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BACKGROUND: Since 2021, an increase in cases of tinea capitis has been detected in adolescents who shave their hair with fade haircut.
METHODS: Multicenter retrospective observational study of cases of cephalic pole dermatophytosis with a history of having been acquired after frequent shaving in hairdressing. A call was made to dermatologists from the Spanish Academy of Dermatology and Venereology (AEDV) to provide cases observed between January 2021 and December 2022. Patients with microbiological confirmation by culture or direct examination with KOH were included.
RESULTS: 107 cases were collected, 106 of which were male. 78 non-inflammatory forms were observed, compared to 29 inflammatory. The most frequently isolated fungus was Trichophyton tonsurans (75.7% of cases). The lesions appeared predominantly on the nape of the neck and temporal area.
CONCLUSIONS: The distribution by sex, age and lesional location seems to indicate that a new social trend, in which male adolescents regularly go to hairdressers to shave the occipital and temporal areas, would be the cause of this grouping of cases of ringworm of the scalp. The most frequent microorganism in our study (T. tonsurans) coincides with the most prevalent in our environment. This study shows an accumulation of cases that can be taken into account by competent Public Health agencies, which are responsible for ensuring compliance with the rules of disinfection of the material used for shaving.

BACKGROUND: Since 2021, an increase in cases of tinea capitis has been detected in adolescents who shave their hair with fade haircut.
METHODS: Multicenter retrospective observational study of cases of cephalic pole dermatophytosis with a history of having been acquired after frequent shaving in hairdressing. A call was made to dermatologists from the Spanish Academy of Dermatology and Venereology (AEDV) to provide cases observed between January 2021 and December 2022. Patients with microbiological confirmation by culture or direct examination with KOH were included.
RESULTS: 107 cases were collected, 106 of which were male. 78 non-inflammatory forms were observed, compared to 29 inflammatory. The most frequently isolated fungus was Trichophyton tonsurans (75.7% of cases). The lesions appeared predominantly on the nape of the neck and temporal area.
CONCLUSIONS: The distribution by sex, age and lesional location seems to indicate that a new social trend, in which male adolescents regularly go to hairdressers to shave the occipital and temporal areas, would be the cause of this grouping of cases of ringworm of the scalp. The most frequent microorganism in our study (T.tonsurans) coincides with the most prevalent in our environment. This study shows an accumulation of cases that can be taken into account by competent Public Health agencies, which are responsible for ensuring compliance with the rules of disinfection of the material used for shaving.

BACKGROUND: Various products are available for lightening hair. There are no data on which applications are actually used in hairdressing, impeding proper estimation of actual exposure and necessary preventive measures.
OBJECTIVE: To assess information about availability, usage and formulation of lightening preparations in the German hairdressing trade.
METHODS: A market survey was conducted and hairdressers were surveyed by online questionnaires.
RESULTS: Of 783 hairdressers clicking the link, 565 hairdressers (91.2% female, mean age of 40.2 ± 11.7 years) from all German states responded (response rate: 72.2%). The questionnaire survey has shown that available hair-lightening preparations in the German hairdressing trade are (multiple selection possible): dust-free (88.5%) and non-dust-free bleaching powders (22.1%), bleaching creams (41.9%), high-lifting hair colour creams (88.8%) and normal hair colour creams (58.4%). Five hundred eighteen (91.7%) hairdressers favour lightening hair with powder. The market survey revealed that bleaching powders and creams contain potassium persulfate, ammonium persulfate and sodium persulfate or combinations of these persulfate salts.
CONCLUSIONS: Hairdressers are exposed to various hair-lightening applications containing different chemicals. Preventive measures need to address adverse skin and respiratory effects. Implementation of targeted health education already in early career stages (i.e., apprenticeship) seems advisable and can be maintained by refresher trainings.

The safety assessment of cosmetics considers the exposure of a \'common consumer\', not the occupational exposure of hairdressers. This review aims to compile and appraise evidence regarding the skin toxicity of cysteamine hydrochloride (cysteamine HCl; CAS no. 156-57-0), polyvinylpyrrolidone (PVP; CAS no. 9003-39-8), PVP copolymers (CAS no. 28211-18-9), sodium laureth sulfate (SLES; CAS no. 9004-82-4), cocamide diethanolamine (cocamide DEA; CAS no. 68603-42-9), and cocamidopropyl betaine (CAPB; CAS no. 61789-40-0). A total of 298 articles were identified, of which 70 were included. Meta-analysis revealed that hairdressers have a 1.7-fold increased risk of developing a contact allergy to CAPB compared to controls who are not hairdressers. Hairdressers might have a higher risk of acquiring quantum sensitization against cysteamine HCl compared to a consumer because of their job responsibilities. Regarding cocamide DEA, the irritant potential of this surfactant should not be overlooked. Original articles for PVP, PVP copolymers, and SLES are lacking. This systematic review indicates that the current standards do not effectively address the occupational risks associated with hairdressers\' usage of hair cosmetics. The considerable irritant and/or allergenic potential of substances used in hair cosmetics should prompt a reassessment of current risk assessment practices.

OBJECTIVE: Respiratory symptoms at work are common among hairdressers. Various working materials, most notably bleaching ingredients such as ammonium persulfate, have been made responsible. The objective of this study is to achieve a better understanding of work-related respiratory symptoms of hairdressers by describing common features in a large affected collective.
METHODS: One hundred forty-eight hairdressers with respiratory symptoms at work presenting between 2012 and 2019 were consecutively included in a case series. Anamnestic and diagnostic data including pulmonary function and allergy testing were retrospectively compiled from records and analysed. Additionally, cases were categorised in five groups with respect to occupational causation certainty.
RESULTS: 30% of the predominantly female collective had changed jobs or were on longer sick-leave. Besides respiratory symptoms, 10% also reported contact urticaria to blonde dyes. In 60% an obstructive airway disease was confirmed. A specific hypersensitivity reaction to ammonium persulfate was found in 15%. Group 1 with a proven immunological occupational causation showed significantly lower age (p < 0.001) and tenure time (p = 0.001), higher sensitization rates against environmental allergens as well as a higher total IgE (p = 0.015), compared to group 4 (obstructive airway disease, specific occupational causation unlikely).
CONCLUSIONS: This case series contributes to a better characterization of work-related respiratory symptoms in hairdressing as one of the largest examined collectives of symptomatic hairdressers. Ammonium persulfate as the most common specific cause showed signs of a type-I-like hypersensitivity reaction with typical risk factors for atopy. Prick testing is recommended in all symptomatic cases. However, a specific occupational causation often cannot be proved.

Objectives. This study examined ergonomic risk levels and upper quadrant musculoskeletal pain (UQMP) levels of hairdressers, and the difference and correlation between genders. Methods. Volunteers participating in the study were assessed with the descriptive data form, rapid upper limb assessment (RULA), Cornell musculoskeletal discomfort questionnaire (CMDQ) and disabilities of the arm, shoulder and hand (DASH) score. Results. In total, 229 (female, 26.6%; male, 73.4%) hairdressers participated in the study. Prevalence of the first three frequencies of pain in the musculoskeletal system was 48.5% in the neck, 41.5% in the upper back and 33.6% in the shoulder. The mean DASH score of the hairdressers was 10.75 ± 10.70, quick DASH-work modulated score was 6.85 ± 10.24 and mean ergonomic risk score was moderate to high (5.36 ± 1.22) according to RULA. Although there was no difference in terms of gender in the ergonomic risk level, a higher level of UQMP was significant in females (p < 0.05). RULA score correlated with CMDQ and DASH scores in both genders (p < 0.05). Conclusions. Hairdressers perform their jobs in work environments with moderate to very high ergonomic risk levels. There is a possibility of UQMP in hairdressers, especially females, due to the effect of their movement patterns as a requirement of their profession.

BACKGROUND: Nickel and cobalt were not regarded as pertinent contact allergens in the hairdressing trade for the last decades. It was even stated that the relevance of nickel allergy in the hairdressing trade has been overestimated for several years. Recently, nickel and cobalt release from a multitude of metal tools in the German hairdressing trade was documented in two field studies.
METHODS: Review of two field studies.
RESULTS: In 2019, nickel release from 9.2% of 229 tested metallic hairdressing tools was evidenced, and in 2021, nickel release from 27.6% as well as cobalt release from 2.1% of 475 tested tools was detected in overall 30 North German hairdressing salons. Tweezers, sectioning clips, hair clips, and straight razors were identified as nickel as well as cobalt releasing tools. Crochet hooks and tail combs were identified as only nickel releasing tools.
CONCLUSIONS: A variety of metallic tools - which are used daily by hairdressers - release nickel and/or cobalt in allergologically relevant amounts. This circumstance has to be considered problematic with regard to the development of work-related allergic contact dermatitis. Thus, nickel and cobalt should possibly receive greater attention as potential contact allergens in the hairdressing trade.
CONCLUSIONS: The proven nickel and cobalt release from metallic hairdressing tools might entail legal ramifications in terms of insurance law. In case of nickel and cobalt allergies within the occupational group of hairdressers, metal tools might be considered as feasible sources for nickel and cobalt exposure.

Current cosmetic regulations primarily focus on protecting consumers, not the professional user who is subjected to a partly different, and certainly more intense exposure to hazardous substances. Against this background, this systematic review aims to compile and appraise evidence regarding skin toxicity of 2-hydroxyethyl methacrylate (HEMA; CAS no. 212-782-2) and ethyl cyanoacrylate (ECA; CAS no. 7085-85-0) contained in cosmetic glues used among hairdressers and beauticians who perform nail treatments and eyelash extension as well as hair extension applications. This systematic review followed the Preferred Reporting Items for Systematic review and Meta-Analysis (PRISMA) 2020 recommendations for reporting systematic reviews and meta-analysis. In total, six publications from six countries were eligible for this systematic review. A meta-analysis revealed that hairdressers and beauticians have a ninefold increased risk of developing contact allergy to HEMA compared with controls who are not hairdressers and beauticians. Results for ECA are lacking. The results of this systematic review clearly show that-regarding contact allergy to acrylates-it is not appropriate to apply risk assessment for consumers to hairdressers and beauticians who occupationally handle cosmetic glues. The regulations in existence do not adequately address occupational risks for hairdressers and beauticians connected with the use of acrylate-containing cosmetic substances and need reconsideration.

BACKGROUND: Limited data exist on occupational allergic contact dermatitis (OACD) in Turkey.
OBJECTIVE: To investigate the epidemiologic profile of OACD in Turkey.
METHODS: A retrospective cohort study on 294 patients with OACD among 2801 consecutively patch-tested patients in the Allergy Unit of the Dermatology Department of İstanbul Faculty of Medicine between 1996 and 2019.
RESULTS: The overall prevalence of OACD was 10.5%, showing a male predominance. OACD was most frequently seen in construction workers (45.2%), followed by hairdressers, metalworkers, health care workers, and miscellaneous. The main relevant allergens were chromium in cement, thiurams in rubber gloves, hairdressing chemicals, resins/glues/plastics, metals, isothiazolinones, and fragrances. Hands were the mainly involved site (95.6%). Airborne eczema was observed in 21.4%. Hand and foot eczema and co-sensitizations to chrome and thiuram and chrome and cobalt were significantly associated with being a construction worker. Sensitizations to isothiazolinones in house painters, ammonium persulfate and p-phenylenediamine in hairdressers, and colophonium increased after 2010.
CONCLUSIONS: This was the largest group of data on OACD from Turkey, reflecting the importance of rubber glove allergy in all occupations and the striking increase in ammonium persulfate allergy among hairdressers. Chrome and cobalt were still the main cement allergens in Turkey, where the cement directive is not yet in force.