3.3 Fungi, Parasites & Communicable Conditions (K.A.R. 28-24-3)
Key Takeaways
Parasites live on or in another organism and take nourishment from it without giving anything back. Head lice (pediculosis capitis) and scabies mites are the key ones, and fungi are also parasitic organisms.
Dermatophyte fungi feed on keratin. They cause tinea pedis (athlete's foot), tinea corporis (ringworm) and tinea unguium (onychomycosis of the nail).
K.A.R. 28-24-3(a) forbids services to a consumer with pediculosis, open sores, inflamed tissue suggesting a communicable condition, fungus, lice or ringworm until a licensed physician signs a statement that it is not contagious.
The same subsection forbids a practitioner from providing services while having any of those conditions, until a physician's statement is obtained.
If a condition is discovered mid-service, K.A.R. 28-24-3(b) requires the practitioner to stop safely, inform the consumer why, and clean and disinfect all affected tools, work areas and waiting areas.
Quick Answer: Fungi (molds, mildews and yeasts) include dermatophytes that feed on keratin. They cause athlete's foot (tinea pedis), ringworm (tinea corporis) and nail fungus (onychomycosis, or tinea unguium). Parasites such as head lice and scabies mites live off a host. Under K.A.R. 28-24-3, a Kansas practitioner may not serve anyone with pediculosis, open sores, inflamed tissue suggesting a communicable condition, fungus, lice or ringworm, or work while having one, until a licensed physician signs a statement that it is not contagious. If you find the condition after starting: stop safely, tell the client why, and clean and disinfect the tools, work areas and waiting areas.
Fungi
Fungi are single-celled or many-celled organisms such as molds, mildews and yeasts. They thrive in warm, dark, moist places, which is why they turn up in feet, shoes, towels, damp pedicure equipment and under lifted nail products. Some fungi form spores that survive drying, so fungal spread is controlled by cleaning and then disinfecting with a fungicidal disinfectant. Kansas requires disinfectants to be bactericidal, virucidal and fungicidal.
Dermatophytes are fungi that digest keratin, the protein of the stratum corneum, hair and nails. The main conditions:
| Condition | Location | What you see |
|---|---|---|
| Tinea pedis (athlete's foot) | Feet, especially between the toes and on the soles | Redness, scaling, peeling, cracks, small blisters, itching |
| Tinea corporis (ringworm) | Body skin | A red, ring-shaped, scaly patch with a clearer center. Ringworm is a fungus, not a worm |
| Tinea manus | Hands | Scaling and redness on the palms or between the fingers |
| Onychomycosis (tinea unguium) | Nail plate and bed | Thickened, discolored (white, yellow or brown), crumbly nail, often lifting with debris underneath |
Kansas rule: "fungus" and "ringworm" are named in K.A.R. 28-24-3(a). A client with visible athlete's foot or nail fungus gets no service on the affected area, and no foot spa, unless they bring a signed physician's statement that the condition is not contagious. Section 7.5 covers how to refuse politely without diagnosing.
Note
Fungus vs. bacteria. Green or black discoloration under a lifted enhancement is bacterial (usually Pseudomonas), not mold or fungus (section 3.1). Exam questions offer "mold" as a distractor.
Parasites
Parasites are organisms that grow, feed and shelter on or in another organism, the host, and contribute nothing to it. They need a living host to survive.
- Head lice (pediculosis capitis): small wingless insects that live on the scalp and lay eggs (nits) glued to hair shafts. They spread by head-to-head contact and shared items such as combs, capes and towels. Kansas lists lice of the head, body or pubic area.
- Scabies: a contagious skin condition caused by the itch mite burrowing under the skin. It causes intense itching and small raised lines or bumps, often between the fingers and on the wrists, exactly where nail technicians work.
The Board's FAQ answers directly: a practitioner is prohibited from serving a person with lice, or working while having lice, unless a licensed physician signs a statement that the condition is not infectious, contagious or in a communicable stage. Lice are a communicable condition.
K.A.R. 28-24-3: The Communicable-Condition Rule
(a) No practitioner shall provide either of the following:
- any service to a consumer who has pediculosis, open sores, inflamed tissue suggesting a communicable disease or condition, fungus, lice (head, body or pubic) or ringworm, until the consumer furnishes a statement signed by a licensed physician that the condition is not in an infectious, contagious or communicable stage; or
- any service while the practitioner has any of those conditions, until the practitioner obtains such a physician's statement.
(b) If a service has already started and the practitioner discovers one of these conditions, the practitioner shall:
- stop services immediately in a safe manner;
- inform the consumer why the service was stopped; and
- clean and disinfect all affected tools, work areas and waiting areas.
"Communicable disease or condition" means one diagnosed by a licensed health care professional as contagious or transmissible and able to spread through cosmetology, nail technology, electrology or esthetics (K.A.R. 28-24-1(d)).
Applying the Rule Step by Step
| Situation | Correct action |
|---|---|
| A new client arrives with scaly, peeling, itchy skin between the toes and wants a pedicure | Do not start. Explain you cannot perform the service on that condition, suggest a physician, and offer to rebook with a physician's statement |
| Mid-manicure you notice a crusted, weeping sore on the client's knuckle | Stop safely (finish nothing that risks contact), tell the client why, clean and disinfect every affected tool, the table and the waiting area |
| You have scabies or lice yourself | Do not work until you have a physician's statement |
| The client shows a physician's note that their nail condition is not contagious | Service may proceed with normal precautions |
| The client insists and offers to sign a waiver | A waiver does not replace the physician's statement. Do not proceed |
Safe Communication
Do not name a disease as a diagnosis. Kansas practitioners are not licensed to diagnose, and you could be wrong. Describe what you observe ("I see redness and peeling between the toes") and why you must stop ("Kansas rules don't allow me to perform this service when the skin shows this kind of condition"). Recommend a physician. Keep the conversation private and respectful.
Prevention Habits
- Inspect hands and feet before every service. Refusing at the start is easier and safer than stopping midway.
- Keep feet and hands dry after soaking, and dry between the toes.
- Change towels for every client and launder them in hot water with detergent (K.A.R. 28-24-4).
- Discard porous items such as files, buffers, pumice stones, foam toe separators and flip flops after one client (K.A.R. 28-24-8).
- Drain, scrub and disinfect pedicure equipment after every client (K.A.R. 28-24-9).
A new client asks for a pedicure, and you see red, scaly, peeling skin and small blisters between her toes. What does Kansas regulation require?
Proceed, but add extra antiseptic to the foot bath water
Proceed with a waterless pedicure, since the foot spa is the only risk
Do not provide the service until she furnishes a statement signed by a licensed physician that the condition is not contagious
Treat the area with an over-the-counter antifungal cream and continue
Halfway through a manicure, a technician notices lice in the client's hair near the neck. Which sequence follows K.A.R. 28-24-3(b)?
Stop the service safely, tell the client why it was stopped, and clean and disinfect all affected tools, work areas and waiting areas
Finish the manicure quickly, then disinfect only the implements
Continue, because lice affect hair and the service involves only the hands
Stop, call the Board to report the client, and close the salon for the day
Which organisms cause athlete's foot, ringworm and onychomycosis?
Pus-forming bacteria such as staphylococci
Bloodborne viruses such as hepatitis B
Dermatophytes, fungi that feed on keratin
Itch mites that burrow under the skin
A nail technician develops scabies. When may she return to providing services under Kansas regulations?
After 48 hours of home treatment, as long as she wears gloves
Immediately, because scabies spreads only through shared towels
After the salon owner gives written permission
After she obtains a statement signed by a licensed physician that the condition is not in an infectious, contagious or communicable stage
Sections you finish are checked off in the contents.