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This section has been reviewed and approved by the PLWC Editorial
Board, 02/05
A potential side effect of radiation therapy and chemotherapy is hair
loss (alopecia). Hair loss may occur throughout the body, including the
head, face, arms, legs, underarms, and pubic area. The hair may fall out
entirely, gradually, or in sections. In some cases, the hair will simply
thin—sometimes unnoticeably—and may become duller and dryer. Losing one's
hair can be a psychologically and emotionally challenging experience, and
can affect a person's self-image and quality of life. However, the hair
loss is usually temporary, and the hair grows back.
Causes
Radiation therapy and chemotherapy cause hair loss by damaging the hair
follicles responsible for hair growth.
Chemotherapy. Not all chemotherapy causes hair loss. (A doctor can
provide more information regarding which drugs are most likely to cause
hair loss.) When hair loss does occur, it is usually not immediate, and
the amount of hair loss varies from person to person, even among those
taking the same medication. Hair loss most often starts after the first
several weeks or rounds of chemotherapy treatment and tends to increase
one to two months into treatment. The amount of hair loss depends on the
type of drug, dose, and how the drug was given (orally, intravenously, or
topically). Hair regrowth following
chemotherapy usually occurs one to three months after maintenance
treatment starts or intensive chemotherapy ends.
Radiation therapy. Radiation therapy only affects the portions of
hair that are in the field of radiation. Hair loss depends on the dose
and method of radiation treatment. When very high doses of radiation are
used to treat cancer, the hair may become permanently lost or thinned in
the treated area. If regrowth does occur,
patients may find the regrown hair to be
different in texture and thickness than the original hair.
Management
In some cases, hair loss due to cancer treatment is not preventable or
treatable with stimulants, solutions, or special shampoos. Therefore,
learning to deal with hair loss before it occurs can help a person better
adjust to this change in physical appearance. Talking about feelings with
a counselor, someone with a similar experience, family member, or friend
may also provide comfort. Also, it may be helpful to talk about
inevitable hair loss with family and friends, especially children, before
it occurs. If children know to expect changes in the physical appearance
of someone they are familiar with, it helps reduce feelings of anxiety.
Some people recommend cutting the hair shorter before treatment. This not
only helps create volume and fullness for the shorter hairstyle, but also
is less dramatic of a change when the hair falls out. Furthermore, when
the hair begins to regrow, it takes less time
to reach the shorter hairstyle. Having a hairstyle similar to the one
before chemotherapy can help a person cope with the end of treatment and
move forward.
Hair and scalp care. The following recommendations may help when
caring for the hair and scalp during cancer treatment:
- Choose a mild shampoo,
such as a baby shampoo, to clean the hair.
- Choose a soft hairbrush
and gently style the remaining hair.
- Use sun protection on
the scalp when outdoors, including sunscreen, hats, or a scarf.
- Cover the head during
the cold months to prevent loss of body heat.
- Avoid blow-drying the
hair with high heat.
- Avoid curling or
straightening the hair with chemical products.
- Avoid permanent or
semi-permanent hair coloring.
- Choose a soft,
comfortable covering for the bed pillow.
Wig and hairpieces. The following information may be
helpful if a patient chooses to wear a wig or hairpiece:
- Select the wig or
hairpiece before the hair falls out if you prefer to match the
current hair color and style. A hairdresser can style the
wig/hairpiece to the your liking.
- If shopping for a
wig/hairpiece in a retail store is not appealing, there are wig and
hairpiece shops specially designed for people with cancer. A home
appointment can also be scheduled, or an order can be placed through
a catalog or the Internet.
- If finances are a concern,
ask the patient's insurance provider if wigs/hairpieces are covered
with cancer treatment or classified as a tax-deductible medical
expense. To be covered by insurance, the doctor may have to
prescribe the use of a wig/hairpiece with proper documentation. Free
or loaner wigs/hairpieces may also be available. Ask an oncology
social worker or nurse for resources within the hospital or local
community.
- Be sure to have the
wig/hairpiece fitted properly, so that it does not irritate the
scalp.
Caring for regrown hair. Complete hair regrowth often takes six to 12 months. When new hair regrows, at least temporarily, the texture may feel
thinner than the hair that was lost. Pigment cells usually restore
themselves, however, and hair usually returns to its original color. When
caring for regrown hair:
- Limit washing the hair
to twice a week.
- Massage the scalp to
remove dry skin and flakes.
- Style hair with care and
limit the amount of hard brushing, pinning, curling, or blow-drying
with high heat, as new hair will initially be much finer and more
prone to breaking than the original hair.
- Gently use a wide-tooth
comb to style the regrown hair.
- Avoid curling or
straightening the hair with chemical products (as in permanent wave
solutions) until the hair is at least 3 inches long, or until it is
comfortable. Some individuals may need to wait for up to one year
before they can chemically curl or straighten their hair.
- Avoid permanent or
semi-permanent hair coloring for at least three months following
treatment.
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