Jun 06, 2019 by AdminNJCC

One question that often comes up in the discussion of cancer treatments is hair loss, also called Alopecia.

It is widely known that hair loss may be a side effect of various types of cancer treatment including chemotherapy, radiation therapy, targeted therapy, or bone marrow/stem cell transplants. Managing side effects such as hair loss is an important part of cancer care called palliative or supportive care. You should have an open and frank discussion with your physician and entire health care team about managing or coping with possible hair loss from cancer treatments.

What causes hair loss?

A simplified explanation is that some forms of cancer treatment can cause hair loss by harming the cells that help hair grow.

We should mention that not all chemotherapy causes hair loss. Also, there may be other reasons that help contribute to hair loss beyond cancer treatment such as low iron levels or thyroid problems. In addition, not every patient responds to treatment exactly the same way so side effects may vary from patient to patient.

When hair loss does occur, it often affects the entire body, including the head, face, arms, underarms, legs, and even the pubic area. Hair may fall out entirely, slowly, or in sections. For some people, hair may simply become thin (sometimes unnoticeably so) or may become duller or dryer.

It should also be noted that hair loss related to cancer treatment is usually temporary. In most instances, hair will grow back as it did before treatment. In rare cases, it may remain thin.

There are various drugs used to treat different forms of cancer. It is important to talk with your doctor before your cancer treatment begins to find out if the treatment he or she prescribes is likely to cause hair loss.

How long after the start of chemotherapy does hair loss begin?

Hair loss does not usually begin right away. It could take several weeks or cycles of treatment before hair begins to fall out. Then, about 1 to 2 months into treatment hair loss tends to increase. The amount of hair loss experienced varies from patient to patient. Even patients who take the exact same drug for the same type of cancer may experience different amounts of hair loss. How much hair you lose could depend on various factors including which drug is prescribed, the dose, on whether you receive the drug as a pill, into a vein, or on the skin, as well other factors.

Hair usually starts to grow back about 1 to 3 months after chemotherapy ends. It often takes between 6 and 12 months for your hair to fill back in to where it was before treatment. The new hair may have a different texture than before. It may feel thinner or a bit coarser. The color may also be a little different than before, but usually hair returns to normal after several years.

If a patient is receiving targeted therapy, which is technically considered chemotherapy but works differently than standard chemo drugs, then complete hair loss is not expected, but hair may become thinner, curlier, or drier than usual.

What about with other forms of therapy besides chemo?

Different cancers often require different treatments. If your diagnosis requires radiation therapy, then chances are only the hair found where the radiation is aimed will be affected. For example, if you receive radiation therapy to the pelvis, you could lose hair in the pubic area. The amount of hair loss depends on the dose and method of radiation therapy. Hair usually grows back in the area of radiation therapy after several months, but it may be thinner or a different texture. With very high doses of radiation therapy, hair may not grow back at all.

For patients receiving hormonal therapy, only a small number will have noticeable hair thinning. It could begin several months or even years after starting treatment. But hormonal therapy does not usually cause complete hair loss.

Managing or coping with hair loss

For many people, hair loss from cancer treatment can be an emotionally challenging experience that affects not only self-image, but also overall quality of life.

Learning how to manage hair loss before, during, and after treatment may help you cope with this side effect.

Talking about your feelings with a trained counselor or someone who has gone through the same experience would probably be beneficial. It may also be helpful to consider talking about potential hair loss with family and friends, especially children, before it occurs. Understanding and expecting changes in the physical appearance of someone they know helps lower fear and reduce anxiety.

Some people recommend cutting hair shorter before beginning treatment. A shorter hairstyle may make hair look fuller and make hair loss seem a less dramatic change.

One treatment often used is the DigniCap® Scalp Cooling System – CLICK HERE TO LEARN MORE. This system cools the scalp before, during, or after chemotherapy and can help prevent hair loss from drugs given through a vein. This treatment works by narrowing the blood vessels in the skin on your head decreasing blood flow, which means that less of the drug reaches the hair follicles. As a result, the hair follicles are less likely to get damaged from the chemotherapy.

There are several medications that may also be used to treat hair loss. An over-the-counter topical medication called minoxidil may be helpful to treat hair thinning from hormonal therapy or targeted therapy. Sometimes oral medications such as spironolactone (Aldactone) or finasteride (Propecia, Proscar) may also improve hair growth.

Talk with your health care team about what side effects to expect from your cancer treatment. If hair loss or alopecia is one of them, ask about possible treatments and medications to help deal with it and whether they may work for you.

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