Female Questionnaire
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SYMPTOMS: SKIN: CONDITIONS

Q645

Did you experience Adolescent Acne?
  • No / not applicable / don't know
  • Yes, moderately / briefly
  • Yes, severely / prolonged

Q646

Have you had Adult Acne?
  • Never had it / not applicable / don't know
  • Probably had it/minor episode(s) now resolved
  • Major episode(s) now resolved
  • Current minor problem
  • Current major problem

Q647

If you have Acne, is it worse with stress and before or during your period?
  • No / not applicable / don't know
  • Somewhat
  • Definitely

Q648

Do you have Telangiectasia (persistent red or blue veins on your face, upper chest or neck)?
  • Don't know
  • No
  • Mild (a few veins)
  • Moderate
  • Severe (many veins)

Q649

Have you had Eczema? This includes many kinds of red, blistering, oozing, scaly, brownish, thickened and itching skin conditions, and may be known as Dermatitis.
  • Never had it / don't know
  • Probably had it/minor episode(s) now resolved
  • Major episode(s) now resolved
  • Current minor problem
  • Current major problem

Q650

Have you had Psoriasis? It is characterized by frequent episodes of redness and itching, and thick, dry, silvery scales in discrete patches on the skin. It is most common on the scalp, trunk, elbows, knees, skin folds and fingernails.
  • Never had it / don't know
  • Probably had it/minor episode(s) now resolved
  • Major episode(s) now resolved
  • Current minor problem
  • Current major problem

Q651

Do you have Rosacea? This is a facial rash usually composed of prominent redness and sometimes also pimple-like bumps that do not become whiteheads or blackheads.
  • Don't know
  • No, definitely not
  • Mild
  • Moderate
  • Severe

Q652

Do you have dandruff (Seborrheic Dermatitis)?
  • No / don't know
  • Some
  • Significant
  • Severe

Q653

Actinic Keratoses. Small, raised, flaky skin lesions usually found on the forehead in older people.
  • Never had them / don't know
  • Probably have a few
  • Current minor problem
  • Current minor problem, have had many removed
  • Current major problem

Q654

Do you have any Seborrheic Keratoses? They have a waxy, stuck-on look, like brown candle wax dropped on the skin. Color ranges from light tan to dark brown or black. They may be smooth, or rough and crumbly; size varies from tiny spots to inches long.
  • None / don't know
  • I believe I have a few
  • I have some (5-10)
  • I have many (11-30)
  • I have very many (over 30)

Q655

How many normal (common) moles do you have? Normal moles have a uniform light tan/brown color and are almost perfectly round.
  • Don't know
  • 10 or fewer
  • Between 10 and 50
  • Between 50 and 100
  • More than 100

Q656

Do you have moles that bleed, are enlarging, are painful, or are tender?
  • Don't know
  • No
  • A few / minor problem
  • Several / definitely an issue

Q657

Do you have any dark moles with a rough/irregular shape and varied color? These are different from normal moles.
  • No / only normal moles / don't know
  • Yes, under 5 irregular dark moles
  • Yes, about 5 to 20 irregular dark moles
  • Yes, more than 20 irregular dark moles

Q658

Have you had any polyps? These are small growths on a mucous membrane, usually inside the nose, colon, or uterus.
  • Never had one / don't know
  • Probably had one/minor episode(s) now resolved
  • Major episode(s) now resolved
  • Current minor problem
  • Current major problem

Q659

Do you have any tender points (very sensitive to touch) in these areas? Sides of: front of neck, rear base of neck, rear base of skull, or breastbone; shoulder blades; elbows; knees; tops of buttocks, outside rear upper legs under buttocks.
  • No / not very sensitive to touch / don't know
  • Not now, but I had them in the past
  • Yes, 1-5 tender points
  • Yes, 6-10 tender points
  • Yes, 11 or more tender points

Q660

Do you tend to get rashes?
  • It is not a problem for me / don't know
  • Generally not, but I do have a rash now
  • Occasional (several times a year) moderate rash
  • Frequent moderate rash / occasional severe
  • Frequent (several times a month) severe rash

Q661

Do you have Vitiligo (patches of depigmented/lighter skin)?
  • Never had it / don't know
  • Probably/minor episode(s) now resolved
  • Major episode(s) now resolved
  • Current minor problem
  • Current major problem

Q662

Do you have warts anywhere on your body other than in the genital area? (Genital warts are covered elsewhere.)
  • No / don't know
  • Probably/minor episode(s) now resolved
  • Major episode(s) now resolved
  • Yes, one or two
  • Yes, more than two

Q663

Whether you are male or female, do you have any unusual problems with your nipples, such as itching or discharge? (Discharge is normal in pregnant or lactating women.)
  • No / don't know
  • Yes, only because I am pregnant or lactating
  • Yes, something is not normal*
* more questions will be asked later

SYMPTOMS: HAIR

Q664

What is your body hair quantity? This question refers to 'normal' female hair patterns i.e. underarm, pubic or leg hair but not chest or upper lip.
  • Don't know
  • Little / none
  • Less than average
  • Average
  • Abundant, more than average

Q665

Do you have any hair growth pattern that is usually seen in males? This means increased hair on the chest/nipples, above the pubic area toward the navel, or on the chin or upper lip.
  • Don't know
  • No
  • Very minor
  • Somewhat / one or two areas
  • Very noticeable / in several areas

Q666

Have you had a recent change in body hair quantity?
  • Much recent loss
  • Some recent loss
  • No / don't know
  • Some recent gain
  • Much recent gain

Q667

Do you have an urge or habit of pulling or plucking hairs from your body beyond the removal of selected hairs for cosmetic reasons?
  • Don't know
  • No
  • Yes, from time to time
  • Yes, I habitually pull hairs out
  • Yes, I habitually pull hairs out and eat them

Q668

Do you have less pubic or underarm hair growth than previously?
  • I can't tell / don't know
  • No, quantity is at least as much as before
  • Yes, the quantity has decreased somewhat
  • Yes, the quantity has decreased substantially

Q669

Do you have male pattern hair loss? Male pattern hair loss is a common condition in which men - and sometimes women - experience a receding hairline and/or balding on the top of the head.
  • No / don't know
  • Mildly / frontal loss only
  • Moderately / partial loss on top only
  • Moderately / complete loss on top only
  • Severely / nearly or totally bald

Q670

Is the hair on your head becoming less dense? In other words, are you losing hair at a noticeable rate?
  • Normal loss / not applicable / don't know
  • Moderate loss
  • Much loss

Q671

How dry or oily is your hair?
  • Generally dry
  • Recently more dry
  • Average / not applicable / don't know
  • Recently more oily
  • Generally oily

Q672

Apart from graying, what color tone is or was the hair on your head?
  • Very light
  • Light
  • Average / not applicable / don't know
  • Dark
  • Very dark

Q673

If you have gray hair, choose the answer that best describes the graying process in your case. Hair graying is both genetic and age-related.
  • I have no hair / no gray hair / don't know
  • It retained its natural color longer than expected
  • It has grayed normally for my age and race
  • Somewhat prematurely (over half gray before 45)
  • Very prematurely (over half gray before 35)

Q674

How dense (thick) is the hair on your head in areas that are not affected by any type of hair loss?
  • I'm bald / my whole head is affected by hair loss
  • Very sparse/thin
  • Somewhat sparse/thin
  • About average / don't know
  • Dense/abundant/thick

Q675

Without hair treatments, how strong and healthy are the hairs on your head? Brittle hair is dull, rough, lifeless, frizzy, has split ends and breaks easily. Healthy, strong hair appears moist and shiny.
  • Very dry/brittle, break easily
  • Somewhat dry/brittle/dull
  • Healthy / strong / I don't have hair / don't know

Q676

Approximately how fast does your head (scalp) hair grow? Hair normally grows about 1/2 inch (1.25cm) per month or 6 inches (15cm) per year.
  • Very slowly (under 3 inches or 8cm per year)
  • Slowly (3-6 inches or 8-15cm per year)
  • Average / not applicable / I have no idea
  • Quickly (6-12 inches or 15-30cm per year)
  • Very quickly (over 12 inches or 30cm per year)

SYMPTOMS: NAILS

Q677

Approximately how fast do your fingernails grow? Normal growth is about 1/12th to 1/8th of an inch (2-3mm) per month.
  • Very slowly
  • A little slower than average
  • Average / I have no idea
  • A little quicker than average
  • Very quickly

Q678

Do you bite your nails?
  • No / don't know
  • Sometimes a little, but my nails look quite normal
  • Moderately - they are bitten back to the nail bed
  • Severely - my nails are deformed or mostly gone

Q679

Do you experience inflamed/red cuticles (the skin around the edge of your nails)?
  • No / don't know
  • Slightly - Occasionally / one or two nails
  • Significantly - Regularly / a few nails
  • Severely - Usually or always / several nails

Q680

Do you suffer from hangnails/agnails (torn skin around the fingernails or toenails)? If there is a physical cause such as biting, picking, cutting or regular exposure to water/soaps/chemicals then select that response.
  • No / don't know
  • Yes, from a known physical cause
  • Occasionally - A few times a year
  • Regularly - A few times a month
  • Frequently - I usually/always have them

Q681

Aside from injury, are your fingernails or toenails at all unusual? For example, white spots/areas, pale, unusual color, weak/brittle, lines/ridges/grooves, or curved backwards? Healthy nails are smooth and strong with a uniform pink nail bed.
  • Not applicable / don't know
  • No, my nails are healthy
  • Yes/probably I have some nail abnormalities*
* more questions will be asked later

LIFESTYLE / EXERCISE

Q682

How many hours do you work each week? Include any tasks which you would prefer not to do, for example housework, studying, childcare.
  • I don't/can't work / don't know
  • Under 35
  • 35 to 47
  • 48 to 60
  • Over 60

Q683

Approximately how much moderately strenuous AEROBIC exercise do you manage to get each week? Examples would include a brisk walk, running, bicycling or swimming.
  • Don't know
  • Less than 2 hours total each week
  • 2-5 hours total each week
  • 5-7 hours total per week
  • Over 7 hours total per week

Q684

Approximately how much moderately strenuous NON-AEROBIC exercise do you manage to get each week? Also known as anaerobic exercise, examples include weight training, circuit training or other load-bearing exercises.
  • Don't know
  • Less than 2 hours total per week
  • 2-5 hours total per week
  • 5-7 hours total per week
  • Over 7 hours total per week

Q685

Aside from specific exercise sessions, for approximately how many hours each week are you strenuously active? This includes activities/jobs that involve lifting/carrying heavy objects, digging, running etc.
  • Don't know
  • None
  • 1 to 5
  • 6 to 10
  • More than 10

Q686

If you are not getting as much exercise as you should (at least 4-5 hours of aerobic exercise per week), what is the reason for this? Work-related activity involving raised heart rate and sweating qualifies as exercise.
  • Not applicable (I do exercise enough) / don't know
  • I just don't feel like it
  • I don't have the time
  • Physical problems prevent me
  • Disease or illness prevents me

Q687

When you exercise (run, walk fast, cycle, etc.), do you get a 'side stitch'?
  • Don't know
  • No, never
  • Rarely
  • Regularly, but under half the time
  • Most of the time

Q688

How long does it take you to recover from moderate physical exertion? Moderate exertion is defined as any activity that causes an increase in pulse / breathing / sweating for at least 10 minutes.
  • Don't know
  • Under an hour
  • Several hours
  • Most of the day
  • 24 hours or more

Q689

Excessive exercise. Would friends say that you exercise compulsively, or that you train too much?
  • No / don't know
  • Some do
  • Yes, definitely

Q690

Do you practice any form of calming/stretching exercise, for example Yoga, Tai Chi, or Pilates?
  • Never / don't know
  • Once per month or less
  • Once per week or less
  • A few times per week
  • At least daily

Q691

Computer use: On average, approximately how much time do you spend in front of a computer?
  • Don't know
  • None / under 1 hour a week
  • 1-20 hours a week (under 3 hours a day)
  • 21-60 hours a week (3-9 hours a day)
  • Over 60 hours a week (over 9 hours a day)

Q692

Television: On average, approximately how much time do you spend in front of the TV?
  • Don't know
  • None / I watch under 1 hour a week
  • 1-10 hours a week (about an hour a day)
  • 11-30 hours a week (1-4 hours a day)
  • Over 30 hours a week (over 4 hours a day)