Chemotherapy Related Hair Loss
Chemotherapy consists of the administration of drugs that destroy rapidly reproducing cancer cells. Cancer cells are some of the most rapidly reproducing cells in the body, but other cells, such as those which contribute to the formulation of the hair shafts and nails, are also rapidly reproducing. Unfortunately, while chemotherapy drugs preferentially destroy cancer cells, the drugs also can destroy those cells responsible for normal growth of hair and nails. Cancer patients sometimes shed the hair and nails during treatment. Chemotherapy drugs are poisonous to the cells of the hair root responsible for hair shaft formation. Usually, the hair is lost rapidly in large quantities during treatment. No hair growth stimulant, shampoos, conditioners or other cosmetic treatments can prevent or retard the hair loss. The good news, however, is that once chemotherapy is completed, the hair usually grows back.
How and when hair growth occurs
Adequate hair growth may take six months to one year.
- Returning hair may be different from the hair that was lost. Due to the absence or alternation of pigment the hair may grow back white, gray or a different color. Eventually, as the pigment cells return to normal, the original color should return.
- It is common for the new hair returning to be finer in texture initially, but like color, the texture should return to its original thickness.
It is sometimes difficult to be patient, but as the body is returning to normal and getting over the significant insult, time is a necessary ingredient.
Hair care tips for new hair growth
- Shampoo hair daily with a mild shampoo such as those intended for hair growth.
- The scalp should also be thoroughly massaged to remove any build up.
- Follow shampoo with a conditioner for fine or limp hair.
- Avoid high heat from blow dryers to the hair and skin.
- Keep hairstyling to a minimum due to the new hair being prone to breakage. Brushing, combing, hair pins and curling should all be minimized. Curling appliances should be avoided as the scalp is very tender following chemotherapy.
- Hair styling aids such as mousse, hair spray, hair spritz, styling gel and sculptng gel may be used in moderation. It is best to select products with normal to light holding ability as the high hold products may not be completely removed with mild shampoos.
- Hair styling aids can build up on the hair shaft resulting in dullness and possibly scalp disease.
Chemical curling or permanent waving
Chemical curling or permanent waving of the hair is best avoided until the hair is at least three inches long. It is difficult to get nice curls if the hair is much shorter even with a healthy head of hair. For best results use a mild body wave with short processing time. The hair should be wrapped loosely on the largest size curling rod possible. Looser curls will be less damaging to the recovering hair shaft, and will thus minimize hair shaft breakage.
WARNING! Many patients cannot tolerate the permanent wave solution on their scalp for up to one year following chemotherapy. This extreme sensitivity of the scalp is not unusual during the regrowth period. In such cases permanents should not be attempted.
Hair coloring may also be irritating to the sensitive scalp and should be avoided until the scalp is healed.
Permanent hair colorings are the most damaging to the hair shaft and should be minimized in favor of semi-permanent hair colorings which are gradually washed away with four to six shampooings.
Bleaching to lighten the hair color should not be attempted at this time. Additionally, the hair should be altered only 3 shades from its regrowth color as more drastic color changes could increase hair shaft breakage.
This period of time following chemotherapy treatment is a time of healing and rebuilding for the body. Hair growth will gradually return, and with time most patients regain a healthy head of hair. Following some of the enclosed hair care tips will insure that the regrown hair looks and feels its very best!
A word of caution to parents with children undergoing chemotherapy. The absence of hair can be used in a positive manner. It can signal to others “handle with care.” While undergoing chemotherapy the child has a low blood count and can be bruised easily.
The insistence of parents, although well meaning, for a child to wear a wig or prostheses can signal the message “You’re not O.K. the way you are.” A child should have all of the options but the choice should be his or hers. Hugs and tender loving care are all that is necessary from the parents.
At the onset of hair loss, (the very first hair fall), some patients choose to shave the total scalp. Their reasons are the following:
- The elimination of uncontrolled hair fall and embarrassing shedding.
- Some feel that total baldness is more attractive than the spotty hair loss (especially males). Many believe that after 25-50% hair loss, males or females looks healthier with no hair at all.
- Shaving facilitates prosthetic hair security and comfort (i.e. vacuum bases, two way tape and other adhesives for hair prostheses. What may seem extreme to some, may not be for others.
- Attractive head coverings are available from a variety of manufacturers as an alternative to wigs.
- Insurance sometimes covers a wig or hair prostheses.
- Assume you will lose all of your hair when you begin chemotherapy treatment. By doing so your advance planning will assist you considerably. (Custom made wigs and hair prosthetics may take from 6 weeks to 4 months to be made and delivered for you.)
- Your first wig or hair prosthesis should duplicate your hair as closely as possible.
- In chemotherapy related hair loss avoid the following: weaves, hair extensions, hair integration and hair intensifiers. You will require a full prosthesis and not a partial hairpiece.