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Do redheads feel more pain?

April 12, 2018 | UCI Health
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Red is the rarest hair color, with less than 2 percent of the world’s population sporting natural carrot tops. It turns out the genes that produce redheads also lead them to experience pain differently than the rest of us.

Redheads are harder to sedate, but they have a different tolerance for pain, says UCI Health anesthesiologist Dr. Yashar Eshraghi.

Eshraghi, whose specialty is pain medicine, became intrigued with redheads’ response to pain during his residency training.

“Classic anesthesia literature has documented that redheads require more anesthesia,” he says. “In addition, there is recent evidence that redheads are more tolerant to local anesthetics and more sensitive to opioids.”

More anesthetic, less analgesic

Here’s what studies have revealed about redheads and pain:

  • They need about 20 percent more anesthesia to be sedated.
  • They also need more local topical anesthetics, such as lidocaine or Novocain, which is why many redheads have a fear of dentists, according to the American Dentistry Association.
  • They need lower doses of pain-killing analgesics, such as opioids.
  • They easily detect changes in hot and cold temperatures.
  • They may be less sensitive to electric shock, needle pricks and stinging pain on the skin.

The redhead gene

Both parents need to pass along a recessive genetic trait for their child to have red hair. They inherit mutations in the melanocortin 1 receptor, or MC1R, on chromosome 16. MC1R is responsible for producing the skin pigment melanin, which redheads can’t produce because of the mutation.

This same gene is responsible not only for hair and skin color, but also for the midbrain function that determines pain response.

But why would redheads be less tolerant to some pain, and more tolerant of others?

Pain and the nervous system

It could be that their brains process pain differently than others do. Eshraghi says a clue might be found in the fact that the two types of pain treatment — anesthesia, which makes people unable to respond to any stimulation, and analgesia, which controls pain but leaves other senses intact — are governed by different parts of the nervous system.

Future research may find the answer, he says.

Susceptible to sunburn — and melanoma

Because MC1R affects the body systemically, the mutation also dictates other differences in the ginger-haired. While it makes redheads more susceptible to sunburn, that very sensitivity to ultraviolet rays also allows their bodies to produce more vitamin D, which is essential to bone development and good health.

But because their bodies don’t produce melanin, which can help protect the skin against damaging ultraviolet rays, it also means that gingers are at greater risk for developing melanoma.

Carrot tops also have fewer strands of hair on their heads, just about 90,000 to the 110,000 for blonds and the 140,000 for dark-haired people. However, the individual strands are thicker, making their hair easier to style. Plus, redheads don’t go gray. The coppery color simply fades as the years wear on and eventually turns white.

Preventing pain

In preoperative conversations with redheaded patients, Eshraghi usually raises the topic as a compliment of sorts, saying, “Do you know that redheads have unique qualities to respond to pain?”

If the patient is indeed a natural redhead, he carefully monitors the patient’s reaction while administering anesthesia to ensure they are properly anesthetized.

Be proactive about your care

Unfortunately, the reactions redheads have to pain medication aren’t more widely known among physicians in other specialties, Eshraghi says. That’s why he recommends that redheads be proactive when undergoing a procedure that requires medication for pain.

“They should always tell their surgeon, anesthesiologist and dentist that they will most likely need more anesthetic or local anesthetic, and that they might be more sensitive to opioids,” he says.

Be wary prescription of pain medications

And when it comes to prescription pain meds, he advises that patients have a detailed discussion with their prescribing physician.

“Redheads need to be aware that they are likely more sensitive to opioids,” he says. “And they should avoid taking extra doses without talking to their doctor.”

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