QUESTION OF THE WEEK

YOUR SECOND AND SUBSEQUENT APPOINTMENT WITH DR. DONOVAN

This page applies to patients in the practice that are long term patients.

“Frequently Asked Questions about Follow up Appointments”

My Follow Appointments with Dr. Donovan

“Emailing Questions After My Appointment”

When is my next appointment going to be ?

The frequency of follow up appointments after the first appointment depends on the diagnosis the patient receives as to the cause of hair loss. In general, our patients enter one of 8 treatment programs for their hair loss. To view typical follow up intervals, click on the following link:

Typical Follow up Appointment Frequencies

 

1) Program for Male Pattern Balding (Male Androgenetic Alopecia)

Frequency of Appointments: Usually every 9-12 months (less frequent once improving)

A variety of FDA approved and off label non surgical treatment options are available for men with male pattern hair loss including finasteride, dutasteride, minoxidil, low level laser, platelet rich plasma, rosemary extracts, pumpkin seed oil. Patients are re-evaluated by Dr. Donovan every 9-15 months. Individuals deemed good candidates for surgical treatment (hair transplantation) are referred to hair transplant surgeons. 

 

2) Program for Female Pattern Hair Loss (Female Androgenetic Alopecia)

Frequency of Appointments: Usually every 9-12 months (less frequent once improving)

A variety of non surgical options are available for pre-menopausal and post menopausal women with female pattern hair loss including both FDA approved and off label treatments. These include minoxidil, spironolactone, finasteride, cyproterone acetate, low level laser, platelet rich plasma, zinc, selenium and various supplements and shampoos. Women with female pattern hair loss are re-evaluated every 9-15 months with the exception of patients undergoing PRP treatment who are seen every 3-4 months for treatment. Individuals deemed good candidates for surgical treatment (hair transplantation) are referred to hair transplant surgeons.   

Our clinic also has a particular clinical interest in the management of hair loss in women who are actively planning pregnancy, both naturally and through IVF. Many hair loss medications can not be used during pregnancy and many medications used during IVF have the potential to cause or worsen hair loss for some women.  We also have a dedicated program focusing on the management of androgenetic and age-related thinning during the peri-menopausal and post menopausal period. Some women have important decisions to make with their physicians regarding hormone replacement therapy and some women have important decisions to make regarding low testosterone levels and whether supplementation is likely to cause hair loss or actually help hair loss. 

 

AGA

 

3) Alopecia Areata Program (Alopecia Areata, Alopecia Totalis, Alopecia Universalis)

Frequency of Appointments: Variable, depending on subtype of alopecia areata (see chart below). Patients on any sort of systemic medication (tofacitinib, methotrexate, dexamethasone, prednisone) will have formal follow up appointments every 4-6 months in situations where Dr Donovan is assisting as the primary doctor overseeing care. Less frequent formal follow up appointments are appropriate in situations where Dr. Donovan is not providing care as the primary doctor overseeing care.

Screen Shot 2017-11-19 at 11.18.25 AM.png

Helpful Links:

-  DPCP CLINIC

-  PAEDIATRIC HAIR LOSS CLINIC

-  INFORMATION AOBUT STEROID INJECTIONS

 

Topical, intralesional and oral treatments are available for children and adults with alopecia areata. We have a large paediatric alopecia areata practice (click for the Pediatric Hair Loss Clinic). In general, treatments for alopecia include topical steroids, injections of triamcinolone acetonide, diphencyprone, anthralin, sulfasalazine, methotrexate, cyclosporine, tofacitinib.  Individuals with alopecia areata are seen by Dr. Donovan every 2-4 months.  Patients requiring corticosteroid injections are seen every 6-8 weeks whereas individuals on other treatments (oral medications, anthralin, DPCP) are seen every 3-4 months.  Individuals with patchy alopecia who develop patches of hair loss from time to time simply reach out to our nurses whenever steroid injections are needed. 

Our outpatient DPCP program has grown to be a large practice supporting the home application of DPCP. An initial appointment at the Whistler centre is required for all patients interested in home DPCP.  This enables patients to review with our DPCP nurses the proper application of DPCP. Thereafter, follow up monitoring and supervision is available through long distance communication. 

 

4) Scarring Alopecia Programs (Lichen planopilaris, Frontal Fibrosing Alopecia, Folliculitis Decalvans, Pseudopelade, Discoid lupus, Central Centrifugal Cicatricial Alopecia)

Frequency of Appointments: Usually every 3-6 months; Stable patients every 9-18 months (see chart below)

A variety of topical, injection and oral treatments are available for individuals with scarring alopecias. The include topical corticosteroids, topical calcineurin inhibitors, triamcinolone acetonide injections, oral doxycycline, oral hydroxychloroquine, oral methotrexate, oral cyclosporine, oral mycophenolate mofetil. Individuals with scarring alopecia are seen by Dr. Donovan every 2-6 months depending on their disease activity and additional care they are receiving.  Patients on any sort of systemic medication (doxycycline, hydroxychloroquine, methotrexate, mycophenolate mofetil, cyclosporine, isotretinoin) will have formal follow up appointments every 4-6 months in situations where Dr Donovan is assisting as the primary doctor overseeing care. Patients with active and progressive scarring alopecia should be properly evaluated every 4 months. Less frequent formal follow up appointments are appropriate in situations where Dr. Donovan is not providing care as the primary doctor overseeing care. For example, if a patient has a main dermatologist closer to home who prescribes all medications and monitors the patient’s disease closely with photos, follow up with Dr. Donovan will typically occur much less frequently than every 4 months. Patients requiring corticosteroid injections are seen every 6-12 weeks for injections.  Generally speaking, the more stable a patient's hair loss conditions is, the less often they are seen by Dr. Donovan.

scarring

 

 

5) Other forms of hair loss (acute and chronic telogen effluvium, traction alopecia)

Frequency of Appointments: Variable, usually every 4-12 months

Individuals with other forms of hair loss are seen at varying frequencies depending on the information uncovered during their appointment. For examples individuals with acute telogen effluvium may only be seen once, where as individuals with chronic shedding may be seen every 9-12 months. Individuals with traction alopecia may be seen every 3-4 months for steroid injections and re-evaluation or referred for hair transplant surgery. 

 

tetA

 

 

6) Program for Evaluation and Management of Complications following Hair Transplantation  (Post op Complications Clinic or 'POCC')

Frequency of Appointments: Variable, depending on diagnosis; Usually every 9-12 months; 

 

Hair transplantation remains a very successful and safe procedure for improving hair density. Despite this, complications can occur in a very small minority.  

Established in 2010, this unique program at the Donovan Hair Clinic provides help to patients and their physicians on the diagnosis and management of an array of scalp complications that occur following hair transplant surgery. The POCC has grown into one of the largest of it's kind anywhere in the world. Dr. Donovan sees patients from all over the world who come to the clinic with the exact same question - Why did this particular phenomenon happen to me after my hair transplant? The exact reason for seeking help in the clinic will differ from patient-to-patient but all patients in the POCC have experienced some type of 'unexpected' post-operative course. Some patients come to the clinic wanting to know why they have didn't achieve good hair growth after their transplant, others come wanting to understand why their scalp remains red or itchy. Others come wanting to know why they have lost their transplanted hair despite initially having a fuller result. Others come wanting to know the reasons for 'bumps' in the scalp. Others come wanting to know why they have scalp pain, tingling and parenthesis. These types of issues are routinely addressed in the POCC.

 

7) Scalp Dysesthesia Clinic 

Frequency of Appointments: Variable, depending on cause; Often every 6-12 months

 

The Scalp 'Dyesthesias' are a group of conditions whereby the scalp looks more or less normal, biopsies return normal, and yet the patient has symptoms of itching, burning or pain. These conditions are challenging - both in their diagnosis and management.  We see many patients with complex scalp pain syndromes, burning scalp syndrome, and sensitive scalp syndrome.  

 

8) Scalp Dermatology Clinic

Frequency of Appointments: Variable, depending on cause of scalp issue; usually every 6-12 months.

In addition to hair loss, we treat a variety of scalp conditions, some of which may or may not be related to hair loss. These include seborrheic dermatitis, eczemas,  pityriasis amiantacea, scalp psoriasis, folliculitis, and scalp rosacea. 

 

 

 

 

 




Share This
-->