Diseases and Disorders of Hair and Scalp
The dividing line
Massachusetts barber exams consistently test whether a condition is contagious (and therefore a reason to refuse service and refer) versus noncontagious (serviceable with care). Learn the vocabulary of disorders: parasitic, bacterial, viral, fungal, and inflammatory.
Contagious conditions - do not service
- Pediculosis (lice) - parasitic infestation.
- Tinea (ringworm of scalp or barber's itch) - fungal.
- Impetigo, folliculitis, furuncles/carbuncles - bacterial.
- Herpes simplex - viral; lesions on the face are a stop sign.
- Scabies - parasitic mite.
Noncontagious conditions - service with judgment
- Dandruff (pityriasis) - mild scaling; treat with medicated shampoo.
- Seborrheic dermatitis - oily scaling; refer if severe.
- Alopecia areata - patchy autoimmune hair loss, noncontagious.
- Androgenetic alopecia - pattern baldness.
- Furuncle vs. carbuncle: a furuncle is a single boil; a carbuncle is a cluster - both bacterial and contagious.
Traps
- Assuming alopecia areata is contagious - it is not.
- Confusing tinea (fungal) with dandruff (noncontagious scaling).
- Treating folliculitis as a simple irritation rather than a bacterial infection requiring referral.
- Forgetting that barber's itch is a tinea infection of the beard area.
Rule of thumb
If it's red, oozing, crusted, or spreading - refer. If it's dry, patchy, or genetic - service with care.
Worked example
A client presents with circular scaly patches on the scalp and broken hairs. This suggests tinea capitis. Correct action: refuse service, disinfect implements and station, and refer to a physician.