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Chemotherapy Related Hair Loss

May 21, 2015

This is some information obtained from www.breastcancer.org that I thought might be helpful to anyone affected by chemotherapy hair loss, whether that be the patient, a friend or family member of the patient. Understanding the why's,  how's, and when's can alleviate everyone's concerns about how to handle what can be a upsetting and disconcerting sympton of breast cancer treatment.  

<3 Judi

Why and How Hair Loss Happens

Hair loss occurs because chemotherapy targets all rapidly dividing cells—healthy cells as well as cancer cells. Hair follicles, the structures in the skin filled with tiny blood vessels that make hair, are some of the fastest-growing cells in the body. If you're not in cancer treatment, your hair follicles divide every 23 to 72 hours. But as the chemo does its work against cancer cells, it also destroys hair cells. Within a few weeks of starting chemo, you may lose some or all of your hair.

If you are having chemotherapy, your hair loss may be gradual or dramatic: clumps in your hairbrush, handfuls in the tub drain or on your pillow. Whichever way it happens, it's startling and depressing, and you'll need a lot of support during this time.

Some chemotherapy drugs affect only the hair on your head. Others cause the loss of eyebrows and eyelashes, pubic hair, and hair on your legs, arms, or underarms.

The extent of hair loss depends on which drugs or other treatments are used, and for how long. The various classes of chemotherapy drugs all produce different reactions.

The timing of your treatments will also affect hair loss. Some types of chemotherapy are given weekly and in small doses, and this minimizes hair loss. Other treatments are scheduled every three to four weeks in higher doses, and may be more likely to cause more hair loss.

Chemotherapy drugs

  • Adriamycin (the “A” in CAF chemo treatment) causes complete hair loss on the head, usually during the first few weeks of treatment. Some women also lose eyelashes and eyebrows.
  • Methotrexate (the “M” in CMF chemo treatment) thins hair in some people but not others. And it's rare to have complete hair loss from methotrexate.
  • Cytoxan and 5-fluorouracil cause minimal hair loss in most women, but some may lose a great deal.Taxol usually causes complete hair loss, including head, brows, lashes, pubic area, legs, and arms.
 For many women, wigs are the answer. One woman became a wig sales specialist after her own experience with breast cancer, mastectomy, and hair loss. “Within four weeks, I lost a major part of my body and all my hair, including eyebrows and eyelashes. I was at my lowest. I know how important a beautiful wig can be,” she said, explaining her career choice.

Finding a wig and some tips too!

  • Cut your hair short before you start chemotherapy. It's less traumatic to lose short clumps of hair than long ones —and it's easier to fit a wig over less hair.
  • If you get used to short hair, you won't have to wait as long for your hair to grow back to feel like yourself. Shorter is also cooler —an important consideration, because wigs can feel hot in the summer.
  • Since a short-haired wig is easier to wear and care for, if your hair is already short, you'll have an easier time living with temporary hair of a similar length.
  • Look through salon books and hairstyle magazines to find the becoming cut that's right for you.
  • Interview a few hairdressers. You may want to book an appointment just to talk to an expert before the actual cut.
  • Your hospital's cancer center or your local breast cancer organizations may have a list of wig specialists in the area.
  • Your hairdresser may be able to suggest a wig shop. Some wig specialists come to your home to provide additional privacy.
  • Ask friends for leads.
  • Some beauty salons offer special services for women going through cancer therapy so that after you select your wig, you can have it styled in a variety of ways.

William Collier Design is your go-to salon to find a lovely, comfortable wig.

[caption id="attachment_1797" align="aligncenter" width="411"]Our beautiful client who lost her hair to chemotherapy treatment wearing her Follea wig. Our beautiful client who lost her hair to chemotherapy treatment wearing her Follea wig.[/caption]

We offer complimentary consultations to discuss your needs. Our speciality is high quality, human hair wigs, however, we have some very nice synthetic wigs available too. 

[caption id="attachment_1798" align="aligncenter" width="287"]A before pic of our client with her support team. A before pic of our client with her support team.[/caption]

Try to pick out your wig BEFORE your chemotherapy begins. You'll have more energy. Plus, the stylist will be able to see your natural hair color and style. You can get used to wearing the wig in trial sessions, alternating with your own hair.

When Will Your Hair Grow Back?

The answer depends on the treatment: chemotherapy, whole brain radiation, or tamoxifen.

If you had chemotherapy, here's a typical timetable:

  • two to three weeks after chemotherapy ends: soft fuzz
  • one month after: real hair starts to grow at its normal rate
  • two months after: an inch of hair
  • How long it takes to grow back a full head of hair (and pubic hair, lashes, and brows if you lost them too) varies from person to person.

Generally, the hair most likely to fall out is the hair that tends to grow back the fastest. The hair on the top of your head grows faster than your eyebrows or eyelashes.

Your new hair may be just like your old hair, or it may be thicker and curlier, or straighter, than your original hair. And your hair might grow back a different color. Women who dyed and processed their hair might not remember what their hair was like originally and may be surprised by the new natural color and texture. Eventually, your hair usually goes back to the way it used to be after the effect of chemotherapy on the hair follicle wears off.

If you lost your hair after whole brain radiation for brain metastases, it may take four to six months before even an inch of growth appears. Your new hair will probably be thinner than it was, and you may have a small bald spot on the top of your head. So you may want to hold on to the wig or other headgear you'd bought for special occasions.

If your hair started thinning from tamoxifen treatment, the loss usually levels off after the first year. But the thinning may last as long as you take the drug, which might be as long as five years. You can use Rogaine (chemical name: minoxidil) for tamoxifen-induced hair loss. It's safe and effective, but a messy daily chore, and it's expensive. However, many drugstores and superstores carry generic versions of Rogaine that are less expensive and just as effective.

Very, very rarely, permanent baldness occurs after many years of strong chemotherapy: Hair follicles get “burned out” and shut down, so there is no new growth. Remember, this situation is extremely rare. If you are one of the very, very few women who remain bald, you may mourn your hair for quite a while. But you can become an expert on what to do to make yourself feel attractive, and help other women deal with their new loss.

Expert Quote

"There are studies that show that for many women, losing their hair is worse than losing a breast. That's because you can conceal the loss of a breast, but hair loss is so obvious and apparent."

-- Marisa Weiss, M.D., president and founder, Breastcancer.org

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