Gloves - to wear or not to wear

• Today I started my dermatology rotation. It's a pretty laid back week looking at a variety of skin lesions and the doctors who treat them. This morning we saw a 13 yo girl with a birthmark of sorts growing on her scalp. When I examined her, I put on gloves in order to pick through her hair and take a look, figuring that glove-wearing is the holy grail of dermatology. (In fact, I was once taught by an Ear Nose & Throat doctor who said that the only people he touches with his bare hands are his son & wife, so obviously there's neuroses everywhere). But when the doctor came in, I noticed that he didn't put on gloves at all. The next patient we saw was covered in scabs on his arms and legs and complaining of severe pain and itchiness. He'd been picking at these lesions. I didn't know what they were but thought potentially about the bacteria that live on the skin, blah blah and thought maybe it was infectious. As he talked more we discovered that he's on methadone which he adamantly stated is for pain not drug detox (it's normally used to detox from a heroin addiction and rarely used for pain) and that he has some mental health problems. Both drugs and certain mental health disorders are associated with picking your skin due to the sensation of having bugs under your skin (that's what they should tell kids to keep them off drugs - yuk!). The doctor examined him glove-free and was sure to address him as "sir", shaking his hand at the end of the meeting. In conversation after this appointment, I asked the doctor when does he use gloves - is it that he just has such a good sense of what various conditions are that he immediately knows what's infectious and what's not and therefore when it's appropriate to glove-up? In reply, he spoke at length about how dehumanizing it is to examine a patient's skin with gloves on and that there are so few conditions that are infectious that it rarely merits glove-wearing because you likely won't catch whatever they have anyway. He referred to this patient and that to him, examining him without gloves and shaking his hand were all important signs of respect for the patient. More of the art of medicine. He seemed to feel the need to make these points explicit to me, although I had recognized what was happening re the "sir" and the hand-shaking. And while he didn't answer my question about the situations/possible diagnoses that prompt him to put on gloves, I suspect he just knows when they're needed and when they're not at all. And happily for his patients, he knows the power of not using them.