Work-related rash in beauticians and hairdressers

This article has been translated from Finnish to English by Semantix. You can find the original article at the web adress

Occupational dermatitis and other rashes that hairdressers and cosmetologists suffer at work

There is a high risk of hand dermatitis associated with the professions of a hairdresser and cosmetologist. Hand dermatitis often begins already during the practical training or in the beginning of the career but professionals with several years of experience can also experience symptoms. Up to 70% of hairdressers get hand dermatitis at some point in their career. This figure is tenfold in comparison to the average of other professions. 

Since hairdressers’ and cosmetologists’ hands and arms are in contact with several substances and water, the occupational dermatitis occurs precisely on these skin areas. The most common occupational dermatitis caused by different factors at the workplace include irritant contact dermatitis and allergic contact dermatitis, which is developed as a result of a delayed hypersensitivity to a substance used at the workplace. Contact urticaria is a less common type of occupational dermatitis, and it is caused by an immediate hypersensitivity to a substance used at the workplace. 
Not all dermatitis that become worse at work are considered occupational diseases. Atopic dermatitis is a skin condition that affects the structure of the skin. It can be the cause for a hand dermatitis that starts or becomes worse in a beauty sector profession. In this case, the work-related factors that irritate the skin make the atopic dermatitis worse, causing symptoms in the hands. However, those factors are not the main cause for the symptoms.

The irritant contact dermatitis and allergic contact dermatitis are long-lasting, i.e. they cause symptoms at least for a few days, including itchy, scaly blisters that are usually small in the beginning. These two skin conditions cannot be distinguished by their appearance, but it is necessary to make allergy tests to determine the cause. Contact urticaria is a rash that develops quickly, causing bumps that resemble nettle stings or mosquito bites. It also disappears quickly (in a few hours), and symptoms usually occur in a small area of skin that came into contact with the offending substance. 

Common causes of occupational dermatitis in beauticians

Irritant contact dermatitis in hairdressers is caused by the repeated exposure to water and the repeated contact with the products, such as hair-cleansing and setting products, products for waving and bleaching and hair dyes. The skin of the hands also become irritated by the friction from the hair and the hot air of hairdryers. Irritant contact dermatitis in cosmetologists is caused by the repeated exposure to water and the repeated contact with cleansers and other cosmetic products. 

The most common causes of allergic contact dermatitis in hairdressers are the hair dyes, bleaching products and the preservatives and fragrances in hair-cleansing and setting products. In cosmetologists and other beauticians, the most common substances causing symptoms include the acrylates in acrylic and gel nail paste, permanent nail polish and eyelash glue and the preservatives and fragrances of the products. Although wearing protective gloves is the most efficient way to protect oneself against occupational dermatitis, the substances used in the gloves can sometimes cause allergic contact dermatitis. The most common substances that cause immediate hypersensitivity and work-related contact urticaria in hairdressers are the persulfates in hair bleaching products. 

How can beauticians prevent occupational hand dermatitis

Protecting the skin from the factors that irritate and cause allergy, cleaning the skin and applying emollient basic creams regularly are the most important methods of protecting yourself from hand dermatitis. 

Protective gloves

The use of protective gloves is the single most efficient method to prevent hand dermatitis when working in the beauty sector. Protective gloves should fit well the user and adequately protect against the handled substances. In tasks where the hands are exposed to water, it is important that the gloves are tight (waterproof) and long enough to provide protection against splashes on the forearms and preventing the water from getting inside the gloves. The protective gloves used in the handling of hair salon chemicals, materials for making acrylic nails and eyelash glues must be disposable. After use, the gloves must be disposed of. They must not be put on again or turned inside out and reused. If the gloves become stained or broken, they must be replaced immediately. The gloves should be removed so that the dirty surface does not come into contact with the skin. 

Disposable nitrile gloves are the most recommended gloves for handling hair dyes. When handling other hair salon products, disposable vinyl or natural rubber gloves can also be used. Hair bleaching products (ammonium and potassium persulfates) are unlikely to permeate intact gloves. Natural rubber gloves are not suitable for a person allergic to natural rubber. 

Protecting oneself when making acrylic nails is challenging since the acrylates contained in the acrylic nail products can quickly permeate most glove materials. This happens especially when the nails are done by combining a powdered and a liquid product to form an acrylic paste. It is difficult to recommend any protective gloves for making acrylic nails as many do not offer sufficient protection. Neoprene disposable gloves provide short-term protection when making gel nails. The gloves should be removed immediately if they become stained with the materials used for making the nails. The best way to protect yourself is to apply the products carefully and try to avoid spillages on the skin. Avoid the dripping of nail products and eyelash glue on the surfaces of the working area and on the outside of the pots and bottles. As the gloves provide only a short-term protection, it is recommended to apply the nails in such a way that the materials do not come into contact with the gloves at all. 

Reusable household vinyl or rubber gloves with long cuffs are suitable for cleaning the working area, surfaces and tools.

Skin cleaning and care

Rings, bracelets and wristwatches should be removed before starting the work, as cleaning the skin becomes difficult and chemicals and water can remain under them. Long nails and acrylic nails also accumulate dirt easily. 
Dirt and chemicals on the skin of the hands and forearm should be removed immediately. Hands should be washed as many times as necessary during the working day, but unnecessary hand washing should be avoided. After using tight protective gloves for a long time, the bacterial count on the hands increases, so it is a good idea to wash the hands. The skin should be cleaned after finishing the work and, as necessary, before having a lunch or coffee break and always before and after going to the toilet. The hands are washed before going to the toilet to prevent any substances from coming into contact with the sensitive skin of the intimate area. 

The pH of the hand wash product should be slightly acidic and close to the skin’s own pH value (5.5). Also, it should not contain fragrances, colorants, solvents or abrasive (exfoliating) ingredients. Instead of soap, you can use skin cream (suitable lotions can be found among the emollient basic creams sold in pharmacies) or cream-like cleansing lotion to clean your skin. Use lukewarm water for washing the hands. After washing your hands, pat them dry with disposable paper towels. You can also use a clean, soft cloth to dry them. You should not dry your hands with towels that are used for customers.

Washing your hands temporarily weakens the protective sebum on the skin. After washing the hands and finishing the working day, a moisturizer should be applied to take care of the skin. The moisturizer should be applied all over the hands, including forearms. At work, it is recommended to use unscented products that do not contain the most common allergens that cause contact dermatitis. At least two types of products should be made available (a light lotion with less oil and a heavier cream with more oil) so that the workers can choose the one that suites best for their skin. 

You should take care of your hands also on your leisure time. If the skin feels dry, you can apply a generous amount of moisturizer on your hands in the night and wear thin cotton gloves to help the absorption of the cream. Using warm gloves in cold weather protects the skin of your hands. Protective gloves should also be used when doing household chores in which hands get wet, such as cleaning and washing the dishes.

What to do if you get a hand dermatitis

The first step is to protect your hands from becoming wet and being in direct contact with the offensive products. If the hand dermatitis has occurred while you have been working as a hairdresser or cosmetologists or while you were in the practical training and the symptoms continue for several weeks despite having protected your skin, you should see a doctor. The doctor will evaluate the situation and may give you a prescription for an ointment for hand dermatitis. They may also give you a sick leave and a referral to a dermatology outpatient clinic for further examination. 

Finding out the cause of the hand dermatitis, avoiding the offending substances and early treatment prevent the condition from becoming prolonged and lower its tendency of recurrence, while reducing the need for sick leave and change of tasks. The most important step in the treatment of occupational dermatitis and preventing its recurrence is to prevent any offending substances from coming into contact with the skin. The studies have found that the offending substance (allergen) should be completely avoided both at work and home by switching to products that do not contain the allergen. The irritation of the skin should be avoided or at least reduced by changing the working methods and providing a better protection.

Maria Pesonen
Docent, Specialist in Dermatology and Allergology
Finnish Institute of Occupational Health