Targeted Education for Standardized Photo Documentation May Improve Hair Loss Care

New research is shedding light on the benefits of providing nurses and medical assistants with accessible educational resources on standardized photo documentation for hair loss patients.1

In the study, utilization of a 2-minute educational training video on proper hair loss picture documentation techniques led to increases in both the quantity and quality of documented pictures, posing important implications for improved dermatologic patient care and outcomes.1

According to the National Alopecia Areata Foundation, about 2% of people across the world will experience alopecia areata at some point in their lifetime. In the US, an estimated 700,000 people currently have some form of alopecia areata. While there are many treatments for hair loss, the slow progression of these conditions paired with the fact that it can take months to see noticeable progress can make it difficult for both physicians and patients to identify improvement.1,2

“Photographic assessment of hair is recognized as a useful tool in documenting patient progress, but has been noted to be cumbersome, time-intensive, and neither standardized nor optimized for best patient outcomes in modern clinic workflow,” Brittany Dulmage, MD, a physician and clinical associate professor of dermatology at The Ohio State University Wexner Medical Center, and colleagues wrote.1 “The value of clinical photography in dermatology is immense, and it allows for improved monitoring of hair loss, improved patient understanding of hair loss conditions, and improved communication between patient and provider. This highlights a need for standardized, user-friendly, and efficient protocols in hair loss photography that can improve patient care and outcomes in clinical practice.”

To standardize dermatologic photos for hair loss and determine whether increasing awareness for the standardization of hair loss photos via educational resources would increase the percentage of patients being treated for hair loss who have clinical photos, investigators created a 2-minute video uploaded to YouTube that taught nurses and medical assistants how to take clinical pictures of hair loss in new and returning patients. This video aligned with the clinic workflow so that pictures were taken after the patient had been examined by a dermatologist.1

In the video, investigators reviewed foundational topics about how to use the EMR-associated mobile application to take pictures, how to position patients in the examination room, how to take pictures from a minimum of 3 views—frontal, temporal, and top or crown, and how to upload pictures into patient charts. Investigators then distributed the educational video via email to all dermatology faculty and staff at the Ohio State University Wexner Medical Center and regularly monitored viewership of the educational material via a survey distributed to the same faculty and staff.1

To assess change from their intervention, investigators analyzed 50 (10%) randomly selected charts from a cohort of 500 unique patients seen for hair loss between October 2022 and August 2023. Post-intervention, they examined an additional 50 (10%) randomly selected charts from a separate cohort of 500 unique patients between October 2023 and January 2024.1

Prior to the implementation of the training video, 32% of hair loss patients had their pictures properly documented with the correct angles and number of minimum photographs. After the distribution of the training video, nurses and medical assistants were statistically significantly more likely to take the correct hair loss photos, with 66% (n = 33) of patients having correct pictures taken with a minimum of 3 views (P <.005).1

“This study demonstrates the positive impact of utilizing a training video to educate nurses and medical assistants on proper hair loss picture documentation techniques,” investigators concluded.1 “By providing staff with accessible educational resources, healthcare facilities can effectively enhance picture documentation practices, with potential for improved dermatologic patient care and outcomes. The significant increase in both the quantity and quality of documented pictures highlights the value of having a targeted educational intervention to promote standardized documentation practices.”

References

1. Rose L, Khuhro A, Rojas S, et al. Standardization of Clinical Photos for Tracking Management of Hair Loss in Dermatology Clinics. JCD. https://doi.org/10.1111/jocd.70381

2. National Alopecia Areata Foundation. Alopecia Areata. Accessed August 13, 2025. https://www.naaf.org/alopecia-areata/