3.2 Hair Diseases and Disorders

The HLO Barbering bulletin groups hair diseases/disorders with histology of hair and scalp. That pairing is the exam trap. A disorder is an abnormal condition of the hair shaft or growth that is usually not spread from client to client. A disease in this chapter, especially an infectious one, can spread in the shop on tools, capes, and hands. Oregon does not give barbers a medical license. ORS 690.005(2) keeps barbering cosmetic. OAR 817-120-0005 still makes you responsible for deciding whether a service would be prohibited, unsafe, or harmful. Textbook language you will meet on the 100-question theory exam is: do not service a client with a contagious condition. Translate that into Oregon practice: stop for tinea and other spreading infections; follow Division 10 if you ever handle head lice; wash hands; never use a soiled tool on the next client.

Non-infectious shaft and growth disorders

Canities is gray or white hair from loss of melanin in the cortex. Congenital canities is present from birth (including some albinism presentations). Acquired canities is the ordinary age-related graying; canities prematura is the exam name for unusually early gray. It is not contagious. Oregon barbering includes cutting and styling that hair. Chemical coloring is hair design, not barbering, under ORS 690.005, so do not invent a color service as a barber solution to gray hair.

Ringed hair (pili annulati) shows alternating light and dark bands along the shaft because air spaces in the cortex scatter light. Hair can be more fragile. It is not contagious. Handle gently, keep tension low, and do not diagnose a rare shaft defect as a fungus.

Hypertrichosis is excessive hair growth in areas that are not usually densely hairy. It can be localized or more generalized, congenital or acquired. Distinguish the exam term from hirsutism, which is androgen-driven excess terminal hair in a female-pattern distribution and is a medical workup, not a barber diagnosis. You may shave or trim hypertrichosis. You may not tell a client they have an endocrine disease.

Trichoptilosis is split ends. The cuticle has worn away and the cortex has frayed. Product can temporarily coat the fiber; only cutting removes the split. Trichorrhexis nodosa is brittle hair with grayish-white nodes where the shaft has fractured almost through; hair breaks at the node. Chemical overprocessing, heat, and rough handling are common causes. Monilethrix is beaded hair: genetic periodic constrictions so the shaft looks like a string of beads and breaks at the narrow points. Fragilitas crinium is brittle hair that breaks along the shaft rather than only at a node or only at the tip. None of these four is contagious. Barber action is trim damaged fiber, reduce tension and heat, skip harsh chemicals, and refer if the breakage is sudden, patchy, or accompanied by scalp inflammation you cannot explain as ordinary dryness.

Pityriasis at the hair-shaft / scalp border

Pityriasis sits on the bulletin line between hair and scalp. Flakes cling to the shaft, but they form from shedding scalp epidermis. Pityriasis capitis simplex is dry dandruff: small, white or gray, lightweight flakes, often with a tight, dry scalp and little redness. Pityriasis steatoides is greasy, yellowish, waxy scale that sticks to the scalp and shaft. When redness and inflammation join the greasy scale, you are looking at the picture textbooks call seborrheic dermatitis—still not a tinea ring, still not a prescription you write. Ordinary dry dandruff on intact skin is a cosmetic shampoo-and-cut. Heavy, inflamed, or malodorous scale is a refer. Do not pick crusts off the scalp. Do not treat with a prescription antifungal or steroid.

Infectious disease: tinea and pediculosis

Tinea of the hair—ringworm—is a fungal infection (dermatophytes such as Microsporum and Trichophyton in textbook language). On the scalp it is tinea capitis. You may see one or more circular patches, scaling, itch, stubbly broken hairs, or black-dot stubble where hairs snapped at the follicle. A boggy, pus-filled plaque (kerion) is a medical emergency for the client, not a fade request. Tinea is contagious. An Oregon barber stops the service, does not clip through the patch, refers the client to a physician, and treats tools and linens as contaminated. Serving that client would not be "just a haircut." It would be an unsafe service under OAR 817-120-0005.

Pediculosis capitis is infestation with head lice (Pediculus humanus capitis). You see moving lice and nits (eggs) cemented to the hair shaft, usually close to the scalp, often behind the ears and at the nape. It is contagious. Standard Milady-style instruction is to refuse service. Oregon writes a specific rule: OAR 817-015-0075 says head lice may be treated at the discretion of the authorization holder, and if you do, you must still comply with OAR Chapter 817, Division 10 safety and infection control. Discretion means you may decline, and you may proceed only if you can isolate the service and disinfect. It does not mean you ignore nits, use a soiled cape on the next client, or diagnose a secondary infection. Pediculosis is still a parasite, not a style problem. Ordinary dry dandruff flakes move; nits do not slide easily along the shaft.

Oregon infection-control duties that attach to every disorder

OAR 817-010-0008 (Servicing Clients), effective 7/1/2024 in the current filing, requires an authorization holder to: (1) perform thorough hand washing with soap and water or an alternative hand-washing product (gel, aerosol spray, foam, or packaged hand wipes) immediately before and after serving each client to prevent cross-contamination and exposure to blood or other potentially infectious materials; (2) wear single-use disposable protective gloves when the service routinely involves exposure to blood or other potentially infectious materials; (3) wear eye goggles, shields, or a mask if spattering is likely; and (4) dispose of refuse that contacted blood or other potentially infectious materials under OAR 817-010-0060. Clipper nicks on a thinning scalp and razor work around a fragile hairline are exactly when gloves become the exam answer.

OAR 817-005-0005 defines soiled as an article that has been used and has not been cleaned or disinfected for use on the next client. A comb that went through pityriasis scale, a neck strip from a lice check, or a brush used on a client you then turned away for tinea is soiled until it is cleaned and disinfected. "I only used it for a second" is not a defense. High-level disinfectant on Oregon's definition is EPA-registered and tuberculocidal; that standard belongs on sharp tools after they are cleaned. Do not carry a soiled tool back to a clean drawer.

Portland shop scenario. During a consultation you see circular scaling with stubbly broken hairs over the crown. The client wants a tight fade "to let it breathe." That is tinea until a physician says otherwise. You do not fade it. You stop, explain that you cannot service a suspected contagious fungal condition, refer, wash hands immediately, and take every implement that touched the head out of service as soiled until cleaned and disinfected. A second client has gray hair and a few split ends. That is canities plus trichoptilosis. Cut the splits, skip the medical lecture, and keep moving.