INTRODUCTION

Beauty salons have become increasingly popular settings for cosmetic procedures such as waxing, hair dyeing, straightening, manicures, pedicures, and eyelash extensions, particularly among women and young adults [1,2]. While generally considered routine, these practices are not without risks. A wide spectrum of dermatological complications, including folliculitis, allergic contact dermatitis, fungal infections, and pigmentary changes, have been linked to salon-based procedures, especially when hygiene and technique are inadequate [3,4].

Although these services are widespread in Morocco, epidemiological data on their dermatological impact remain limited. Existing reports from different regions have highlighted infectious, allergic, and chemical-related dermatoses among salon clients and workers [5–7]. Moreover, cases of viral transmission through waxing [8], ocular disorders associated with eyelash extensions [9], and the role of beauty salons as potential reservoirs for disease spread [2,6] underscore the public health significance of this issue.

This study, therefore, aimed to evaluate the frequency and nature of salon-related complications, analyze demographic and behavioral correlates, and assess the clients’ perception of hygiene and awareness of transmission risks.

MATERIALS AND METHODS

This was a cross-sectional, survey-based study conducted between March and July in Morocco.

RESULTS

A total of 230 participants completed the survey. The majority were women (200; 87%), with only 30 men (13%). The predominant age group was 15–25 years (110; 48%), followed by 26–35 years (85; 37%), and 36–45 years (35; 15%). Most participants had a university-level education (154; 67%), while 24% had secondary and 9% primary education.

Regarding the frequency of beauty salon attendance, 62 respondents (27%) reported weekly visits, 99 (43%) monthly, 49 (21%) every 2–3 months, and only 20 (9%) rarely.

The most frequently performed procedures were hair removal (170; 74%), manicure/pedicure (136; 59%), and hair coloring or straightening (126; 55%). Less common procedures included artificial nails (74; 32%), eyelash extensions (48; 21%), professional makeup (44; 19%), facial treatments (37; 16%), and semi-permanent makeup (14; 6%) (Table 1).

Table 1: Frequency of salon attendance and types of procedures performed.

Overall, 136 participants (59%) reported at least one dermatological complication after beauty procedures. The most frequent were folliculitis/ingrown hairs after hair removal (62; 27%), scalp irritation or hair loss after coloring/straightening (42; 18%), allergic contact dermatitis related to adhesives used for nails or eyelash extensions (37; 16%), onychomycosis (30; 13%), and paronychia (18; 8%). Other reported conditions included acne flares or herpes reactivation after professional makeup (25; 11%), adverse reactions to facial peeling (14; 6%), and post-inflammatory hyperpigmentation or scarring (7; 3%) (Table 2).

Table 2: Reported dermatological complications and their management.

With respect to the management of complications, only 67 participants (29%) sought medical advice from a dermatologist. The remainder either self-medicated (81; 35%), took no action (35; 15%), or reported persistence or worsening of the lesions (22; 10%).

Notably, 95 respondents (41%) repeated the same procedure despite experiencing adverse effects, including 55 (24%) who returned to the same salon.

The perception of hygiene in salons was generally poor: 124 respondents (54%) rated hygiene as average, 46 (20%) as poor, and only 60 (26%) as very good (defined as rigorous disinfection and single-use materials).

Knowledge of infection transmission risks was limited. A total of 145 participants (63%) did not know that inadequately sterilized instruments could transmit infections such as hepatitis or bacterial diseases, and 161 (70%) were unaware that reused wax could potentially transmit HPV.

Correlation analysis highlighted age- and behavior-dependent patterns. Younger participants (15–25 years) were significantly more likely to report folliculitis and allergic reactions to adhesives (p < 0.01), while older participants (36–45 years) more frequently reported fungal infections such as onychomycosis (p < 0.05). Frequent salon attendance (weekly) was associated with a higher risk of dermatological complications compared to occasional visitors (p < 0.05). Additionally, lower education levels were significantly associated with reduced awareness of infection transmission and hygiene risks (p < 0.01). No significant association was found between sex and the type of complication, although women were more frequently exposed due to more frequent use of salon services (Table 3).

Table 3: Correlations between demographic/behavioral factors and dermatological complications.

DISCUSSION

Our survey reveals that beauty salon procedures carry a substantial risk of dermatological complications, with over half of the participants reporting at least one adverse event. This prevalence aligns with observational studies reporting a broad spectrum of salon-related dermatoses, such as folliculitis, contact dermatitis, fungal and bacterial infections, and thermal or chemical injuries after cosmetic interventions [1,3].

Mechanical trauma (e.g., epilation, aggressive manicuring), chemical exposure (e.g., hair dyes, straightening agents, peel solutions), and microbial contamination (e.g., improperly disinfected instruments, recycled wax) represent the primary pathophysiological pathways leading to the observed complications. Folliculitis and ingrown hairs often follow hair removal due to follicular obstruction and secondary bacterial infection. Allergic contact dermatitis is frequently linked to acrylate or cyanoacrylate adhesives used for false nails and eyelash extensions, while onychomycosis may follow repeated microtrauma and humid occlusion [4].

A key and concerning finding is the low rate of medical consultation: only 29% of the affected participants sought dermatological advice despite the high complication rate. A large proportion opted for self-medication or no action. This under-reporting mirrors previous studies and reflects a public health gap in awareness and dermatological care-seeking [3,5].

The age-stratified analysis provides further nuance: younger clients were more often affected by allergic or irritant reactions related to eyelash extensions, artificial nails, and frequent epilation, while older clients more frequently presented with fungal infections such as onychomycosis and paronychia. [5,7]. These patterns likely reflect both exposure differences and cumulative host factors, suggesting that preventive strategies should be targeted according to procedure type and age.

Hygiene practices and infection control remain modifiable determinants. Our data, consistent with prior reports, show that many clients perceive salon hygiene as average or poor, and awareness of specific risks (e.g., viral transmission via reused wax) is strikingly low [2,8].

Importantly, eyelash extensions merit particular attention. They pose a triple risk: strong allergenicity (formaldehyde-releasing resins, cyanoacrylates), mechanical stress on hair follicles, and proximity to the ocular surface. Documented complications include keratoconjunctivitis and allergic blepharitis [9]. Our finding of adhesive-related dermatitis and lash loss reflects this risk, underscoring the need for dermatologists and ophthalmologists to inquire about cosmetic exposures when assessing periocular complaints.

From a public health standpoint, these results suggest several actionable interventions:

CONCLUSION

This cross-sectional survey highlights that beauty salon practices, although widely used for aesthetic purposes, are associated with a significant risk of dermatological complications, particularly folliculitis, fungal infections, and allergic reactions. Alarmingly, most affected clients do not seek medical care and frequently repeat the same procedures, reflecting a gap in awareness and risk perception. Our findings underscore the urgent need for public education, salon staff training, and regulatory oversight to improve hygiene and safety standards. For dermatologists, incorporating questions about cosmetic exposures into routine consultations may facilitate early recognition and appropriate management of salon-related dermatoses.

REFERENCES

1.  Al Faker I, Marraha F, Gourinda A, Bousgheiri F, Chahoub H, Rahmani N, et al. Body hair removal:A cross-sectional survey among women in the north of Morocco. Our Dermatol Online. 2024;15:20-5.

2.  Alharbi N, Alhashim H. Beauty salons are key potential sources of disease spread:Review. Infect Drug Resist. 2021;14:1247-53.

3.  Kolalapudi SA, Mahesh AR, Arumilli PC, Kotha S, Krishna Snigdha AG, Saka S, et al. Dermatoses occurring after parlor procedures:An observational study. J Cutan Aesthet Surg. 2020;13:357-60.

4.  Hoorens I, Ongenae K. Nail salon-related dermatoses:An underestimated problem. Contact Dermatitis. 2013;68:324-31.

5.  Hassan I, Shah FY, Saqib N, Bhat MA, Shah AA, Bashir Y, et al. Prevalence of dermatoses among hairdressers and beauticians in Srinagar, the capital city of Kashmir, India. Our Dermatol Online. 2021;12:367-73.

6.  Zare A, Janghorban R. Awareness and practice of female beauty salon staff about human papilloma virus and its transmission in pubic hair removal using wax in Shiraz, southwest of Iran. Adv Biomed Res. 2020;9:24.

7.  Shanshal M. Dermatologic Emergencies CME Part II:Infections and infection-related complications. Our Dermatol Online. 2022;13:483-94.

8.  Broekaert SM, Deschamps B, Theate I. Brazilian waxing and human papillomavirus:A case report. J Dermatol. 2014;41:444-5.

9.  Amano Y, Sugimoto Y, Sugita M. Ocular disorders due to eyelash extensions. Cornea. 2012;31:121-5.