with only 10 people in each category. 
 
 
 
 Another study in the Journal of Hospital Infection examined how facial hair affects the prevalence of potential pathogens such as Staphylococcus aureus (golden staph). 
 
 
 
 It found that having a beard actually reduced the likelihood of antibiotic-resistant bacteria and S. aureus being present on the skin. It also found that hospital workers with beards shed more bacteria than those without beards, supporting the earlier study mentioned. 
 
 However, the unbearded workers still shed enough bacteria to emphasise the importance of everyone wearing face coverings for sterile procedures, regardless of your facial hair situation. 
 
 So in summary: there is more crap in these stories about poo in beards than there is in beards. So chaps, you can all relax. ||||| Beards are big -- literally and figuratively. 
 
 A handful of brave men allowed Action 7 News to swab their beards, and the results showed some beards are as dirty as toilets. 
 
 Quest Diagnostics microbiologist John Golobic tested the swabs, and the results blew his mind. 
 
 “I'm usually not surprised and I was surprised by this,” Golobic said. 
 
 Several of the beards that were tested contained a lot of normal bacteria, but some were comparable to toilets. 
 
 “Those are the types of things you'd find in (fecal matter),” Golobic said, referring to the tests. 
 
 Even though some of the bacteria won’t lead to illness, Golobic said it’s still a little concerning. 
 
 “There would be a degree of uncleanliness that would be somewhat disturbing,” Golobic said. 
 
 Golobic recommends a thorough beard scrubbing and lots of hand-washing. 
 
 “(Also), try to keep your hands away from your face, as much as possible,” he said. 
 
 If the city were to find similar samples in the water system, Golobic said it would need to be shut down for disinfecting. 
 
 RELATED: 7 ways to stop germs in their tracks 
 
 Mobile users: Tap for video ||||| Beards in the operating room have sparked controversy because of their potential to retain and transmit pathogenic organisms.1–5 Even after it is washed with soap and water, facial hair may retain enough microorganisms to establish infection.1 In an extreme example, an outbreak of 16 severe surgical site infections was linked to a surgeon whose hair was colonized by Staphylococcus aureus despite negative throat and nose culture findings.2 
 
 McLure et al6 compared rates of bacterial shedding in bearded and clean-shaven medical personnel who wore surgical masks and performed a series of facial motions. This study found that bearded men shed more colony-forming units (CFUs) than both clean-shaven men (P<.01) and women (P<.001) and concluded that facial hair may be unsafe in a sterile environment. 
 
 Despite the potential risk of infection posed by beards, they are common among surgeons and operating room staff. At the authors' institution, many surgeons, including those with and without beards, elect to wear nonsterile surgical hoods to minimize the risk of surgical site infection. These hoods have been shown to be superior to surgical masks alone and as efficacious as sterile ventilated hoods in decreasing the number of bacterial CFUs in wounds by 98% to 99%.7 Multiple studies have shown that facial hair can act as a reservoir for pathogenic organisms. However, the study by McLure et al6 is the only investigation that has compared the degree of bacterial shedding over a sterile field in bearded and clean-shaven men.1–5 The goal of the current study was to determine whether non-sterile surgical hoods reduce the risk of bacterial shedding posed by beards. 
 
 Materials and Methods After institutional review board approval was obtained, 10 bearded and 10 clean-shaven subjects at the study institution were identified and provided consent to participate in the study. The clean-shaven group consisted entirely of orthopedic surgeons. Because of a limited number of bearded orthopedic surgeons, the bearded group included 6 orthopedic surgeons, 2 general surgeons, and 2 orthopedic surgical ancillary staff. Beard length was measured by placing a ruler perpendicular to the underside of the chin, specifically, 1 cm posterior to the apex of the chin in the midline. The average of 3 measurements, rounded to the nearest half centimeter, was recorded as the final beard length. Average beard length (±SD) was 12±7 mm (range, 5–25 mm). Three beards were shorter than 10 mm (mean length, 5±0 mm), 4 were between 10 and 19 mm (12.5±2.9 mm), and 3 were 20 mm or longer (21.6±2.8 mm) (Figure 1). Figure 1: Photographs of 1 tested subject. Clean-shaven. The mustache shown was not present during testing (A). Beard between 10 and 20 mm (B). Beard of 20 mm or more (C). The clean-shaven subjects had no facial hair present. The bearded subjects had full beards. No mustaches, goatees, or other styles of facial hair were included. The experimental protocol described by McLure et al6 was used to compare the results. To minimize bacterial contamination, participants were tested in an empty room in the presence of a single investigator. Bacterial shedding was assessed with 2 standard blood agar plates placed 15 cm below the chin of the seated subject. Two plates placed 50 cm from the subject acted as the control. Subjects performed a series of facial motions in a standardized pattern for 90 seconds. To minimize contamination by oral flora, subjects were asked not to open their mouths. All subjects wore clean disposable surgical caps and a surgical scrub top. Each subject was evaluated 3 times: while unmasked, while masked, and while masked with a nonsterile surgical hood. Flat pleated, tie-on surgical masks (Model 1818; 3M, St Paul, Minnesota) and polypropylene spunbound surgical hoods (Filtration Systems Products, Inc, Pevely, Missouri) (Figure 2) were studied. One plate each was incubated at 37°C aerobically and anaerobically for 48 hours. Colonies were counted and identified with matrix-assisted laser desorption ionization time-of-flight mass spectrometry (MALDI BioTyper; Bruker Daltonics, Billerica, Massachusetts). Figure 2: Photograph showing the surgical mask and nonsterile surgical hood used in the experimental protocol. Based on the data of McLure et al,6 power analysis determined that inclusion of 10 subjects per group was sufficient to detect a 40% difference between the number of CFUs in masked bearded and clean-shaven groups. The Wilcoxon signed rank-sum test was used to evaluate differences within groups. The Kruskal-Wallis rank-sum test was used to determine differences between groups. All analysis was performed with the JMP statistical software package, version 8 (SAS Institute Inc, Cary, North Carolina). P<.05 was considered statistically significant. 
 
 Results A mean of 6.5 CFUs (anaerobic and aerobic) were isolated per subject while unmasked, and this number was significantly higher than the number isolated while masked (1.4 CFUs, P=.02) or hooded (1.1 CFUs, P=.01). The addition of a surgical hood, compared with the use of masks alone, did not lower the number of CFUs isolated (P=.5). Bearded and clean-shaven subjects shed similar amounts of bacteria while unmasked (9.5 vs 3.3 CFUs, P=.1), masked (1.6 vs 1.2 CFUs, P=.9), or hooded (0.9 vs 1.3 CFUs, P=.6) (Figure 3). Figure 3: Mean total (both anaerobic and aerobic) colony-forming units (CFUs) isolated from each subject. Bearded and clean-shaven subjects shed similar amounts of bacteria while unmasked (9.5 vs 3.3 CFUs, P=.1), masked (1.6 vs 1.2 CFUs, P=.9), or hooded (0.9 vs 1.3 CFUs, P=.6). Error bars represent standard error. The number of aerobic CFUs isolated was similar in bearded and clean-shaven subjects while unmasked (4.6 vs 2.5 CFUs, P=.4), masked (0.4 vs 0.6 CFUs, P=.9), or hooded (0.8 vs 0.5 CFUs, P=.9). The organisms isolated from aerobic cultures are shown in Table 1. Table 1: Organisms Isolated From Aerobic Culture in Order of Prevalence The number of anaerobic CFUs isolated was similar in bearded and clean-shaven subjects while unmasked (4.9 vs 0.8 CFUs, P=.07), masked (1.2 vs 0.6 CFUs, P=.5), or hooded (0.8 vs 0.5 CFUs, P=.9). The organisms isolated from anaerobic cultures are shown in Table 2. Table 2: Organisms Isolated From Anaerobic Culture in Order of Prevalence When participants were stratified by beard length (0 mm, <10 mm, 10–19 mm, and ≥20 mm), subjects with beards that were 2 cm or longer shed more than clean-shaven subjects (18 vs 3.3 CFUs, P=.03). No differences in shedding were observed between any group while masked (P=.4) or hooded (P=.3) (Figure 4). Figure 4: Mean total (both anaerobic and aerobic) colony-forming units (CFUs) isolated from each subject after stratification by beard length (0 mm, <10 mm, 10-19 mm, and ≥20 mm). No differences in shedding were observed between any of the groups while masked (P=.4) or hooded (P=.3). Participants with beards that were 2 cm or longer showed more shedding than clean-shaven subjects (18 vs 3.3 CFUs, P=.03) while unmasked. Error bars represent standard error. 
 
 Discussion McLure et al6 previously reported that bearded men wearing surgical masks and performing facial motions showed more aerobic bacterial shedding than clean-shaven subjects. The current study replicated the experimental protocol of McLure et al6 to compare data. McLure et al6 found that 10 bearded men shed a total of 29 CFUs compared with 8 CFUs shed by women (P<.0001) and 5 CFUs shed by clean-shaven men (P<.01). In comparison, the 10 bearded and 10 clean-shaven men in the current study shed a total of 4 and 6 aerobic CFUs, respectively. Further, the current study found no difference in bacterial shedding between bearded and clean-shaven subjects while unmasked, masked, or hooded. There was a trend for bearded subjects to shed more bacteria while unmasked, but this difference did not reach statistical significance. This trend was eliminated with the addition of surgical masks, with or without hoods. It is unclear why the current study did not find the significant difference in bacterial shedding between bearded and clean-shaven groups that was reported by McLure et al.6 Contributing variables may include the brand of surgical masks used; however, the current study used the same soft tie-on variety that McLure et al6 reported using. The current study also cultured the plates for 48 vs 24 hours, which theoretically would have increased the number of CFUs observed. An important variable may be beard length, which was not reported by McLure et al.6 In the current study, average beard length was 12±7 mm (range, 5–25 mm), and all participants had a full beard. Mustaches, goatees, soul patches, and other beard variants were excluded. In this study, participants with beards that were 2 cm or longer showed significantly more shedding than the clean-shaven subjects, but this difference was eliminated with the addition of a mask. No notable difference was found in bacterial shedding between beards of different lengths while the participants were masked. However, there was a trend for the longest beards to shed the least when the participants wore a mask and hood. A possible explanation for this finding may be that longer hair creates a less abrasive articulation with the material and therefore decreases shedding, although a greater number of subjects would be needed to demonstrate this finding. At the study institution, all personnel who enter the operating room wear a non-sterile surgical hood for arthroplasty procedures. The goal of the current study was to reevaluate the risk of bacterial shedding posed by beards and the ability of masks and nonsterile surgical hoods to reduce this risk. This is an important consideration for surgeons who want to eliminate variables that are responsible for surgical site infections but also wish to wear beards. According to the social science literature, beards convey superior health, maturity, attractiveness, and dominance.8–14 The current findings are tempered by the experimental design, which attempted to isolate bacterial shedding posed by beards alone. This study likely underestimated the protective ability of both masks and hoods by eliminating confounding factors, such as talking and movement of the head and neck. A study by Friberg et al7 found nonsterile hoods to be superior to surgical masks in simulated laminar flow opera tive conditions. 
 
 Conclusion Bearded surgeons did not appear to have an increased likelihood of bacterial shedding compared with their nonbearded counterparts while wearing surgical masks. The addition of nonsterile surgical hoods did not decrease the amount of bacterial shedding observed compared with the use of surgical masks alone. 
 
 References Barbeito MS, Mathews CT, Taylor LA. Microbiological laboratory hazard of bearded men. Appl Microbiol. 1967; 15(4):899–906. Dineen P, Drusin L. Epidemics of postoperative wound infections associated with hair carriers. Lancet. 1973; 2(7839):1157–1159. doi:10.1016/S0140-6736(73)92933-4 [CrossRef] Summers MM, Lynch PF, Black T. Hair as a reservoir of staphylococci. J Clin Pathol. 1965; 18:13–15. doi:10.1136/jcp.18.1.13 [CrossRef] Black WA, Bannerman CM, Black DA. Carriage of potentially pathogenic bacteria in the hair. Br J Surg. 1974; 61(9):735–738. doi:10.1002/bjs.1800610916 [CrossRef] Carpel CG. Forbid beards among health personnel [in Swedish]. Lakartidningen. 1990; 87(44):3591. McLure HA, Mannam M, Talboys CA, Azadian BS, Yentis SM. The effect of facial hair and sex on the dispersal of bacteria below a masked subject. Anaesthesia. 2000; 55(2):173–176. doi:10.1046/j.1365-2044.2000.055002173.x [CrossRef] Friberg B, Friberg S, Ostensson R, Burman LG. Surgical area contamination: comparable bacterial counts using disposable head and mask and helmet aspirator system, but dramatic increase upon omission of head-gear. An experimental study in horizontal laminar air-flow. J Hosp Infect. 2001; 47(2):110–115. doi:10.1053/jhin.2000.0909 [CrossRef] Urban JA. Cost analysis of surgical site infections. Surg Infect (Larchmt). 2006; 7(suppl 1):S19–S22. doi:10.1089/sur.2006.7.s1-19 [CrossRef] Li GQ, Guo FF, Ou Y, Dong GW, Zhou W. Epidemiology and outcomes of surgical site infections following orthopedic surgery. Am J Infect Control. 2013; 41(12):1268–1271. doi:10.1016/j.ajic.2013.03.305 [CrossRef] de Lissovoy G, Fraeman K, Hutchins V, Murphy D, Song D, Vaughn BB. Surgical site infection: incidence and impact on hospital utilization and treatment costs. Am J Infect Control. 2009; 37(5):387–397. doi:10.1016/j.ajic.2008.12.010 [CrossRef] Whitehouse JD, Friedman ND, Kirkland KB, Richardson WJ, Sexton DJ. The impact of surgical-site infections following orthopedic surgery at a community hospital and a university hospital: adverse quality of life, ex cess length of stay, and extra cost. Infect Control Hosp Epidemiol. 2002; 23(4):183–189. doi:10.1086/502033 [CrossRef] Dixson BJ, Brooks RC. The role of facial hair in women's perceptions of men's attractiveness, health, masculinity and parenting abilities. Evol Hum Behav. 2013; 34(3):236–241. doi:10.1016/j.evolhumbehav.2013.02.003 [CrossRef] Neave N, Shields K. The effects of facial hair manipulation on female perceptions of attractiveness, masculinity, and dominance in male faces. Pers Individ Dif. 2008; 45(5):373–377. doi:10.1016/j.paid.2008.05.007 [CrossRef] Reed JA, Blunk EM. The influence of facial hair on impression formation. Soc Behav Pers. 1990; 18(1):169–175. doi:10.2224/sbp.1990.18.1.169 [CrossRef] 
 
 Table 1 Organisms Isolated From Aerobic Culture in Order of Prevalence Organism No. Bearded Clean-shaven Staphylococcus epidermidis 45 9 Staphylococcus capitis 7 4 Staphylococcus aureus 4 6 Corynebacterium pseudodiphtheriticum 1 6 Micrococcus luteus 1 4 Staphylococcus species 0 3 Dietzia cinnamea 1 2 Rothia mucilaginosa 1 0 Paenibacillus species 0 1 Pantoea agglomerans 0 1 Staphylococcus pasteuri 1 0 Staphylococcus lugdunensis 1 0 Staphylococcus caprae 1 0 Micrococcus terreus 1 0 Acinetobacter baumannii 1 0 Neisseria flavescens 1 0
– Beard hygiene is important unless you want to have the equivalent of a dirty toilet seat growing out of your face, according to a microbiologist who swabbed a bunch of beards and was shocked by the results. "I'm usually not surprised and I was surprised by this," Quest Diagnostics expert John Golobic tells KOAT, explaining that some samples yielded the "types of things you'd find in" fecal matter, signaling a "degree of uncleanliness that would be somewhat disturbing" even if the beard matter probably won't make people sick. Golobic says that similar results in a public water system would close it for disinfecting. He urges the bearded to keep their beards—and hands—clean, and "to keep your hands away from your face, as much as possible." Nick Evershed at the Guardian, however, notes that this wasn't exactly a scientific study—and even if it was, the diversity of microbes found on human skin means it wouldn't have to be cause for concern. Evershed checked out a few more serious studies on beard bacteria, which were conducted in hospitals, and found that while bearded workers do appear to shed more bacteria than others, even clean-shaven workers shed enough to show the importance of "face coverings for sterile procedures, regardless of your facial hair situation." (A bank robber in Pittsburgh disguised his beard with another beard.)