Improving Hair Loss Documentation with Standardized Photography in Clinic

A new study demonstrated the effectiveness and benefits of integrating standardized clinical photography protocols to help manage hair loss in patients.¹ Researchers aimed to increase the correct use of standardized photos by 60%, thus increasing the percentage of patients being properly treated for alopecia and other similar conditions.

Background

Previous research has shown that photographic assessments of the hair can improve follow-up rates in patients with alopecia.² It helps the patient and clinician better establish a comparison while increasing patient satisfaction and motivation, decreasing complaints, and improving tolerability for procedures and therapies.³ But the challenges associated with regular use of clinical photographs include a lack of training, time, consistent image quality, and standardization.

“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,” the authors wrote. “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.”

Methods & Materials

In an initial 10-month observation period at the Ohio State University Wexner Medical Center Department of Dermatology, only 32% of randomly selected patients at an academic practice had optimal standardized photos. Investigators discovered that this was due to the lack of training provided to the nurses and medical assistants: 75% of staff members had not obtained formal training to take clinical photos. However, 100% were interested in being formally trained.

A 2-minute educational YouTube video was created and distributed to the department. The clip demonstrated the appropriate time to take photos of hair loss during appointments, the correct views to take (frontal, bilateral temporal, and crown of the scalp), and the method for uploading into patient charts via the mobile app. Viewership was closely monitored and a post-survey was administered to all faculty members. To assess change, investigators randomly analyzed 50 charts from a cohort of 500 patients seen between October 2022 and August 2023. Post-intervention, an additional 50 charts from October 2023 and January 2024 were assessed. Approximately 3500 unique visits related to an alopecia diagnosis were recorded. Two researchers evaluated the quality of each image

Results & Limitations

After the video was utilized, nurses and medical assistants were more likely to take correct clinical photos of patients with hair loss, with both the quality and quantity of documented pictures improving. About 66% of patients had correct pictures taken with a minimum of 3 views, increasing from the initial 32% (p < 0.005). Pre-intervention, the average number of correct photos was 16 compared to 34 incorrect photos. After the video education was implemented, 33 photos were correct and only 17 were incorrect.

The video did have some limitations, however, including an assumed certain degree of technological literacy and a lack of different hair types demonstrated. This is vital to fully represent a diverse population and the considerations needed when working with various types of hair.

Future Directions

With this research, the authors emphasize that continued efforts are needed to improve clinical picture documentation among healthcare providers. The instructional video and other methods should be implemented into onboarding and training to boost the skills of staff members. Further studies are recommended to evaluate the long-term impact of improved photography on patient satisfaction and treatment adherence, as well as its effectiveness across diverse hair types. They noted that while emerging AI technology may offer objective measurements, its high cost and time-consuming nature limit its use in busy clinics. Therefore, future research should explore ways to integrate advanced imaging into clinical practice in a more efficient and affordable manner.

References

1. Rose L, Khuhro A, Rojas S, et al. Standardization of Clinical Photos for Tracking Management of Hair Loss in Dermatology Clinics. J Cosmet Dermatol. 2025;24(8):e70381. doi:10.1111/jocd.70381

2. Lee S, Lee H, Lee CH, Lee WS. Photographic assessment improves adherence to recommended follow-up in patients with androgenetic alopecia and alopecia areata: A retrospective cohort study. Indian J Dermatol Venereol Leprol. 2019;85(4):431-433. doi:10.4103/ijdvl.IJDVL_696_18

3. Park SY, Lee WS. Impact of phototrichogram education on satisfaction of patients with androgenetic alopecia in clinical practice. J Dermatol. 2014;41(8):773-774. doi:10.1111/1346-8138.12548