Hair Loss due to Chemotherapy

It is well known that Cancer Chemotherapy causes hair loss.  This is a very different type of hair loss to typical male or female pattern baldness.

As most people know, Chemotherapy is a cancer treatment which uses very powerful anti-cancer drugs to destroy cancer cells.  These drugs work by attacking the cancer cells and disrupting their growth. Unfortunately, they can also affect the normal cells in the body, including the cells of the hair follicles.  This causes hair loss, also known as alopecia. Unlike cancer cells, however, the normal cells quickly recover, so if you lose your hair due to chemotherapy it will almost always grow back when your treatment is over.

Not all chemotherapy drugs make your hair fall out, and sometimes the loss is so small it’s hardly noticeable.  However, some people will have temporary, partial or complete baldness. Some chemotherapy drugs make other body hair fall out, such as eyebrows, eyelashes, nasal hair, beard, moustache, chest, underarm, leg and pubic hair.  The amount of hair that falls out depends on the drug or combination of drugs used, the doses given and the way that your body reacts to the drug.

If your hair is going to fall out, it usually starts within two to three weeks of starting chemotherapy, although very occasionally it can start within a few days. The first thing you may notice is that your hair starts to come out more when you brush, comb or wash it. You may also find hair on your pillow in the morning.

Hair may just thin and become dry, fragile and break easily. For other people their hair may carry on falling out over a few weeks so that they become completely bald. Sometimes the hair comes out very quickly over 1-2 days, which can be very upsetting. Some people find that their scalp feels tender.

Preventing hair loss during chemotherapy
By cooling the scalp,  it is sometimes possible to reduce the amount of chemotherapy drugs that reach the hair follicles on your scalp.  This reduces, and in some cases prevents, the hair from falling out.  It’s done by using a ‘cold cap’ or a machine that cools the scalp. There are many different ways of cooling the scalp so the methods used vary from one hospital to another.

Types of scalp cooling
There are two widely available methods for scalp cooling: one uses a hat known as a cold cap which is filled with gel that can be chilled and the other uses a refrigerated cooling system to pump liquid coolant through a cap that is attached to the system.

Cold caps that are filled with gel can be applied easily and kept in place by Velcro. The cap can be very uncomfortable and heavy, as well as being very cold, and may give you a headache. It also needs to be changed every 20-40 minutes to keep your scalp cool.

Caps attached to the refrigerated cooling system generally feel lighter than the gel caps. You need to sit by the machine while the cap is in place, so you can’t walk about freely. However, the cap can be disconnected for short periods if necessary, for example if you need to use the toilet.

Both methods of scalp cooling need to be worn for some time before and after the chemotherapy drugs are given. You may have the cap on for a few hours in total. You may feel chilly during the treatment, but the chemotherapy staff will do all they can to make you as comfortable as possible.

Scalp cooling is only effective when used with certain chemotherapy drugs and it’s not always possible to know how effective the treatment will be until you try it.  Scalp cooling is not advisable when treating some types of cancer.  Your doctor or chemotherapy nurse can tell you if it’s available and whether it’s appropriate for you.
How will my hair grow back after chemotherapy?

Hair almost always grows back after chemotherapy.  It may begin to grow back before you finish your treatment. At first the hair is very fine but you will probably have a full head of hair after 3-6 months. You may find that your new hair is curlier, straighter or finer than it was before.  It may also be a slightly different colour, or sometimes a mixture of dark and grey hair.  Very rarely, after high doses of chemotherapy the hair does not grow back at all.

Hair loss shampoos, will probably not help prevent hair loss due to chemotherapy.  If they do the effect will probably only be transient as many hair loss shampoos increase blood flow to the scalp, which will actually help deliver more chemotherapy to the scalp and may accelerate the hair loss.

Where ProFusion and other hair loss shampoos may help, would be when chemotherapy is complete and fine hair begins to grow again.  Using ProFusion should help the new hair to grow more quickly and stronger.  However it is always best to consult your GP or oncologist before using any additional treatment, even a hair loss shampoo.

Most people have experienced cancer in themselves or a friend or family member at some stage of their lives.  Fortunately modern cancer treatments are much more effective than they were a few years ago and survival rates are getting better all of the time.  If you are a cancer sufferer and have experienced hair loss, you might wish to contribute to this blog so that others can reply and share their experiences and please remember that Macmillan Nurses can also offer help support and advice during this time.

With thanks to http://www.macmillan.org.uk for the main content in this article.