QUESTION
I wanted to know more about "barber's itch" but could not find it in any of the medical books in my personal library. I am familiar with folliculitis barbae, and with pseudofolliculitis barbae, but not sure if either of these complaints is the same as barber's itch. The books don't say. Why am I having trouble with this?

ANSWER
Folliculitis barbae (which is inflammation of hair follicles in the beard area of the face and neck, caused by bacterial infection), and pseudofolliculitis barbae (a condition of ingrown facial hairs that simulates folliculitis in some ways) must not be confused with barber's itch (which is a fungal or bacterial infection of the skin). You will find barber's itch in your library under its proper medical name, which is tinea barbae when caused by fungus, or sycosis vulgaris when caused by bacteria. It is strange that so few medical dictionaries cross-reference these names with the common term, barber's itch.

The name tinea is applied to many different fungal infections of the skin. (Tinea, a Latin word meaning moth or worm, and the synonym "ringworm" are misnomers, since there are no "worms" involved and the lesions do not always take the form of a ring.)

The fungi that cause the highly contagious tinea barbae can live on the superficial, keratinized portion of the skin, nails and hair, and different species of fungi show up in different areas of the body. In North America the most familiar fungal infections are "athlete's foot" and "jock itch," but tinea of the nails, scalp and body are also common.

Depending on which specie of fungus is involved, tinea barbae may cause just a few reddened scaly patches on the surface of the skin -- without too much visible damage -- but most often it invades the hair follicles and causes severe, puss-filled swellings, through which stumpy hairs project. These hairs are loosened or broken by the suppuration around them and easily fall away.

In an extensive case of tinea there may be considerable pain and discomfort. The problem is exacerbated when hair of the scalp or beard is involved, but the high risk of contagion entirely prohibits any electrolysis treatment until the patient is cured. A dermatologist can prescribe creams or pills to kill the fungus. If the barber's itch is caused by bacteria (sycosis vulgaris) instead of by fungus (tinea barbae) then the dermtologist can prescribe topical and oral antibiotics that work against staph infections.

QUESTION
After talking with a colleague about the different kinds of skin ailments we might come across in the electrolysis clinic, I have been reading up on dermatitis. I am very interested to know more about "dermatitis artefacta." Is it for real?

ANSWER
The dermatitis you speak of is characterized by lesions that are self-inflicted by the patient, whether by heat, chemicals, or other physical or mechanical means. Dermatitis artefacta is very real, and not as rare as you might think.

Patients who have this condition are often neurotic or hysterical, and their lesions are usually intended to attract sympathy or avoid unpleasant work or duties. However, the motive of personal financial gain -- either by way of disability compensation, or threats of legal action -- is not uncommon, and cannot be ruled out.

Electrologists should be aware that the self-inflicted wounds of dermatitis artefacta have, as a rule, certain features in common: They are on parts of the body that are within easy reach for the patient, and they are few in number; they are on parts of the body that are normally exposed; they are often regular in outline (square or perfectly round) and the surrounding skin is usually normal in appearance. If the lesions are obviously not caused mechanically, i.e. by pinching, cutting or scratching, they may be produced by easily accessible household chemicals (caustics and irritants).

If, after one or two electrolysis sessions, a client returns to the electrologist's office exhibiting suspicious-looking lesions and complaining of improper treatments, they should be promptly referred to their family doctor or a dermatologist who is familiar with electrolysis and post epilation conditions.