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Cancer treatment and hair loss

Why does chemotherapy cause hair loss?

Hair loss is a common worry for people considering chemotherapy. ^1,2

Chemotherapy drugs are designed to destroy cancer cells. However, they can also kill healthy cells, such as the cells that make your hair grow. ¹

What types of chemotherapy cause hair loss?What types of chemotherapy cause hair loss?

Some chemotherapy drugs do not result in hair loss at all, some drugs cause the thinning of hair whilst others can cause complete hair loss, including eye lashes, eye brows and the hair on your arms and legs.¹

Chemotherapy drugs that have been associated with hair loss and thinning of hair include: ¹

Altretamine (Hexalen)	Docetaxel (Taxotere)
Cyclophosphamide (Neosar)	Cisplatin (Platinol)
Epirubicin (Ellence)	Doxorubicin (Adriamycin, Doxil)
Idarubicin (Idamycin)	Gemcitabine (Gemzar)
Vincristine (Marqibo, Vincasar)	Fluorouracil (5-FU)
Carboplatin (Paraplatin)	Paclitaxel (multiple brand names)
Ifosfamide (Ifex)	Vinorelbine (Alocrest, Navelbine)

Radiation therapy and hair loss

Radiation therapy can result in hair loss and thinning, but usually only to the area of body in which radiation is being targeted. ¹

The amount and scheduling of radiation treatment will have an effect on hair loss.

Moderate doses of radiation usually result in hair regrowth in a few months after treatment, whilst higher doses of radiation may result in permanent hair loss. ¹

Hair loss usually starts a few weeks after treatment begins. ³

Prevention of hair loss and scalp cooling

One method that can help reduce hair loss whilst undergoing cancer treatment is by using a cooling cap. ⁴ The cooling cap is worn on the head and a cooling liquid is run through the cap to help reduce the blood flow and therefore cancer drugs to the hair follicles. ⁴

The cooling cap also acts to reduce the action of the hair follicle, therefore making it less appealing to the chemotherapy drugs, which seek out cells that divide quickly. ⁴This helps protect the hair follicles and hair loss. ⁴For the cooling cap to be as effective as it can be, it should be worn before, as well as during and a period of time after the chemotherapy treatment. ⁵

Tips for managing hair loss

There are numerous options you can try to help manage your hair loss while undergoing treatment which include: ^{1, 5}

Reduce the temperature of your showers to lukewarm, as hot water can be hard on your scalp
Reduce the number of times you wash your hair each week.
Avoid using your hair dryer on a high heat
Brush your hair very gently, with a wide-tooth comb/brush to prevent tangles and accidental pulling of your hair
Talk to your healthcare team or hairdresser about hair dye options, and avoid all permanent and semi-permanent dyes
During cooler weather and sunny days, ensure your head is covered to protect it from the elements.
If you are considering a wig or hair piece, consider one from a shop that specialises in wigs for cancer patients so as not to get one that is too heavy, or pulls on your hair
Having a hair style that involves the hair being relatively short can make your hair look fuller

Frequently asked questionsFAQs

How long will it take for my hair to grow back after chemotherapy treatment?

Hair loss and thinning usually occurs a few weeks after chemotherapy treatment begins. It can take up to a year for you hair to grow completely back once your treatment has finished although hair usually starts to grow back 1 to 3 months after treatment finishes. ^1,2

Are there medications I can take to help manage my hair loss?

There are medications you can apply to your scalp as well as take orally to help manage hair regrowth, however it is best to speak with your specialist team before taking any medication for management of your hair loss. ¹

Where can I get more information?

ReferencesReferences

For a full list of references, click here.

American Society of Clinical Oncology (ASCO). (2018). Hair loss or alopecia. Retrieved on 18^th June 2019 from https://www.cancer.net/coping-with-cancer/physical-emotional-and-social-effects-cancer/managing-physical-side-effects/hair-loss-or-alopecia
Cancer Council. (2018). Hair Loss. Retrieved on 18^th June 2019 from https://www.cancercouncil.com.au/cancer-information/cancer-treatment/chemotherapy/side-effects/hair-loss/
American Cancer Society. (2018). Coping with hair loss. Retrieved on 18^th June 2019 from https://www.cancer.org/treatment/treatments-and-side-effects/physical-side-effects/hair-loss/coping-with-hair-loss.html
American Cancer Society. (2018). Cooling Caps. (Scalp Hypothermia) to Reduce Hair Loss. Retrieved on 18^th June 2019 from https://www.cancer.org/treatment/treatments-and-side-effects/physical-side-effects/hair-loss/cold-caps.html
Breast Cancer Network Australia. (2016). Hair loss during breast cancer treatment. Retrieved on 18^th June 2019 from https://www.bcna.org.au/media/4914/bcna-fact-sheet-hair-loss-during-breast-cancer-treatment-june-2017.pdf

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