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1.
American Cancer Society.  Cancer Facts and Figures 2008. Atlanta, GA: American Cancer Society; 2008
2.
Solomon FM, Linnan LA, Wasilewski Y, Lee AM, Katz ML, Yang J. Observational study in ten beauty salons: results informing development of the North Carolina BEAUTY and Health Project.  Health Educ Behav. 2004;31(6):790-807PubMedArticle
3.
Forte DA. Community-based breast cancer intervention program for older African American women in beauty salons.  Public Health Rep. 1995;110(2):179-183PubMed
4.
Hess PL, Reingold JS, Jones J,  et al.  Barbershops as hypertension detection, referral, and follow-up centers for black men.  Hypertension. 2007;49(5):1040-1046PubMedArticle
5.
Roosta N, Wong MK, Woodley DT.Norris Comprehensive Cancer Center Melanoma Working Group.  Utilizing hairdressers for early detection of head and neck melanoma: an untapped resource.  J Am Acad Dermatol. 2012;66(4):687-688PubMedArticle
Research Letter
Oct 2012

The Style Project: Feasibility of Collaborating With Salons for Prevention and Early Detection of Skin Cancer

Author Affiliations

Author Affiliations: Prevention Research Center/Department of Biobehavioral Health (Drs Turrisi and Mallett and Ms Hultgren), Department of Dermatology, Milton S. Hershey Medical Center (Drs Gunn and Warner), The Pennsylvania State University, State College.

Arch Dermatol. 2012;148(10):1206-1207. doi:10.1001/archdermatol.2012.1724

Early detection of skin cancer is known to decrease risk of mortality and improve overall outcome.1 Unfortunately, for many people the warning signs of skin cancer are unknown, and the cancer can progress to more aggressive stages before treatment is sought. Training individuals who are easily accessible, approachable, and are part of peoples' normal routine, such as salon hairstylists, to recognize suspect skin areas and make dermatologist referrals may increase the number of cases of skin cancer that are caught at earlier stages.

Salons provide a comfortable environment where health topics are already discussed between stylists and their clients during the appointments.2 Research using salons for a variety of health education and prevention campaigns has shown that salons are largely successful at disseminating health information and improving their clients' knowledge on health topics. Some salons and barbershops have even been used as referral and screening centers.3,4 Furthermore, breast cancer prevention and early detection research programs have had success in using salons to contact a subset of people who were not reachable or affected by conventional methods.3 These studies indicate that salons may be useful in educating in prevention, making referrals, and reaching a broad population. Importantly, a recent article has suggested that hairstylists are promising resources for melanoma detection, and additional research should be conducted to assess their attitudes and practices related to skin lesion detection and referrals.5

The purpose of the present study is to explore the feasibility of dermatologists partnering with salon owners and employees to launch a community-based skin cancer prevention and early detection campaign. In this investigation, the stylists' current practices of detecting skin lesions, making referrals, and overall general interest in using these methods for skin cancer education and prevention are assessed.

Methods

Participants consisted of 74 stylists from 67 different salons located in central Pennsylvania. Participants were invited by random selection of salons compiled by online resources. A total of 168 salons were telephoned; 79 salon owners or managers were reached; and 67 salons agreed to have 1 or 2 hairstylists complete the style survey. A total of 103 style surveys were distributed, and 74 were collected or returned via mail.

The style survey asked hairstylists how frequently clients presented with suspect skin lesions and how they responded. In addition, the survey measured the stylists' general interest in participating in a salon-based skin cancer prevention and early detection campaign, their typical interactions with their clients involving skin cancer, their preferred method of education, and their opinions about optimal dissemination of the information. This study was approved by the institutional review board at The Pennsylvania State University, College of Medicine at Hershey.

Results

Seventy-nine percent of the respondents reported that they had seen concerning skin lesions on their clients (n = 58). Of those, 98% reported that they “generally say something about the lesion to the client” (n = 73), and 100% reported that they make recommendations to have the lesions looked at by a physician (n = 74). Furthermore, 72% of the stylists reported that they would feel “comfortable” or “very comfortable” talking with their clients about skin cancer prevention (n = 53), and 63% reported that they already talk about sun exposure to their clients (n = 47).

Comment

The study showed that almost three-quarters of the hairstylists surveyed had seen a suspect skin lesion on a client (n = 56) and that 100% of those hairstylists reported recommending having the lesion examined by a physician (n = 74). Furthermore, more than 60% of stylists reported that they discuss sun exposure with their clients (n = 44). These responses indicate that salons may already be educating clients on sun exposure and skin cancer prevention and making referrals to physicians when thought necessary.

Since a large number of surveyed hairstylists reported making referrals or communicating information about sun exposure, efforts should be made to educate and train these professionals to ensure that they are using optimal screening methods and providing accurate information. Over 70 percent of respondents indicated they would feel “comfortable” or “very comfortable” discussing skin cancer prevention with their clients (n = 52), indicating that hairstylists are willing to talk about this topic and that many are currently communicating about prevention and making referrals. If hairstylists are trained in how to accurately screen for suspicious lesions, more individuals with skin cancer may seek treatment before the disease advances to more aggressive stages. Future studies will examine the efficacy of training hairstylists to screen clients for potential skin cancer lesions, make appropriate referrals, and offer information about skin cancer prevention.

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Article Information

Correspondence: Dr Turrisi, Prevention Research Center, The Pennsylvania State University, 204 E Calder Way, Ste 208, State College, PA 16801 (rturrisi@psu.edu).

Accepted for Publication: April 6, 2012.

Author Contributions: Dr Turrisi had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis. Study concept and design: Turrisi, Gunn, Warner, and Mallett. Acquisition of data: Gunn, Warner, and Mallett. Analysis and interpretation of data: Turrisi, Gunn, Hultgren, Warner, and Mallett. Drafting of the manuscript: Turrisi, Gunn, Hultgren, and Warner. Critical revision of the manuscript for important intellectual content: Turrisi, Gunn, and Hultgren. Statistical analysis: Turrisi. Obtained funding: Turrisi and Gunn. Administrative, technical, and material support: Turrisi, Gunn, and Warner. Study supervision: Gunn.

Financial Disclosure: None reported.

Funding/Support: Funding was provided by the Pennsylvania State University Children, Youth, and Family Consortium.

References
1.
American Cancer Society.  Cancer Facts and Figures 2008. Atlanta, GA: American Cancer Society; 2008
2.
Solomon FM, Linnan LA, Wasilewski Y, Lee AM, Katz ML, Yang J. Observational study in ten beauty salons: results informing development of the North Carolina BEAUTY and Health Project.  Health Educ Behav. 2004;31(6):790-807PubMedArticle
3.
Forte DA. Community-based breast cancer intervention program for older African American women in beauty salons.  Public Health Rep. 1995;110(2):179-183PubMed
4.
Hess PL, Reingold JS, Jones J,  et al.  Barbershops as hypertension detection, referral, and follow-up centers for black men.  Hypertension. 2007;49(5):1040-1046PubMedArticle
5.
Roosta N, Wong MK, Woodley DT.Norris Comprehensive Cancer Center Melanoma Working Group.  Utilizing hairdressers for early detection of head and neck melanoma: an untapped resource.  J Am Acad Dermatol. 2012;66(4):687-688PubMedArticle
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