Impact of Preoperative Hair Removal on Self-Esteem after Brain Tumor Surgery

While surgical outcomes for brain tumors have traditionally focused on neurological and functional recovery, cosmetic and psychosocial factors such as hair shaving are increasingly recognized for their impact on patient well-being. This study aimed to evaluate the association between the extent of preoperative hair shaving and postoperative self-esteem, and to identify factors associated with low self-esteem following brain tumor surgery.

A retrospective cohort study was conducted among 179 patients who underwent brain tumor surgery. Patients were categorized into three groups based on shaving extent: no shaving, partial shaving, and total shaving. Postoperative self-esteem was assessed using the Rosenberg Self-Esteem Scale (RSES). Functional outcomes (Karnofsky Performance Status, Barthel Index, and Glasgow Coma Scale) and quality of life were routinely recorded. Analysis of variance (ANOVA) and logistic regression were used to assess associations between clinical variables and self-esteem.

The median RSES score was highest in the no shaving group (22.5, interquartile range [IQR] 6.0) and lowest in the total shaving group (19.0, IQR 4.5). One-way ANOVA revealed a significant difference in self-esteem scores among the shaving groups ( p  < 0.001). Multivariable logistic regression identified total shaving as an independent predictor of low self-esteem (adjusted odds ratio = 9.54; 95% confidence interval: 1.12-80.78; p  = 0.04). Functional and neurological scores were not significantly associated with self-esteem outcomes.

Total head shaving is significantly associated with lower postoperative self-esteem in brain tumor patients. Minimizing shaving when clinically feasible may enhance psychological outcomes and support holistic recovery.