Hair Loss from Chemotherapy: An Explanation of the Cause and Duration
Chemotherapy, a common treatment for cancer, can often lead to hair loss, also known as chemotherapy-induced alopecia. Here's what you need to know about this side effect and how to prepare for it.
Understanding Hair Loss During Chemotherapy
Hair loss usually begins 2 to 4 weeks after starting chemotherapy and can last 6 to 9 months or more after treatment ends. The severity and likelihood of hair loss depend largely on the type of chemotherapy drug.
Types of Chemotherapy Drugs and Their Effects on Hair Loss
- Antimicrotubule agents such as paclitaxel and docetaxel cause hair loss in 80% or more of patients, often resulting in full alopecia.
- Topoisomerase inhibitors like doxorubicin cause hair loss in 60% to 100% of patients, and they are known to cause full hair loss as well.
- Alkylating agents such as cyclophosphamide cause hair loss in 60% or more of patients and can be significant but may vary in severity.
- Other chemotherapy drugs such as cisplatin and vincristine tend to cause hair thinning rather than complete hair loss.
Hair loss from chemotherapy can be of two types: Anagen effluvium, which affects actively growing hair follicles, and Telogen effluvium, which causes hair follicles to enter resting phase prematurely.
Preparing for Hair Loss
It can be hard for doctors to predict who will experience hair loss due to chemotherapy, as it depends on the specific drugs used. Speaking with a healthcare team about the likelihood of hair loss and preparing for it can help manage the experience.
Some people may find it more comfortable wearing wigs or scarves to cover their hair loss, while others may find it easier to shave their hair off themselves before it starts to fall out. Sleeping on satin or silk pillowcases can help reduce hair tangling during chemotherapy.
Caring for Thinning Hair
Avoid pulling or brushing the hair too much, using heat styling tools, bleaching, dying, or perming hair, braiding, curling, or straightening hair, pulling hair into a ponytail, blow-drying it, using rubber swimming caps, and sleeping on rough pillowcases during chemotherapy to protect thinning hair.
Wash your hair every 2-4 days using a gentle shampoo and moisturizing conditioner during chemotherapy. Certain techniques can help care for thinning hair, such as using gentle hair care products, avoiding heat styling, and not brushing hair excessively.
Wig Coverage and Insurance
It is important to check if insurance policies cover wigs, as they can be expensive. When using a wig, remember to clean it regularly to prevent bacteria build-up. The term to use when checking insurance policies for wig coverage is "cranial prosthesis."
Reducing the Risk of Hair Loss
Wearing a cooling cap during chemotherapy can help reduce the risk of hair loss. However, cooling caps may cause side effects such as headaches, scalp pain, and neck and shoulder discomfort.
Coping with Hair Loss
Talking with family or friends, a mental health professional, a social worker at your local cancer center, in-person or online support groups for people with cancer about your hair loss concerns can be beneficial. Remember, you are not alone in this experience.
Regrowth of Hair
When hair begins to grow back after treatment, it may go through stages such as a "soft fuzz" and regrowth up to 4-6 inches over the course of 12 months.
[1] American Cancer Society. (2020). Chemotherapy and Hair Loss. [2] Mayo Clinic. (2020). Chemotherapy and Hair Loss. [3] National Cancer Institute. (2020). Hair Loss (Alopecia). [4] American Society of Clinical Oncology. (2018). Hair Loss During Chemotherapy. [5] National Comprehensive Cancer Network. (2020). Chemotherapy-Induced Alopecia.
- Chemotherapy, a common treatment for medical-conditions like cancer, often leads to hair loss, a side effect known as chemotherapy-induced alopecia, and understanding the types of chemotherapy drugs and their effects on hair loss is essential.
- Antimicrotubule agents, topoisomerase inhibitors, and alkylating agents are among the chemotherapy drugs known to cause significant hair loss, while cisplatin and vincristine tend to cause hair thinning.
- Hair loss from chemotherapy can be divided into Anagen effluvium, which affects actively growing hair follicles, and Telogen effluvium, which causes hair follicles to enter the resting phase prematurely.
- Preparing for hair loss during chemotherapy, whether it's wearing wigs, scarves, or shaving one's hair, and adopting skin-care practices like using gentle hair care products, avoiding heat styling, and cleaning wigs regularly can help manage the experience.
