Hair and Scalp Care
Hair and scalp questions test structure, growth, analysis technique, and - heavily - your judgment about when to refer instead of treat.
Structure and growth
- Cuticle - outer overlapping scales; protects the cortex.
- Cortex - the bulk of the fiber, holds melanin and the disulfide bonds that perming and relaxing alter.
- Medulla - central core, sometimes absent in fine hair.
- Anagen (active, roughly 2–6 years, about 90% of scalp hair at any time), catagen (transition, weeks), telogen (resting, about 3 months, then shedding). Losing 50–100 hairs daily is normal.
Analysis before service
Assess texture (fine, medium, coarse), density, porosity (how quickly hair absorbs water; overly porous hair grabs color and relaxer fast), and elasticity (a wet strand should stretch and spring back). Note scalp condition: normal, dry, oily, flaking, red, or broken.
Scope
A barber shampoos, conditions, massages, and applies scalp preparations. A barber does not diagnose or treat disease. Refer: suspected tinea capitis (patchy scaling with broken hairs, contagious), pediculosis (lice and nits), impetigo, weeping or spreading dermatitis, smooth round patches suggesting alopecia areata, and any undiagnosed lesion.
Worked example
A client has greasy yellow scale along the hairline and behind the ears with no broken hairs. That pattern suggests seborrheic dermatitis rather than fungal infection. Appropriate action: shampoo with a medicated preparation, do not pick or scrub the scale, and refer if the area is inflamed, weeping, or spreading.
Traps that cost marks
- Labeling all flaking as dandruff and treating it.
- Massaging an inflamed or broken scalp.
- Calling traction alopecia "normal" because it is common at tight hairlines.