This isn't about living skeletons, no siree, this is about fleshy-bodied characters with notably fleshless heads.
In some cases a character is covered in so much armor or clothing that it's impossible to see their body, in which case you may assume whatever you like about what's under there, but if their dressed body shape seems like it would be fleshed-out, then they qualify as having a Skull for a Head.
Also, if their skull-head is supposed to be a helmet, but they've never ever taken the helmet off, how is anyone supposed to know that there's a real head under there? In those instances, they still qualify as having a Skull for a Head.
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