Dandruff (Pityriasis)
Dandruff is one of the most common scalp conditions encountered in the salon. The medical term is pityriasis. There are two main types:
- Pityriasis capitis simplex (dry dandruff): Small, white, dry flakes that fall from the scalp easily. Caused by excessive shedding of the stratum corneum (outer skin layer). The scalp may itch but is not oily.
- Pityriasis steatoides (oily dandruff): Larger, yellowish, greasy flakes that stick to the scalp and hair shaft. Associated with overactive sebaceous glands. Often linked to seborrheic dermatitis.
Dandruff itself is not contagious. You may service a client with dandruff. However, if the scalp has open sores, active inflammation, or signs of infection, service must be refused.
Seborrheic Dermatitis
A chronic inflammatory skin condition that primarily affects the scalp. Presents as red, flaky, itchy patches with yellowish-white scales. It is more severe than typical dandruff and may spread to the eyebrows, sides of the nose, and ears. It is not contagious. Clients with active, inflamed seborrheic dermatitis should be referred to a dermatologist before chemical services.
Alopecia: Types and Causes
Alopecia is the general term for hair loss. The type of alopecia determines its cause and whether it is reversible.
| Type | Cause | Pattern | Reversible? |
|---|---|---|---|
| Alopecia areata | Autoimmune; immune system attacks follicles | Round, smooth, patchy bald spots | Often yes; refer to dermatologist |
| Androgenetic alopecia | Genetic; sensitivity to DHT hormone | Receding hairline in men; diffuse thinning on crown in women | Partially; treatable, not curable |
| Traction alopecia | Mechanical tension from tight hairstyles | Hair loss along the hairline and edges | Yes, if caught early |
| Alopecia totalis | Autoimmune (severe alopecia areata) | Complete loss of all scalp hair | Unpredictable |
| Alopecia universalis | Autoimmune (most severe form) | Complete loss of all body hair | Unpredictable |
Hypertrichosis vs. Hirsutism
- Hypertrichosis: Excessive hair growth anywhere on the body, in any pattern, regardless of sex. Can be genetic or drug-induced.
- Hirsutism: Excessive hair growth in women in a male pattern (face, chest, abdomen). Usually hormone-related (elevated androgens).
When to Refuse Service
A cosmetologist must refuse service when the scalp shows:
- Open wounds, sores, or abrasions
- Active contagious conditions (tinea capitis, impetigo, head lice/pediculosis capitis)
- Severe scalp inflammation or pustules