Dear Doctors: When I told my dentist that I was going to have knee surgery this summer, she told me to make sure the surgeon knew my hair was naturally red and not dyed. She said redheads react differently to painkillers and she actually needs to use more anesthetic on me. Is it really true?
Dear reader: It sounds like the kind of weird health claim that goes viral on social media, so it’s no surprise you’re skeptical. Yet, there is both research and anecdotal evidence to support the idea that people with naturally red hair may have different requirements when it comes to medications that control pain.
There is a school of thought that says redheads need more local anesthetics to manage pain, as well as greater amounts of general anesthesia to induce unconsciousness, than the rest of the population. That said, it’s a bit of a new concept and still evolving. It’s also a bit controversial, with its fair share of detractors. While more research is needed to definitively say whether this redhead theory is right or wrong, we can help lay out some of the thinking behind it.
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Less than 2% of the world’s population are natural redheads. This makes red the rarest hair color. Red hair results from variants associated with the MC1R gene, which provides the instructions that lead to each person’s individual pigmentation. In addition to hair color, this gene influences a person’s skin color, their response to UV rays, and their risk of developing melanoma. The gene also plays a role in pain perception.
A person with red hair has two copies of the MC1R gene, receiving one from each parent. The gene also carries a certain mutation in most people who have red hair. It is this variant that has been identified as playing a role in why redheads may react to painkillers differently than others. But research on the specifics has sometimes yielded contradictory results.
Two small studies conducted in the early 2000s focused on pain tolerance. One found that people with MC1R variants are more sensitive to heat and cold. However, in a separate study, people with MC1R variants were less sensitive to stimuli from electrical currents. This was followed by a small study published in the journal Anesthesiology, which found that red-haired women required up to 20% more anesthesia to remain sedated than dark-haired women. A later study, conducted in 2009, found that redhead patients needed higher levels of anesthetics to numb the pain of dental procedures. This confirms your dentist’s experience with your own pain control needs. And to add to the mixed nature of this line of research, a recent study linked differences in pain sensitivity to MC1R variants that are distinct from those that cause someone to have red hair.
So where does this leave you as a redhead patient? As mentioned earlier, there is anecdotal evidence, from both patients and clinicians, regarding red hair and pain response. It’s worth discussing the issue with your surgeon and letting them know about your dentist’s experience with your unique pain relief needs.
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