2.3 Diseases, Disorders, and Conditions of the Hair & Scalp

2.3 Diseases, Disorders, and Conditions of the Hair & Scalp

Introduction to Hair and Scalp Disorders

As a cosmetologist licensed by the Florida Department of Business and Professional Regulation (DBPR), you are legally and ethically obligated to recognize diseases and disorders of the hair and scalp. While you cannot diagnose or treat medical conditions, you must know when it is safe to perform a service and when you must refuse service and refer the client to a physician.

Types of Hair Loss (Alopecia)

Alopecia is the technical term for abnormal hair loss. The three most common types seen in the salon are:

1. Androgenetic Alopecia: Also known as male or female pattern baldness. It is caused by a combination of genetics, aging, and hormonal changes. Specifically, the hormone dihydrotestosterone (DHT) causes the hair follicles to shrink, transitioning terminal hair (long, coarse scalp hair) into vellus hair (short, fine, peach-fuzz hair).
2. Alopecia Areata: An autoimmune disorder where the body's immune system mistakenly attacks the hair follicles. It is characterized by sudden hair loss in round, smooth patches on the scalp. It can progress to alopecia totalis (loss of all scalp hair) or alopecia universalis (loss of all body hair).
3. Postpartum Alopecia: Temporary hair loss experienced at the conclusion of pregnancy. During pregnancy, high estrogen levels keep a large percentage of hair in the growth (anagen) phase. When hormone levels drop rapidly after childbirth, these hairs enter the telogen (resting) phase all at once, resulting in heavy shedding about 2 to 4 months postpartum. Hair growth typically returns to its normal cycle within 9 to 12 months.

Hair Shaft Disorders and Abnormal Growth

• Canities: The technical term for gray hair. It is caused by the loss of melanin pigment in the hair shaft.
  • Congenital canities exists at or before birth (e.g., albinism).
  • Acquired canities develops with age or as a result of stress, illness, or genetics.
• Hypertrichosis (also called hirsuties): A condition characterized by the abnormal growth of terminal hair on areas of the body that normally only grow vellus hair (such as a beard on a woman).
• Trichoptilosis: The technical term for split ends. The only treatment is to cut the hair to prevent the split from traveling up the shaft.
• Trichorrhexis Nodosa: Knotted hair, characterized by brittleness and the formation of nodular swellings along the hair shaft. The hair breaks easily at these nodes.
• Monilethrix: Beaded hair, where the hair shaft has alternating nodes (beads) and constrictions. The hair breaks easily between the nodes.
• Fragilitas Crinium: Brittle hair, which splits or breaks easily.

Infectious Scalp Conditions

Infectious diseases are caused by fungi, parasites, or bacteria. Under Florida cosmetology law, you must refuse service to any client with an infectious scalp condition.

Fungal Infections

Fungal infections are caused by microscopic plant-like organisms (dermatophytes).

• Tinea: The technical term for ringworm. It is highly contagious, characterized by itching, scales, and painful circular lesions. Contrary to its common name, tinea is caused by a vegetable parasite (fungus), not a worm.
• Tinea Capitis: Ringworm of the scalp, characterized by red spots at the opening of the hair follicles, brittle hair, and bald patches.
• Tinea Favosa (favus): Characterized by dry, sulfur-yellow, cup-like crusts on the scalp called scutula. It has a distinct, unpleasant odor.
• Pityriasis: The technical term for dandruff. It is characterized by the excessive production and accumulation of skin cells. Dandruff is caused by a naturally occurring fungus called Malassezia, which grows out of control.
  • Pityriasis Capitis Simplex: Classic dry dandruff, characterized by scalp irritation, large flakes, and itchiness.
  • Pityriasis Steatoides: Greasy or waxy dandruff, characterized by an accumulation of greasy scales mixed with sebum that stick to the scalp in crusts.

Parasitic Infestations

• Scabies: A highly contagious skin disease caused by the itch mite (Sarcoptes scabiei), which burrows under the skin to lay eggs. It causes intense itching and pustules.
• Pediculosis Capitis: The infestation of the hair and scalp with head lice. Lice are easily transmitted through direct contact or shared personal items like combs and hats.

Bacterial Infections

• Furuncle: The technical term for a boil, which is an acute, localized bacterial infection of a hair follicle that causes constant, throbbing pain.
• Carbuncle: A larger inflammation of the subcutaneous tissue, similar to a furuncle but larger and involving multiple hair follicles.

Both are caused by Staphylococci bacteria.

Florida DBPR Sanitation Requirements for Contagious Conditions

When a cosmetologist suspects a client has a contagious condition, they must discreetly refuse service. If the client is already in the chair, the service must be halted immediately. Under Florida Administrative Code, any tools or implements that have come into contact with a client suspected of having an infectious or parasitic condition must be isolated and immediately disinfected. This involves washing the tools in hot, soapy water, rinsing, and then completely immersing them in an EPA-registered disinfectant for the full contact time specified on the manufacturer's label (typically 10 minutes). Non-porous surfaces must be wiped down with disinfectant, and porous items (such as neck strips or emery boards) must be discarded in a closed trash receptacle.