Why don't surgeons wear white? The scientific and historical truth

September 21, 2025 •

4 min read

White was once the standard color for medical professionals, a symbol of purity and cleanliness. However, for over a century, surgeons have donned colored scrubs, a shift rooted in surprising physiological and practical reasons. This comprehensive guide answers the question: Why don't surgeons wear white?

Quick Summary

Surgeons transitioned from white scrubs to green or blue to reduce eye strain and afterimages caused by bright operating room lights, helping to maintain focus on the patient. This choice also made blood and gore less visually jarring.

Key Points

Visual Fatigue: Surgeons switched from white scrubs to green or blue to reduce eye strain and visual fatigue caused by staring at red blood against a bright white background.
Afterimage Effect: Green and blue are complementary colors to red, which helps refresh the surgeon's vision and minimizes distracting afterimages that can disrupt focus.
Blood Camouflage: Darker colored scrubs make blood and other stains less obvious, which can be less psychologically unsettling for both the surgical team and patients' families.
Beyond Symbolism: The shift from white was not a move away from cleanliness, but rather a more practical and scientific approach to enhancing surgical precision and focus.
Medical Hierarchy: Many hospitals now use a color-coded system for scrubs to easily identify different medical roles, improving communication and efficiency.
Historical Shift: The transition to colored scrubs began in the early 20th century as medical practice evolved to include a deeper understanding of visual perception and sterile environments.

From White to Green: The Rise of the Colored Scrub

For many years, the white uniform was a revered symbol in medicine, representing hope and sterile conditions. As antiseptic principles became standard practice in the late 19th and early 20th centuries, surgeons adopted white as their operating color to symbolize a new commitment to sanitation. But around 1914, a prominent surgeon made a radical switch to green scrubs, citing very practical, scientific reasons for the change. The move, initially met with skepticism, eventually caught on across the medical community, forever altering the landscape of surgical attire. The shift wasn't a fashion statement; it was a matter of surgical precision and physician well-being.

The Problem with the Color White

Imagine staring intently at red blood and internal tissue for hours under the harsh, bright lights of an operating room. Now, imagine looking away and glancing at a pristine, white surface. For a brief moment, you would see a distracting, greenish-blue afterimage. This physiological phenomenon, known as the afterimage effect, is a result of the eye's saturation with one color (red) and its subsequent overcompensation when shifting focus to a white background. For a surgeon, this brief visual distortion could disrupt focus and concentration, potentially impacting the success of a delicate procedure. The afterimage effect is a key reason why don't surgeons wear white today.

The Science Behind Green and Blue Scrubs

The choice of green or blue was no accident. These colors sit on the opposite side of the color wheel from red, making them complementary. Staring at a green or blue surface helps a surgeon's eyes reset and relax. When a surgeon looks up from the reddish tones of a patient's body to a green or blue scrub, it doesn't produce a distracting afterimage. Instead, it offers a visual palate cleanser, refreshing their vision and allowing them to focus more intensely on the task at hand. This simple but brilliant change significantly improved the surgical environment and the surgeon's ability to maintain peak performance.

The Psychological Impact of Scrub Colors

Beyond just visual perception, the color of a surgeon's attire also has a psychological effect. While white was meant to convey purity, it also starkly emphasized any blood or stains, which can be unsettling for the surgical team. Darker shades like green and blue make these stains less prominent, allowing the focus to remain on the procedure rather than the inevitable byproducts. Furthermore, for the patient and their family, the shift from a blood-stained white coat to a more neutral color can be less jarring and more reassuring. These psychological benefits, combined with the practical advantages, cemented the end of the all-white surgical uniform.

Infection Control: Perception vs. Reality

Early medical practice linked cleanliness with the visual purity of white. If a white garment was stained, it was visibly contaminated and therefore required cleaning. However, this focus on visual cleanliness overlooked the microscopic reality of germs. The modern understanding of infection control emphasizes strict sterilization protocols, which are far more effective than relying on garment color alone. Single-use, sterile surgical gowns, often made from specialized paper-like materials, provide a much more reliable barrier against contamination than any reusable cotton fabric, regardless of color. This modern approach to hygiene made the symbolic function of white garments obsolete.

Comparing White vs. Colored Scrubs


Feature	White Scrubs (Historic)	Green/Blue Scrubs (Modern)
Visual Fatigue	High, due to intense glare and afterimages from red blood.	Low, provides a calming backdrop that reduces eye strain.
Afterimage Effect	Pronounced, causing temporary visual distortions.	Minimized, allowing the surgeon's vision to be refreshed.
Stain Visibility	High contrast makes blood and stains highly visible.	Lower contrast makes blood and stains less distracting.
Psychological Effect	Sterile, but can appear cold or intimidating.	Calming and reassuring for both patients and staff.
Infection Control	Based on visible cleanliness, less effective against microbes.	Backed by modern sterilization methods; garment color is secondary.

Modern Trends in Surgical Attire

Today, scrub colors vary widely across hospitals and even within different departments. While green and blue remain standard for operating rooms, many institutions use a color-coding system to easily identify different roles. For instance, nurses might wear navy blue, while phlebotomists wear brown, and surgeons wear royal blue. This modern, color-coded approach improves communication and efficiency within a busy hospital setting. The history of surgical attire is a fascinating tale of medical innovation, where the simple choice of a color was a deliberate step toward enhancing patient safety and optimizing a surgeon's performance. It’s a subtle yet powerful testament to the fact that every detail in the operating room is meticulously considered for the best possible outcome.

For more detailed information on the history of surgical attire and medical advancements, you can consult authoritative medical resources like the National Center for Biotechnology Information. The journey from symbolic white to scientifically backed colors illustrates medicine's constant evolution, always seeking to refine every aspect of practice for the benefit of both the caregiver and the patient.

Frequently Asked Questions

Surgeons stopped wearing white to prevent visual fatigue and distracting afterimages. The high contrast of red blood on white fabric under bright lights caused eye strain, leading to the adoption of calming green or blue.

While most wear green or blue in the operating room, white coats are sometimes still used in other sterile environments, such as laboratories, but are no longer standard for surgery due to visual and psychological disadvantages.

The initial shift to green was rooted in the science of visual perception rather than symbolism. However, blue is often associated with calmness and trust, providing psychological benefits to both staff and patients.

The afterimage effect occurs when a surgeon stares at the reddish hues of internal tissue for an extended period. Looking away at a white surface would cause a distracting greenish-blue visual ghost, a physiological phenomenon that colored scrubs help prevent.

In many modern hospital systems, specific scrub colors are assigned to different roles and departments (e.g., surgeons, nurses, technicians) to easily identify staff and their functions.

In the past, medical professionals wore white uniforms to project an image of purity, cleanliness, and authority, a cultural norm that reflected medicine's increasing focus on sanitation.

Indirectly, yes. By reducing visual fatigue and minimizing the distracting afterimage effect, green or blue scrubs help surgeons maintain focus and concentration during long and complex surgeries.

Yes, modern scrubs are designed with antimicrobial fabrics and are often disposable or subject to rigorous, high-temperature sterilization. The color change was a functional improvement, but modern hygiene advancements are more about material and process.