4 Tips to Manage Your Hair Loss During Chemotherapy
There is no question that the skin-related side effects from cancer treatment can be some of the most traumatic – both physically and emotionally. One of the most common of these is hair loss, which is so intimately associated with cancer treatment that it has become an expected side effect. Perhaps because it is so common, the emotional impact is often overlooked by physicians. The emotional impact can be enormous though – patients rank hair loss as the second most severe side effect from chemotherapy and 8 percent of women say they would consider turning down life-saving chemotherapy due to fear of hair loss. Many women feel that losing their hair was a worse experience than losing their breast during breast cancer treatment. If you haven’t embraced going bald – you’re not alone. So many patients battling cancer start their doctor appointment saying, “I don’t want to complain, but …” I’m here to say that it’s OK to complain – in fact, it’s great. It’s your doctor’s job to listen to you! If you are deeply affected by your hair loss, you are completely normal and you are definitely not alone.
Why It Happens
Alopecia is the medical term for any type of hair loss. Chemotherapy-induced alopecia is the hair loss caused by many different types of chemotherapy drugs. Some of the chemotherapies that are most likely to do it are cyclophosphamide, etoposide, topotecan and paclitaxel. These drugs work for cancer because they target the cells in your body that are dividing very quickly – which is what cancer cells do. Unfortunately, your skin, hair and nails are also dividing quickly and become innocent bystanders in the attack on your cancer. The most common type of alopecia that is caused by chemotherapy is called anagen effluvium. All hairs cycle through phases of growth, resting and then shedding. Anagen is the growth phase and this is when the hair cells are most rapidly dividing to form the new hair. This rapid growth is what makes them vulnerable to the chemotherapy, which causes weakening of the hair so it can fall out with just mild pressure or sometimes break off when it reaches the surface of the scalp. The broken, traumatized hairs then go into their resting phase called telogen, and stay there until the chemotherapy is over. This type of alopecia can affect most of the hair on your head quickly – about one or two months after you start treatment. The important question though is – what can you do about it?
Flaunt It
Although not embraced by many, there is always the option to show off your new low-maintenance ‘do. Hey, hair only detracts from your beautiful face anyway! I was recently inspired by a photographer from Michigan who started the Oldham Project – an organization that provides free portrait sessions to people suffering from life-threatening illnesses. If you want be inspired by some gorgeous, confident, bald women, check out the website.
Disguise It
The most common current treatment for alopecia is covering it up. While some women embrace this and rock a bright purple wig or 70’s patterned turban, others opt for a wig that closely matches their pre-chemotherapy hair. When shopping for a wig, you should look for an experienced person to help you find a good match and comfortable fit. They may even be able to get your insurance company to cover all or part of the cost. You can order wigs and other head coverings through the American Cancer Society’s Tender Loving Care website. Make sure you learn how to take care of your wig so you can keep it looking great.
Prevent It?
The hope for many is to prevent the hair loss from starting in the first place, and research is being done! The most promising studies so far are using a device to keep the scalp cold during infusion of the chemotherapy. The idea is that cooling the skin makes the blood vessels shrink and slows down metabolism so less of the chemotherapy is able to reach the hair follicles. While some studies using scalp cooling were done more than 20 years ago, it hasn’t been widely used because doctors were afraid that keeping the scalp cool would protect not only the hair but also cancer cells that might be hiding out in the scalp. More recent studies though show that, while scalp cooling may not be safe in patients with hematologic cancers like leukemia, it is probably safe for breast cancer patients. Ask your oncologist if it is something he/she recommends and offers at your infusion center. Research is being done about other preventive measures for hair loss, so hopefully in the near future, patients will have more options.
Make It Grow Faster
If you can’t prevent the hair loss, then at least make it grow back faster! Believe it or not, regular old Rogaine or the generic minoxidil may speed up your hair growth after chemotherapy. You should apply 1 milliliter of 2 percent minoxidil solution (available over the counter) to the entire scalp throughout chemotherapy and up to four months after treatment. In one study, this regimen shortened the time to first hair growth by over a month! While people using minoxidil for age-related hair loss have to keep using it indefinitely to maintain the effects, this is not the case for chemotherapy-induced alopecia. Make sure to keep the minoxidil off your face and anywhere else you don’t want extra hair growing.
Watch Out For …
Some chemotherapy drugs can affect the scalp in ways other than just causing hair loss. If you have bumps, lumps, flaking, itching, drainage or pain associated with your hair loss, you should see a dermatologist who is experienced with chemotherapy side effects.
Beth McLellan, M.D., is a board certified dermatologist at the New York University Langone Medical Center. She focuses on the treatment of diseases of the skin, hair and nails in cancer patients.
Photo credit: Dee
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9 Comments
Thank you from a very bald lady waiting for her hair to grow back…smile. I find that it depends what I’m doing or where I am going: I’ll wear my wig when out at a meeting or a concert, I’ll wear my hat with friends and walking and I’ll go comando when I’m home with the kids. I do have one question: Does Rogaine and those things have chemicals in them? I know that putting any chemicals on your head is not a good thing!
When I lost my hair from chemo I wore the cutest hats I could find. They became my tademark. When my hair gew back after 7 months, I had my stylist cut it as short as possible, I found it liberating. Today two years later, I still wear it short (Jamie Lee style with no hair color). Cancer taught me that I don’t have to be a slave to my hair ever again!
Thanks for your comments! Claudia – Rogaine contains the medication minoxidil which is usually well-tolerated without any side effects. The most common side effects are irritation of the skin and facial hair growth. You ultimately have to decide what you want to put on your skin but its always nice to know the options!
I turned everything into a party: a head shaving party where my friends and family took turns with the buzzer after my first round; a turban party where my friends and family bought me gifts and we ate cookies shaped like breasts! It sounds corny, but 2 years later I have fond memories of those parties and can barely remember being bald.
I have a wig for work functions, but mostly prefer to wear a hat. My friends held a hat party for me, and now I own multiple very cute hats. Check out headcovers.com (no association, I just have a bunch of their hats). I’d heard of cold caps but wasn’t willing to not have the chemo go everywhere – I had leukemia as a teenager, so that’s probably why. Losing my hair this time was not neatly as traumatic as it was 20 years ago, but I’m still self-conscious about it – maybe I’ll look into the portraits that were mentioned!
When I first lost my hair I wore a wig. But after about a month I decided that if I had to tolerate chemo others could tolerate my bald head!
Now a year later I am still sporting short hair. I’ve grown to like my “involuntary hair cut”
Love all your positive attitudes and ideas! I will be sure to share the head shaving party idea with my patients! Cyndi – I think the link to the portraits was wrong so check out http://theoldhamproject.org/ Maybe you can find something similar in your area. I was so moved by the photos – it seems like it would be very empowering!
For Claudia and others – we definitely should be wondering what’s in Rogaine before we follow doc’s instructions. Here is the link to EWG’s SkinDeep DB, detailing the ingredients in Rogaine, some of which are considered hazardous to our health and potentially carcinogenic.
One of the best ways to grow your hair is start drinking wheatgrass immediately. Within 2 years, my hair thickened by 50% and it grows so fast. Drink 8-10 oz. or more per day. The best tasting wheatgrass is grown outside (rather than inside in flats) and when it is flash frozen, it retains all of the superfood benefits. I buy all my wheatgrass from http://www.dynamicgreens.com. I do not own them, or own stock, or anything, but love their service and product. Wheatgrass will help you grow your hair and reduce the toxins in your system.
January 18, 2012