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Head Cover requirements and recommendations from FDA, ACS and AORN for Medical, Laboratory and Human Food Industries summed up into one place here
Our classic clean looking bouffant-style scrub caps are ideal for medical professionals and human food workers who want an all day comfortable hygienic head cover, as opposed to those who don’t want that. You can them buy now here.
Our Standard or Long Reusable Head Covers:
- All day comfort. You decide how snug you want it.
- Doesn’t give you hat head when you take it off.
- Doesn’t give you a light indentation across your forehead like elastic ones do.
- 100% breathable cool cotton.
- Super Eco-Friendly and compostable.
- Standard size fits all from bald to bushy and grapefruit to pumpkin. Fits buns and should length ponytails.
- Long size made for long ponytails and dreadlocks.
- Ties in back to adjust for size.
- This cloth scrub cap is washable 50 to 70 times
- Pick your look. Pull it down in back for flat on head or keep it as a flat hat.
- Cover ears or wear above.
Approximate dimensions for Surgical Scrub Caps
- 4” high in front
- 5” high on sides
- 8 ½” from front to back
- 6” from side to side.
- Ties in the back to adjust as necessary
Let me go on the record as saying that I am against human food. I think it is gross and wrong.
But there is a lot of writing about head covers and what is accepted by the American College of Surgeons (ACS), the American periOperative Registered Nurses (AORN), and the FDA requirements for health care and human food workers. And there are a lot of questions people ask. Can I wear a ponytail out of my surgical cap?
Does a bouffant cap need to cover my mutton chop sideburns? Does the reusable skull cap need to cover the ears? Etc. I consolidated all of the info here to make it easy to purchase the correct headcover. For example, this giant 2020 study shows that wearing or not wearing head covers and surgical jackets in surgeries doesn’t increase or decrease infections in patients. Lisa Spruce, of the AORN, says, "You must keep in mind that we have no recommendation for the type of headcovers worn in semi-restricted or restricted areas. The evidence does not demonstrate any association between the type of head covering or extent of hair coverage in the outcome of SSI rates.”
I also listed ideas at the end for Alternative Head Covers should you decide to not push the easy button and purchase our all day comfort reusable cloth bouffant / surgical caps and run out later.
The answers to the top 8 Frequently Asked Questions about Surgical Caps, Bouffant Caps and other reusable Head Covers are below.
- What are the FDA rules and regulations for disposable and reusable Bouffant caps and Surgical Head Covers?
- Which material is the best for surgical caps or bouffant cap head covers?
- How much of the hair does the reusable head cover or skull cap need to cover?
- Do chefs and other Human Food Industry workers need to wear head covers?
- Can a ponytail stick out of a surgical cap?
- Do bald people need to wear reusable surgical caps?
- Does a reusable surgical cap or skull cap need to cover your ears?
- What are the religious beliefs and reusable surgical caps or head cover rules?
Why the Shortage? About 10 years ago, most hospitals moved to disposable spunbound polypropylene (plastic) disposable shower cap type hats for head covers. But currently, that raw material is all being used up to make the more popular gowns and face masks. Therefore, there has been a huge shortage of head covers… until now. What a perfect time for the world to return to reusable, natural and washable cloth head covers. They’re cheaper to own, better looking and 1000X better for the environment.
Terminology: Surgeons use skull caps, surgical caps or bandanas. Nurses use scrub caps or bouffant caps. Nurses in operating rooms use surgical caps and those in the food industry use head or hair covers. I will be using all of the terms interchangeably. They are all head and hair covers and generally the same design and usable in all industries.
Vermeer c. 1665 Girl with a Pearl Earring and Cool Head Cover
You just need to decide which kind to buy. See if you can tell which ones we prefer
- Reusable sustainable head covers or disposable trash hats that don’t decompose
- All day comfort tie behind the head bouffant caps or irritating elastic band shower caps.
- Breathable cotton reusable head covers or warm sweaty synthetic scrub caps.
- Classic and sexy looking cloth head covers or generic nerdy looking shower caps.
Four purposes of our reusable and washable cloth Surgical cap, Bouffant caps or Skull caps
- To protect patients during surgery - No one wants Coronavirus microbes, loose hairs, dandruff or last night’s confetti falling into an incision or open wound.
- To keep food clean - No one wants to eat other people’s junk that fell out during food prep at the processing plant or restaurant.
- To keep coronavirus off your hair - When you get into the car or get home, there’s a chance the virus microbes can fall off your head and be inhaled.
- To keep dandruff off your shoulders - This is not a substitute for Head and Shoulders, but equally as potent of a solution as wearing a white shirt so people don’t see dandruff on your shoulder.
Head Cover Frequently Asked Questions
What are the FDA rules and regulations for Bouffant caps and Surgical Head Covers?
Let me sum up what the FDA says about Bouffant Caps and Surgical Hats to save you the trouble. They classify head covers as a Class 1 non-medical device and are exempt from FDA regulations. Their main advice is that you cover as much hair as you can with your head cover.
Which material is the best for surgical caps or bouffant cap head covers? No one I found had any guidance for which materials to use, whether they should be water resistant, repellent or non-flammable. A wide variety of materials are used to make reusable and washable surgical, scrub, skull and bouffant caps. Polyester/cotton mixes, wool and 100% cotton. Polyester is a nice material for some things, but it does not breath well, is warm and can get kind of stinky like fake kitchen cleaning sponges. Cotton is expensive for several reasons, but it’s the best for all day comfort.
"There are lots of different practices and very little data. Making a lot of rules around meaningless stuff distracts from the real issue. Most bacteria that causes infection is from the patient themselves.'' - Chief of Surgery at Boston Medical Center, Dr. Gerard Doherty
The 5 reasons to only use cotton reusable head covers are:
- Cotton breathes well - The highest quality most expensive shirts are made of 100% cotton because they breathe so well, you don’t sweat. And since a lot of heat leaves our bodies through our head, wear 100% cotton reusable head covers.
- Cotton washes thoroughly - Cotton cloth is hard for infectious microbes to hold on to. Polyester fabrics, similar to a stinky kitchen polymer sponge, often develop a funky odor because microbes aren’t as easily washed off and therefore multiply.
- Body temperature regulation - A luxury bedding manufacturer told me that the expensive and quality hotels only buy 100% cotton bedding so people sleep better. Your body needs to breathe for a solid night’s rest. Arabian history tells us that
robes and tunics were always made of cotton or silk to combat the sweltering heat.
- Cotton is environmentally great - Did you know you can compost 100% cotton garments for the garden. Bury it and it turns back into dirt in a short time.
- Cotton is absorbent - When you’re sweating in a hot room, cotton soaks it up and evaporates it out.
How much of the hair does the reusable head cover or skull cap need to cover?
To sum it up, The American College of Surgeons (ACS) says. “The skull cap is symbolic of the surgical profession.” Read their guidelines for OR attire here. The skull cap, chef hat or bouffant surgical cap can be used so almost all hair is covered up. Only a small amount of hair on the back of the neck and only modest sideburns can remain uncovered. They recommend to try to keep sideburns to a reasonable length. Would you want a surgeon with big fat lamb chops full of taco meat and cilantro operating on you?
Do chefs and human food preparation industry workers need to wear head covers?
I found, in the FDA’s 767 page document of rules for “human food employees”, (I’m not joking) what they say about hair covers. Let me sum it up here. If you’re a human food employee in the chain from the time it dies and is cleaned, up to the time it is ready to be eaten by humans, then you need to wear something like a scarf, bouffant cap, hat, headband, hair net or “other effective restraints” so your hair or what’s in your hair doesn’t get into the food or anything that goes with food like silverware or linens. If you are a food employee at a restaurant, like front counter staff, waiters, hostesses etc. who are a “minimal risk of contaminating exposed food”, then you don’t need to wear a head or hair cover. Read more of the same FDA’s guidelines here.
Can a ponytail stick out of a surgical cap? It should be contained during surgeries according to the ACS. But there is no regulation I could find that said it was a rule to tuck the hair in during general medical procedures where there was no open wound or incision. We have designed a reusable bouffant cap with space to comfortably tuck your hair into.
Do bald people need to wear reusable surgical caps? Yes, because the dry skin flakes and virus microbes that landed on their chrome dome can fall off during surgeries. Gravity kills.
Does a head cover like a reusable surgical cap or skull cap need to cover your ears? Lisa Spruce, director of evidence-based perioperative practice for The Association of Perioperative Registered Nurses (AORN) says they say they have no rule or recommendation about covering the ears. She said there is “Moderate-quality evidence” that ears are a “potential reservoir for pathogens”, but there isn’t any research that shows any more or any fewer surgical site infections happen by your head cover being above or below the ears. She stated that “covering the ears may have potential harms such as causing impaired hearing, which could potentially interfere with important team communication”. It could also interfere with the use of a stethoscope and make it so protective eyewear doesn’t fit well.
What about religious restrictions for reusable surgical caps and bouffant covers? The ACS says, “Religious beliefs regarding headwear should be respected without compromising patient safety”. I say they should use fabric that doesn’t have much lint.
Caps are important because, as it turns out, hair captures more contaminants than most other parts of the body, especially since you won’t wash your hair throughout the day the same way that you might wash your hands. So as you can see, there are many reasons that it's a good idea to have several of these around.
The Big Debate
If you need more drama in your life and are interested in reading how a nurse tried to mandate all skull caps be banned and bouffant caps or surgical caps be policy for all surgical personnel and how the rest of the medical world fought back and overturned her, read the story here. It’s kind of funny. And then read how they responded and backed off here.
Other reading on how head covers are overrated
Two large reviews of published studies in the last five years found little or no evidence that head covers prevent surgical infections. You can read all about how head covers probably don’t matter, but they matter to that one who gets sick and dies though.
Write on your surgical cap with washable markers
Write your name on the reusable head cover with a washable marker
If you write your first name and job role on your surgical cap, bouffant cap or scrub cap with washable markers, it will make for faster and better communication during surgeries or urgent times since faces are usually covered up. It also helps personalize the situation during a stressful and scary time in a patient’s life. https://www.aorn.org/blog/theater-cap-challenge
Alternative Head Covers for if you run out
There are alternative head covers you can give a try if you run out of regular surgical bouffant caps. Or you can just buy ours.
Like the Moroccan Berber Tuareg Scarf Turban reusable scrub or surgical caps my wife and I wore in the Sahara a few years back.
Or the Kippah or Yarmulke reusable and washable surgical skull cap alternative.
Or the Hijab or Niqab reusable bouffant cap alternative
Or the Bishop’s miter, which is reusable and washable, and a great substitute for a skull cap. Be a thermostat, not a thermometer.
Or the Eastern Orthodox Russian Kamilavka & Epanokamelavkion. It covers the back of the neck, unlike most bouffant caps.
Or an Abaya for the whole body reusable head cover if you’re contagious.
Or a nice fez is always a fine choice as a bouffant cap in a pinch. Often comes with a go kart.
I’ve always been fond of a good washable and reusable kumi or massar for parties. It’s what cool people wear.
Or you could go old school turkish turban for an alternative bouffant and keep your lunch warm too.
Or a good old fashioned greek fisherman’s hat-like beret like Rembrandt used to cover his head with in this self portrait.
The keffiyeh is great for surgery or for keeping the sun off in the desert like this actual picture of Lawrence of Arabia
Kufi hats work well as a reusable skull cap or surgical cap
Sahdguru’s style head cover is part of what has made him so popular and it can work for you too.
A nun’s habit is not just for celibate women, but for celibate men too, no matter where you work.
Sikh’s wear a handsome dastar or dumala cover up every single hear on your head. Some call it a Keski. This is a great video teaching how to tie one off.