P170 Sharp styles, sharper consequences: skin-fade haircuts and paediatric tinea capitis

Abstract

Skin-fade hairstyles have become increasingly popular in boys and adolescent male individuals, and these require regular fortnightly maintenance with close-contact electric clippers or razors. These instruments can cause microinjuries to the scalp, compromising the skin barrier and facilitating dermatophyte inoculation within hair shafts. Over a short 8-month period, we observed a sharp increase in cases of tinea capitis associated with skin-fade haircuts in our tertiary paediatric dermatology centre. We characterized the clinical, diagnostic and management challenges associated with this emerging trend and highlight the infection-control implications from barbershop practices. We performed a retrospective case series analysis of patients who developed tinea capitis after a skin-fade haircut, reviewing demographics, symptom duration, clinical features, mycological sampling outcomes, prior management and treatment responses. Nineteen patients aged 5–16 years (mean 9.6) were identified. Symptom duration ranged from 3 weeks to 12 months (mean 4.1 months). All patients presented with alopecia; 11 developed kerions and 10 had lymph­adenopathy on presentation. Four reported associated household contacts with tinea. Of 18 samples submitted, nearly half were unprocessed due to insufficient material or contamination, likely reflecting sampling difficulty in kerions, which often lack surface scale. Prior to specialist review, most patients underwent multiple ineffective interventions including topical steroids, antifungal shampoos, repeated oral antibiotics and incision and drainage surgical procedures. Four patients with mild superficial tinea improved with topical antifungals alone; the remaining 15 required weight-based oral antifungals for 4–18 weeks. One patient developed a transient, mild liver function abnormality. Skin-fade haircuts represent a significant risk factor for tinea capitis in children, compounded by diagnostic uncertainty and mismanagement in initial care pathways. Early recognition, appropriate mycological testing and timely systemic therapy are essential. Crucially, strengthened public awareness and strict adherence to barbershop disinfection protocols are needed to prevent avoidable infections in this vulnerable paediatric population.