Hair
Our hair is our identity, what many of us feel defines us, makes us who we are.
This is why hair loss during treatment can feel like the hardest aspect to cope with. Learn more about what happens to hair during treatment, and ways that you can help to prevent hair loss during and after treatment.
The Hair Cycle
At any given time, the majority of hairs on your scalp (90%) are in the growing phase. This is why chemotherapy affects the hair follicles on the scalp so strongly. When you have your first treatment, the majority of hair on your scalp is affected, Hair loss can be expected within a few weeks of your first treatment.
Chemotherapy and Endocrine Blockers
- Adriamycin Causes complete hair loss on the scalp, usually during the first few weeks of treatment. Many women also lose eyelashes and eyebrows. May be less effective in cold cap regimens.
- Methotrexate 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 & Taxotere usually causes complete hair loss, including head, brows, lashes, pubic area, legs, and arms.
- Carboplatin usually in combination with taxol or taxotere can cause complete hair loss on scalp, although alone only causes moderate hair loss
- Perjeta often used in HER2+ cancer, can cause mild hair loss.
- Herceptin also used in HER2+ cancer, is not usually associated with hair loss.
- Tamoxifen is a common estrogen blocker used in hormone positive cancer patients. By blocking estrogen it can have effects on the scalp such as mild shedding.
- Aromatase inhibitors are often used in combination with lupron in young women and in post menopausal women to block estrogen formation in peripheral tissues for highly estrogen/progesterone positive patients. Similar to tamoxifen can cause shedding and decreased quantity of hair.
What can I expect if coldcapping isn't an option?
Hair may start to shed in the first 2-4 weeks after the first chemotherapy session. Your hair may shed quickly, or you may notice clumps falling out. Many feel a scalp tenderness that can be helped by cutting hair short or shaving the scalp to take the weight of the hair off of the hair follicles.
Covering the scalp can help to protect it from cold and heat.
This is a great site for tutorials on wrapping with scarves and head covers:
Why do we get "chemo curls" after chemotherapy?
Hair may change texture and pigment when it begins growing back after chemotherapy.
Chemotherapy affects the follicular cells, and they may change shape, which results in curls. In addition there may be increased time that the hair is in the hair shaft, causing increased pigment. Many of these changes are temporary and resolve within 2-3 months after stopping chemotherapy. Chemo curls can be fragile, and it is important to treat them with care, and avoid heat styling, color processing, and excess tension that may cause stress to the hair shaft.
What can I do to prevent hair loss?