Lesson 1Family and genetic history: patterns of hair loss in first- and second-degree relatives and age of onsetThis section covers eliciting family patterns of hair loss and scalp disease. Learners will map inheritance, age of onset, and severity to support diagnosis of androgenetic alopecia and genetic syndromes.
Ask about hair loss in first-degree relativesExtend history to second-degree relativesClarify age of onset and progression in familyIdentify family history of scarring alopeciasExplore ethnic and racial pattern differencesDraw a simple family hair loss pedigreeLesson 2Styling and mechanical factors: heat tool use, drying practices, tight hairstyles, hair accessory use, and parting habitsThis section examines mechanical and styling practices that contribute to hair and scalp damage. Focus is on traction, heat, friction, and product buildup, with questions that quantify frequency and technique.
Assess frequency of blow-drying and hot toolsClarify temperature and heat protection useAsk about tight styles, braids, and extensionsReview use of wigs, weaves, and hair systemsEvaluate combing, brushing, and detangling habitsIdentify helmet, headwear, and friction sourcesLesson 3Symptom-specific questioning: onset, pattern, duration of shedding, pruritus, pain, scalp symptoms, and seasonal variationThis section focuses on targeted symptom questions for hair and scalp complaints. Learners will refine onset, duration, pattern, associated sensations, and triggers to distinguish common alopecia and scalp disease types.
Clarify onset, tempo, and duration of symptomsCharacterize shedding pattern and daily amountLocalize hair loss distribution and symmetryAssess pruritus, pain, burning, and tendernessAsk about flaking, pustules, and crustingExplore seasonal or cyclical symptom changesLesson 4Psychosocial and stress assessment: recent life events, occupational stress, sleep, and mental health screening questionsThis section guides structured questioning about stress, mood, and sleep. Learners will connect psychosocial stressors, anxiety, depression, and poor sleep with telogen effluvium and maladaptive hair behaviors.
Explore recent major life events and lossesAssess occupational and caregiver stress loadScreen for anxiety, depression, and burnoutAsk about sleep duration and sleep qualityIdentify hair-focused body repetitive behaviorsDiscuss coping strategies and support systemsLesson 5Medication, supplement, and hormonal history: prescription drugs, OTCs, steroids, contraceptives, and recent changesThis section explains how to obtain a precise list of medications, supplements, and hormonal agents. Emphasis is placed on timing of changes, dose, and known drug-induced alopecia or telogen effluvium triggers.
Compile full prescription medication listReview over-the-counter and herbal productsScreen for retinoids, anticoagulants, and chemoAssess contraceptives and hormone therapiesClarify recent dose or regimen modificationsCorrelate drug timeline with hair changesLesson 6Lifestyle, nutrition, and substance use: diet patterns, protein and micronutrient intake, caffeine, alcohol, smoking, and recent weight loss or dietingThis section explores lifestyle, diet, and substance use factors that affect hair. Learners will assess nutritional adequacy, restrictive eating, weight change, and exposure to alcohol, nicotine, and caffeine.
Assess typical daily and weekly diet patternScreen for restrictive or fad dieting historyDocument recent weight loss and appetite changeEvaluate protein and micronutrient intakeAsk about alcohol, smoking, and vapingReview caffeine intake and energy drink useLesson 7Red flags and urgent symptoms: sudden hair loss, scarring signs, pustules, systemic symptoms, or rapid progression that require immediate referralThis section trains clinicians to recognize red flag symptoms that demand urgent action. Emphasis is on rapid loss, scarring, pustules, systemic illness, and when to expedite dermatology or emergency referral.
Identify sudden diffuse or patchy hair lossRecognize signs of scarring and atrophyScreen for painful, boggy, or purulent lesionsLink fever, weight loss, or night sweatsFlag rapid progression despite gentle careDefine criteria for urgent specialist referralLesson 8Structured medical history: systemic illnesses, recent infections, surgeries, autoimmune disease, thyroid disease, and chronic conditionsThis section teaches how to structure a concise but complete medical history. Focus is on systemic illnesses, endocrine and autoimmune disease, infections, surgeries, and chronic conditions that influence hair growth.
Screen for thyroid and other endocrine diseaseReview autoimmune and connective tissue diseaseAsk about recent infections and high feversDocument surgeries, anesthesia, and hospital staysAssess chronic liver, kidney, and gut disordersReview chronic pain, fatigue, and other symptomsLesson 9Reproductive and endocrine history: menstrual pattern, pregnancies, menopausal symptoms, libido changes, and signs of androgen excessThis section details reproductive and endocrine history relevant to hair. Learners will connect menstrual patterns, pregnancy, menopause, libido, and androgen excess signs with common hormonal alopecias.
Clarify menarche, cycle length, and regularityAsk about pregnancies, births, and miscarriagesReview postpartum hair shedding episodesScreen for hot flashes and menopausal timingAssess hirsutism, acne, and androgenic signsDiscuss libido changes and sexual functionLesson 10Haircare and chemical exposure history: frequency and type of coloring, bleaching, perming, relaxers, professional salon treatments, and at-home productsThis section details how to systematically explore haircare routines and chemical exposures. Learners will link coloring, relaxing, bleaching, and product use with breakage, fragility, scalp irritation, and chronic damage patterns.
Document hair wash and conditioning frequencyAssess salon versus at-home chemical treatmentsClarify history of coloring, bleaching, and toningReview relaxers, perms, and keratin treatmentsIdentify use of harsh shampoos or cleansersRecord leave-in, oil, and styling product use
