Especially when that head is teeming with head lice, as Adam of Usk reported when he attended King Henry IV's coronation on 13th October 1399!
King Henry's affliction was commonplace in medieval times, and lice were certainly no respecter of social status.
Filth was a fact of life for all classes in the Middle Ages. Towns and cities were filthy, the streets open sewers; there was no running water and knowledge of hygiene was non-existent. Dung, garbage and animal carcasses were thrown into rivers and ditches, poisoning the water and the neighboring areas. Fleas, rats and mice flourished in these conditions. Indeed this was the perfect environment for the spread of infectious disease and plague: the Black Death was to kill over half of England's population between 1348 and 1350.
As there was no knowledge of germs or how diseases spread in the Middle Ages, the Church explained away illness as 'divine retribution' for leading a sinful life.
Common diseases in the Middle Ages included dysentery ('the flux'), tuberculosis, arthritis and 'sweating sickness' (probably influenza). Infant mortality was high and childbirth was risky for both mother and child.
Rushes and grasses used as floor coverings presented a very real hygiene problem. While the top layer might be replaced, the base level was often left to fester.
A lack of hygiene among medieval people led to horrific skin complaints. Poor people washed in cold water, without soap, so this did little to prevent infection. The most disfiguring skin diseases were generally classed as leprosy and indeed leprosy, caused by the bacterium mycobacterium leprae, can arise from dirty conditions. It attacks and destroys the extremities of the body, particularly the toes and fingers, and sometimes the nose. (Pictured right: Richard of Wallingford, Abbot of St Albans; his face is disfigured by leprosy.)
Leprosy was not the only disease that could affect someone in this way: the affliction known as St Anthony's Fire could also lead to gangrene and seizures. This condition was caused by a fungus, ergot, that grows on rye. When the grain was ground to make bread, people who tied the bread became poisoned.