Hair loss (alopecia) due to chemotherapy is one of chemo treatments' most distressing side effects. Hair loss happens because chemotherapy affects all cells in the body, not just the cancer cells. The lining of the mouth, stomach and hair follicles are susceptible because those cells multiply rapidly, just like the cancer cells. The difference is that the normal cells will repair themselves, making these side effects temporary.

Why does it happen?

Patients undergoing chemotherapy experience hair loss because chemotherapy targets all rapidly dividing cells- healthy and cancer cells. Hair follicles are the structures in the skin with tiny blood vessels that make hair. They are some of the fastest-growing cells in the body and get attacked by chemotherapy drugs, causing hair loss.

Also Read: Home Remedies for Hair loss - Anti cancer foods

Do all chemotherapy patients lose hair?

Not all chemotherapy drugs cause rapid hair loss. The degree of hair loss is different for different drug types. For example, breast cancer drugs cause the most hair loss. Each Chemotherapy treatment uses a specific mix of cancer drugs, which is why all chemotherapy patients do not experience aggressive hair fall. Nominal side effects (such as hair thinning or partial balding) are still seen in most patients due to hair follicles being attacked.

When does hair start falling during chemotherapy?

Generally, Chemotherapy patients start losing hair in the first 2-3 weeks of their treatment. Some patients lose hair gradually, and in some cases, the change is more drastic where they lose large quantities of hair (next to balding) very fast. By the time most people get to their second cycle of chemotherapy, they go wholly/nearly bald.

Does fallen hair grow back after chemotherapy?

Yes. Any hair loss caused during chemotherapy is not permanent, and this side effect should never act as a deterrent for people who have been advised to undergo chemotherapy.

Can you prevent hair loss?

No treatment can guarantee your hair won't fall out during or after chemotherapy. Several therapies have investigated possible ways to prevent hair loss, but none have been effective.

Coping with hair loss

These tips can help if you worry about hair loss or thinning from cancer treatment.

• Ask about a wig before you start treatment to match the colour and texture of your natural hair.
• If you are feeling adventurous, choose a wig for a whole new look.
• Think about having your hair gradually cut short before your treatment starts. This might help you when seeing yourself with less hair.
• Some people shave their hair off completely to avoid the distress of seeing their hair fall out.
• Wear a hair net at night so you won't wake up with hair all over your pillow, which can be upsetting.
• Rub in oil or moisturizer; if your scalp feels dry and itchy, try unperfumed products such as Epaderm, Hydromol or Doublebase.
• Try a moisturizing liquid (emollient) instead of soap if your scalp is dry, for example, aqueous cream, Oilatum or Diprobase.
• Protect your scalp by covering your head in the sun - your scalp is susceptible to the sun.

Tips for hair loss or thinning

• Use gentle hair products such as baby shampoos.
• Don't use perms or hair colours on thinning hair colours may not take well, and perms can damage the hair.
• Use a soft baby brush and comb thinning hair gently.
• Avoid using hair dryers, curling tongs, hair straighteners and curlers on thinning hair and pat your hair dry after washing.
• If your scalp itches, it is dry use oil or moisturizer, not dandruff shampoo.
• Protect your scalp by covering your head from the sun.
• Wash your hair every 2 to 4 days. Use baby shampoo or other mild shampoos and a hair conditioner or cream rinse.
• Use shampoos and conditioners that have sunscreen. It will prevent sun damage to your scalp.
• Always rinse your hair well and use a soft towel to pat it dry.
• Wash your hair after swimming in a pool.
• Don't expose your scalp to the sun.
• Keep your head covered in the summer.
• In the winter, cover your head with a hat, scarf, turban, or wig to keep it warm. This can also help to catch falling hair.
• Sleep on a satin or silk pillowcase. These are smoother than other fabrics and can decrease hair tangles.
• Brush or comb your hair gently with a soft-bristle brush or comb. Start brushing or combing your hair at the ends and gently work your way up to your scalp. You can also search through your hair with your fingers. Wet your fingers with water first.
• If your hair is long, you may want to have it cut short before you begin treatment.
• Tell your hairdresser that you're receiving chemotherapy. They may be able to recommend gentle hair products.
• Try using Bumble and bumble Hair Powder to cover bald spots and thinning areas of your hair. You can buy it at Sephora or online from various beauty supply websites.
• Covering your head

There are many ways to cover your head if your hair falls out.

Wig

A wig is the most obvious choice. But not everyone wants to wear one. They can be a bit hot and itchy, especially in the summer. You can wear a soft inner cap (a wig stocking) under the wig to make it more comfortable. Some people worry that the wig will slip or fall off. You can buy sticky pads explicitly designed to keep the wig still.

Some people prefer hats, scarves or baseball caps. Or you can leave your head uncovered if you feel confident with your bald head.

Custom-made wigs

Custom-made wigs are made by hand and are usually the most expensive type of wig. These wigs are made using your specific head measurements. Getting a custom-made wig may require several visits to the wig store for it. Custom wigs are usually made of human hair but can be made of synthetic (not human) materials.

Ready-made or stock wigs

Ready-made or stock wigs are usually made of a stretchy material and come in 1 size. It is the least expensive type of wig.

Hairpieces

If you lose your hair in only 1 area, then a hairpiece is a good option for you. A rug will blend into your hair. It can be in any shape, size and colour.

Also Read: Dealing with Hair Loss During Cancer Treatment

Head coverings: Turbans, scarves, and hats

You can use scarves, turbans, and hats to control hair falling out and hide a bald scalp. There are different hats and scarves you can wear when you have hair loss or thinning. You can buy these in high street shops or on the internet. Avoid silk scarves as they can easily slide off your head. Try a scarf made of a cotton blend because it can be more comfortable.

Conclusion

So, the next time a friend or a family member in the process of considering or receiving chemotherapy gets distressed about losing hair, give them the right emotional insights and tell them that the hair loss aspect is temporary and should never dissuade them from receiving the proper cancer treatment.

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Reference:

1. Rebora A, Guarrera M. Why Do Not All Chemotherapy Patients Lose Their Hair? Answering an Intriguing Question. Skin Appendage Disord. 2021 Jun;7(4):280-285. doi: 10.1159/000514342. Epub 2021 May 6. PMID: 34307475; PMCID: PMC8280404.