Sampling barber shops and hair salons for anthropophilic dermatophytes potentially causing tinea capitis in adults

Abstract

Tinea capitis has emerged as an increasingly common scalp infection in adults in Malta, despite previously being rare and mostly affecting children. Researchers observed a notable rise in cases, particularly those caused by Trichophyton tonsurans, often linked to poor hygiene practices in hairdressing environments. This study investigates the factors contributing to the growing prevalence of adult tinea capitis in Malta. It explores transmission routes, diagnostic approaches, and public health concerns, aiming to highlight the importance of effective hygiene protocols and early detection in controlling the spread of infection. This cross-sectional study used questionnaires and microbiological analysis of hair samples collected from barber shops across Malta and Gozo. Researchers cultured samples on Sabouraud Dextrose Agar with Chloramphenicol and Cycloheximide (SDCC) medium and identified fungi using microscopy and MALDI-TOF MS. Historical T. tonsurans data was retrieved from the Laboratory Information System for comparative analysis. The study identified Maltese males aged between 30-39 as the majority respondents, mainly barber shop owners. It recorded a wide regional distribution of shops and detected two anthropophilic dermatophyte cases in the South. The study highlighted varied hygiene practices and found hair trims, fades, and usage of blades to be popular trends. The study reveals a sharp rise in Trichophyton tonsurans cases in Malta since 2022, peaking in 2024. Poor hygiene in barber shops, like low-temperature laundering, tool reuse, and infrequent cleaning, likely drives transmission. Findings highlight the need for public health interventions, stricter sanitation protocols, and further research to curb dermatophyte spread in high-contact grooming environments.