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Carry Out Expanded Trichological Investigations

URN: SKAATS1

Business Sectors (Suites): Trichology,Advanced Trichology

Developed by: SkillsActive

Approved on: 30 Mar 2022

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Overview

This standard coexists with and should be used in conjunction alongside, SKAHDBRBNST1 Implement and maintain safe, hygienic and effective working practices and SKATCS1 Carry out a trichological consultation service. This standard is for practitioners and trichologists providing a trichological service who wish to expand their consultation with further investigation to critically analyse, evaluate, determine and manage scalp and hair conditions. Practitioners must work within their scope of practice and limits of their authority and refer individuals to relevant healthcare professionals when necessary. Users of this standard will need to have the relevant underpinning knowledge to understand the aetiology and pathophysiology of the trichological conditions which they observe. Users of this standard must ensure that their practices reflect up-to-date information, evidence, policies, procedures and best practice guidance for practice appropriate to these procedures, and where the evidence base is limited or anecdotal this must be made clear to the individual seeking your services. You will also be required to evaluate and reflect upon your practice and take steps to evidence continuous development. It is advisable users of this standard are aware of and comply with first aid requirements in accordance with legislation and organisational policies and procedures.

Performance criteria

You must be able to:

1. follow legal requirements and other relevant standards, insurance guidelines and, organisational protocols when carrying out trichological investigations *

2. maintain your responsibilities for the health, safety, hygiene and welfare of the individual and yourself before, during and after the *trichological investigations

3. follow a concise and comprehensive trichological consultation and interpret the additional trichological investigations necessary

4. discuss and provide the rationale for the proposed trichological investigations and the protocols for undertaking them.

5. ensure the individual’s understanding and obtain informed consent for the proposed investigative procedures

6. carry out, or facilitate the trichological investigations to determine, review and monitor the presenting trichological condition, following organisational protocols

7. gain consent, record and securely store visual media for future reference and monitoring purposes in accordance with legislative, regulatory and indemnity requirements

8. evaluate the presenting trichological condition against known classification scales *

9. collate, critically analyse, evaluate and interpret the information gathered from the trichological consultation, the *trichological investigations and available evidence base relating to the presenting trichological condition to inform the management plan

10. discuss, formulate and agree with the individual their management plan based on the conclusion of the trichological investigations to include:

10.1. critical evaluation of the evidence base

10.2. impact on the prognosis and alterations required to the management plan

10.3. the best interests of the individual and your ethical responsibilities

10.4. working within your scope of practice

10.5. adapting communication styles to meet the individuals needs

10.6. contraindications and potential comorbidities

11. refer to other professionals where indicated by the outcome of the trichological investigations *

12. record the information gathered and the outcomes of the *trichological investigations to meet legal requirements and organisational protocols

13. review and reflect on your performance to inform continuous professional development

Knowledge and Understanding

You need to know and understand:

1. the legal requirements and other relevant standards, insurance guidelines and, organisational protocols when carrying out trichological investigations

2. how to maintain your role and responsibilities for the health, safety and welfare of the individual and yourself before, during and after the trichological investigations and the importance of working within the scope of your practice

3. the trichological consultation factors that inform the range of trichological investigations and how to interpret them

4. the rationale for the proposed trichological investigations, expected findings in different trichological conditions and the role of evidence based practice

5. the investigative procedures used in trichological consultation services and how to carry them out to determine, review and monitor the presenting trichological condition, following industry and organisational protocols

6. the importance and requirements of gaining informed consent

7. how to gain consent, record and securely store visual media of the individual's treatment area in accordance with legislative, regulatory and indemnity requirements

8. how to interpret the results of the trichological investigations and evaluate the features and severity of presenting trichological conditions in relation to known classification scales

9. how the trichological consultation, initial assessment, available evidence and the trichological investigations outcomes collectively inform a bespoke management plan to include:

9.1 evaluation and interpretation of differential hypotheses

9.2 evaluation and interpretation of clinical reasoning theories

9.3 critical evaluation of the evidence base

10. the anatomy and physiology and related sciences relevant to this standard

11. the normal and adverse signs and patterns of trichological conditions across all skin and hair types

12. the biological variables, associated symptoms, physiological indicators and comorbidities that can contribute to the pathophysiology of the observed hair and scalp changes

13. the biochemical markers that can result in scalp and hair growth disturbances

14. how to develop an agreed management plan with the individual based on the conclusion of the trichological investigation, to include:

14.1. the impact on the prognosis

14.2. the variety of options available for management

15. how to act within the best interests of the individual and your ethical responsibilities

16. the importance of shared decision making

17. the importance of working within your scope of practice

18. the different communication styles to meet the individual’s needs

19. the impact of potential contraindications

20. when further medical investigation, treatment and referral to another professional may be necessary and the processes for doing so to include:

20.1 the importance of gaining informed consent for sharing relevant information with other professionals

20.2 the information to include within the referral
21. how to complete accurate, secure and contemporaneous records of the information gathered and the outcomes of the trichological investigations to meet legal requirements and organisational protocols, taking into account:

21.1. the rights of the individual

21.2. audit and accountability

22. the importance of collaboration with competent professionals to support effective and safe working practices

23. the importance to engage in and document continuous professional development, up-to-date information policies, procedures and best practice guidance

Scope/range

Trichological Investigations
*

1. Visual examination of the scalp and hair
2. Digital trichoscopy
3. Standardised photography
4. Measurements of hair density
5. Measurements of affected areas of the scalp
6. Woods light
7. Hair pull test
8. Daily hair count test
9. Adapted wash test
10. Phototrichogram (shaved/unshaved)
11. Unit area trichogram (UAT)
12. Refer or facilitate skin/hair fungal analysis
13. Refer or facilitate further blood tests

Classification scales

1. Fitzpatrick skin classification scale
2. Severity of alopecia tool (SALT)

3. Frontal fibrosing alopecia severity index and other scales representing cicatricial alopecia
4. Sinclair and other scales representing female pattern hair loss
5. Norwood and other scales representing male pattern hair loss
6. Visual analogue scale of pruritus
7. Adapted severity of psoriasis index (for the scalp)

Related science

1. Anatomy and physiology of the pilosebaceous unit, scalp and head
2. Interdependence of body systems and organs, tissues and cellular organisation and homeostasis,
3. The skin barrier function, regulation, and impact of wound healing
4. Aetiology and pathophysiology of hair and scalp disorders
5. The regulatory factors of the hair growth cycle
6. Fundamental principles of genetic inheritance and expression
7. Fundamental principles of hormonal and immunological influence on hair and scalp disorders
8. Fundamental principles of haematological parameters and significance to health, and where referral is required.
9. Fundamental principles of nutritional science, nutrient absorption, interactions, and dietary education
10. Fundamental principles of cosmetic science, including product formulations and actions.

Signs and patterns

*
1. Follicle presence, loss and activity

2. Hair shafts per follicular unit
3. Hair shaft diameter variability
4. Normal and dystrophic features of the hair shaft and bulb
5. The presence, extent and location of erythema
6. Vascular patterns within the scalp
7. The presence, extent and location of scale or hyperkeratosis
8. Signs indicative of scarring and fibrosis
9. Discolouration, hyper or hypopigmentation of the hair and scalp
10. Primary and secondary scalp lesions
11. Benign and suspicious scalp lesions
12. Presence of contact irritant or allergy response
13. Presence of infection or infestation
14. Fungal fluorescence and hyphae
15. Affected locations on the scalp
16. Patterns of diffuse and patchy hair loss
17. Hyper or hypo secretion of sebum and sweat
18. Odour

Scope Performance

Scope Knowledge

Values

Behaviours

Skills

Glossary

Evidence-based practice

Is based on the best available, current, valid and relevant evidence

Refer

To ask someone else to provide care, treatment or other services which are beyond the scope of the practitioners practice, or where relevant because the individual has requested a second opinion.

Scope of practice

The procedures, actions and processes that a practitioner is allowed to undertake according to their specific education, level of expertise and competence.

Trichologist

Someone with an interest in the scientific study of the hair and scalp: does not require a formal qualification however voluntary membership exists to denote those who have undertaken relevant training.

Visual media

To cover all images recorded including video, photography and digital microscopic images of the hair and/or scalp. This must be carried out with the individuals consent.

Links To Other NOS

SKANSC1.2

External Links

Version Number

Indicative Review Date

30 Mar 2025

Validity

Current

Status

Original

Originating Organisation

SkillsActive

Original URN

n/a

Relevant Occupations

Trichologists

SOC Code

6221

Keywords

Trichology, hair science, hair diseases, hair disorder