Of all the side effects it causes, chemotherapy hair loss is the most well known.
Chemotherapy is the use of chemicals and drugs to treat cancer.
But, as well as cancer cells, chemotherapy also affects areas of the body where normal cells divide frequently. These include the mouth, the digestive system, bone marrow, skin and hair.
Since hair follicle cells are fast growing, they can be damaged by chemotherapy and result in hair loss (called anagen effluvium).
Chemotherapy hair loss might only involve thinning of the hair, or could result in complete loss. This can include thinning or loss of the eyebrows, eyelashes and other body hair (including pubic hair).
Some people may experience chemotherapy hair loss from drugs that don't usually cause it. And, for others, there's no hair loss when it is normally expected. Everyone can react differently to drugs.
Given this individuality, it's important to consider many things before chemotherapy starts. These include: kidney and liver function, the extent of the disease and your health in general. To take these things into account, a number of tests are performed before treatment, and the results of which can determine which drugs are the most suitable to use.
Chemotherapy treatment
Just as there are many forms of cancer, there are also many drugs that can be used to treat it through chemotherapy (over fifty in fact). Those that can cause extreme chemotherapy hair loss include:
Amsacrine
Dactinomycin
Idarubicin
Topotecan
Those drugs that don't normally cause chemotherapy hair loss include:
Asparaginase
Bleomycin
Busulphan
Capecitabine
Whether or not hair loss from chemotherapy is experienced also depends upon the dosage of the drugs being used.
Treatment can be given in tablet form, or as a liquid injected into a vein in your arm or chest. The drugs involved are used either on their own or in combination with others.
Chemotherapy hair loss can start within a few days of beginning treatment but it's normally 2 to 3 weeks before you first notice it. This type of hair loss is usually a gradual process, not sudden.
Other side effects of chemotherapy can include fatigue, diarrhoea, sickness, mouth ulcers, etc.
How to deal with chemotherapy hair loss
If you do suffer hair loss from chemotherapy, it will grow back after you complete your treatment.
Regrowth will probably start as very fine, vellus hair (like a babies). But, after 3 to 6 months you should have a good head of hair once again. Your new hair should grow back at its normal rate, but might be a different colour, texture (e.g., softer) or more curly.
If you're concerned about the hair loss caused, these things can help:
Avoid hair dyes - Products containing bleach can make weak hair break off.
Avoid harsh chemicals and shampoos - They can cause a dry and itchy scalp. Switch to gentle products (like a frequent use baby shampoo).
If your scalp does start to flake or itch - Use a light moisturiser or oil and gently massage. Do not use a dandruff shampoo. Also, avoid nylon pillowcases as they can irritate the scalp (use cotton instead).
Have your hair cut short - This will reduce long hair pulling at your scalp. (Do this before you start treatment).
Wear a hair net at night - This means you won't wake up with hair all over the pillow.
Don't brush or comb too hard - A soft bristled brush can help prevent irritation to your scalp if it's tender.
Avoid hair dryers - Gently dry your hair with a towel or let it dry naturally.
If you've lost underarm hair - Don't use deodorants (use scent-free talcum power instead).
Cold caps
A cold cap can be used to help reduce chemotherapy hair loss.
Wearing a cold cap will temporarily reduce blood flow to the scalp. Obviously, this will also restrict the amount of drug reaching the hair follicles, and so may reduce the hair loss experienced.
The cap is put on 15 minutes before treatment begins and worn until 1 or 2 hours after it finishes. However, some find it too uncomfortable to wear (cooling the scalp to 17°C will feel very cold).
The cold cap works better for some drugs than it does with others. For example, a success rate of up to 85% may be possible with cyclophosphamide, docetaxel, epirubicin and paclitaxel.
Also, this system is not suitable for every type of cancer (e.g., leukaemia) and, unfortunately, won't work for everyone.
The availability and type of cold cap used will vary between hospitals.
It's important to remember that, whether you wear a cold cap or not will have no influence on the outcome of the treatment.
Finally, if you find the thought of chemotherapy hair loss extremely upsetting, an alternative form of treatment might be available. Such a possibility can be discussed with your doctor before treatment begins. However, the priority when dealing with cancer is to use the most effective treatment possible.
Radiotherapy hair loss
Radiotherapy is the use of ionizing radiation to treat cancer.
Like chemotherapy, it can cause hair loss through damage to the hair follicles. However, this hair loss is localised - it will only fall from the area being treated. Also, it's usually temporary loss, and so will regrow completely after treatment (this takes 6 to 12 months).
