Hair Professionals Often Check Customers for Worrisome Skin Lesions

New survey results suggest that some cosmetologists and barbers inspect their customers’ scalps, necks, and faces for the presence of skin lesions that they think may be cancerous.

Elizabeth E. Bailey, MD, with Brigham and Women’s Hospital in Boston, Massachusetts, and colleagues analyzed responses to questionnaires completed by 203 hair professionals from 17 salons in a single chain in the greater Houston area. The chain was selected because its clientele are both male and female and reside in economically and geographically diverse areas. The questionnaire focused on skin cancer knowledge, attitudes, and behaviors of hair professionals working in a salon.

Melanoma of the scalp and skin were responsible for 6% of all melanomas and 10% of all melanoma deaths in the United States between 1973 and 2003, and had a 5-year survival probability of 83.1% for stage I melanoma of the scalp and neck compared with 92.1% for stage I melanoma of other sites. The relatively high mortality rate for melanoma of the scalp and neck is probably due to the difficulty in detecting suspicious lesions during self-examination by patients and during routine examination by doctors.

While nonmelanoma skin cancer has a fairly low mortality rate, it may cause significant cosmetic disfigurement and functional impairment when the scalp, neck, and face are affected.

According to Bailey and associates, hair professionals have a “natural view of difficult-to-see areas,” and they also meet with their customers on a regular basis and may discuss such subjects as health and illness, diet, and medical care, all of which make them well suited for identifying skin cancer “that is otherwise unseen by the customer and customer’s physician.”

The primary outcome measure was the frequency with which hair professionals looked for lesions on their customers’ scalps, necks, and faces during the prior month.

Overall, 37.1% of survey respondents reported looking at more than 50% of their customers’ scalps, 28.8% maintained that they looked at more than 50% of their customers’ necks, and 15.3% said that they looked at more than 50% of their customers’ faces. Fifty-eight percent of hair professionals claimed that they had recommended at least once that a customer see a health professional for an abnormal mole.

Bailey and colleagues warned that the results may not be broadly generalizable given that the cohort was drawn from a single salon chain in a single city. Also, the study did not provide longitudinal data, which would have made it possible to determine causality.

The investigators are now conducting a prospective study examining the impact of a 20-minute education session about skin cancer and the role that hair professionals can play in its early detection and prevention. Pamphlets and customer information cards are used to facilitate the discussion of skin cancer.

Bailey EE, Marghoob AA, Orengo IF, et al. Skin cancer knowledge, attitudes, and behaviors in the salon. Arch Dermatol. 2011;147(10)1159-1165.