Chemotherapy And Hair Loss
Chemotherapy destroys cancer cells by interfering with their ability to divide and grow.
It can affect healthy cells throughout the body such as cells in the hair follicles. This is why chemotherapy can make your hair fall out.
As well as the hair on your head, this can also affect your body hair including eyebrows, eyelashes, nasal and pubic hair, and chest hair for men.
Not all chemotherapy will make your hair fall out. Some drugs dont cause any hair loss and some cause hair to thin. However, others make hair fall out completely.
How much hair you lose will depend on the type of drugs you are given and the dose. Drugs that are given in smaller doses on a weekly basis or are taken by mouth are less likely to cause hair loss.
If you are receiving a combination of chemotherapy drugs you are more likely to have hair loss. Your treatment team will talk to you about your treatment and how likely you are to lose your hair.
Targeted Therapy For Her2
In about 1 in 5 women with breast cancer, the cancer cells have too much of a growth-promoting protein known as HER2 on their surface. These cancers, known as HER2-positive breastcancers, tend to grow and spread more aggressively. Different types of drugs have been developed that target the HER2 protein.
How You May Feel
Hair loss is a visible side effect of treatment and can change how you view yourself.
For many of us, the way we feel about ourselves is closely linked to the way we look, and losing your hair can be devastating. You may feel anxious at the thought of losing your hair, or angry and unhappy that this has happened in addition to your cancer diagnosis and treatment.
Hair loss may also make you feel vulnerable and exposed. You may see it as a constant reminder of your treatment, labelling you as a cancer patient or feel that hair loss has prevented you keeping your diagnosis private.
Some people feel guilty about being upset when they lose their hair as they feel there are other, more important things to worry about.
Theres no right or wrong way to feel and whether you lose some or all of your hair, the experience can be very distressing.
Some people describe hair loss as the most difficult side effect to deal with. Others find that losing their hair isnt as upsetting as they thought it would be. While some people adjust quickly to hair loss, others find that it takes longer, or is more difficult to accept and adapt to than they imagined.
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Hair Cutting Or Shaving
If youre having chemotherapy and its likely that youll lose a lot or all of your hair, you may want to cut it short or shave it off before you start treatment.
For some people, this makes hair loss easier to deal with, as it can provide a sense of control over the situation but its a very personal decision.
How Much Dht Causes Hair Loss
As stated previously, testosterone converts to DHT. So you may be thinking, if I increase my testosterone, wont my DHT levels increase? The answer is yes. The next question is: If DHT is related to hair loss, then wont increased DHT cause increased hair loss? Luckily some researchers answered this exact question. In this study, researchers compared levels of DHT in individuals with hair loss and compared them with people without hair loss. They found that DHT levels were similar in both groups. The researchers concluded that, increased serum concentrations of DHT were not correlated with the advance of alopecia. They went on to say, Based on the results of our study and others, the most important factors would appear to be the genetically-determined sensitivity of the follicles to DHT and their different reactions to androgen concentration.
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Hair Loss And Your Job
There tends to be a lot less stigma with being open about a cancer diagnosis in the workplace than there was even a generation ago. If youre planning to continue working or to job hunt during treatment, youre likely to find that many colleagues are understanding about what youre going through.
Still, its up to you to decide how comfortable you feel telling your colleagues or others you interact with in your job about your diagnosis and treatment. If youve lost your hair and you want to maintain your privacy at work, you might choose to wear a wig that looks as close as possible to your natural hair and to otherwise conceal your hair loss . If youre not as concerned about privacy, you might wear a scarf or choose not to hide your hair loss.
How you decide to handle hair loss at work might also depend on your job role and industry. For instance, if you work in a field in which your appearance is front and center more, you might decide that concealing your hair loss on the days you go into work helps you feel more confident.
For more info about navigating your work life during breast cancer treatment, including what to do if you think youve experienced discrimination, see Breast Cancer and Your Job.
Written by: Jen Uscher, contributing writer
This page was developed with contributions from the following experts:
Nik Georgopoulos, Ph.D., associate professor in cell biology, Paxman Scalp Cooling Research Centre, School of Applied Sciences, University of Huddersfield, UK
Radiation Isnt As Effective As Other Treatments
Of course, the treatment that is right for you will depend upon a number of factors, and the treatment regimen recommended by your doctor may or may not includeradiation therapy. However, in general, radiation therapy is an underused resource for the treatment of breast cancer, at least in part because so many people are afraid of it. It can be used at any stage of breast cancer and in conjunction with other types of treatments as well.
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What Is The Best Treatment For Radiation
One way to reduce side effects is by using radioprotective drugs, but these are only used for certain types of radiation given to certain parts of the body. These drugs are given before radiation treatment to protect certain normal tissues in the treatment area. The one most commonly used today is amifostine. This drug may be used in people with head and neck cancer to reduce the mouth problems caused by radiation therapy.
How Fertility Might Be Affected
For women: Talk to your cancer care team about how radiation might affect your fertility . Its best to do this before starting treatment so you are aware of possible risks to your fertility.
Depending on the radiation dose, women getting radiation therapy in the pelvic area sometimes stop having menstrual periods and have other symptoms of menopause. Report these symptoms to your cancer care and ask them how to relieve these side effects.Sometimes menstrual periods will return when radiation therapy is over, but sometimes they do not.
See Fertility and Women With Cancer to learn more.
For men: Radiation therapy to an area that includes the testicles can reduce both the number of sperm and their ability to function. If you want to father a child in the future and are concerned about reduced fertility, talk to your cancer care team before starting treatment. One option may be to bank your sperm ahead of time.
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How Will Radiation Therapy Affect My Scalp
During radiation, your scalp may become dry, irritated, or inflamed. Initially, the area exposed to radiation will lose hair, and the scalp may look like it is severely sunburned. It may turn red or pinkish due to inflammation and will feel tender to the touch.
After two weeks of radiation therapy, the scalp can get dry and itchy. This is a temporary condition, and the scalp will recover once the radiation therapy is over. During this time, the doctor may prescribe medicines to relieve inflammation and scalp discomfort.
Apart from medication, you may take precautions to reduce scalp sensitivity during radiation.
Tips For Coping With Cancer
Some of the most difficult side effects of cancer treatments may not cause physical pain. They may not cause fatigue or digestive issues. And they may only be temporary. But for some cancer patients, hair loss may be one of the most distressing side effects of cancer treatment.
Hair loss, or alopecia, may make you feel vulnerable, self-conscious and exposed as a cancer patient. Hair loss is also a tangible sign that your life has changed, which may trigger feelings of anger and depression. And you may be faced with questions from others that you arent prepared to deal with yet.
For some, the threat of hair loss may intensify the lack of control you may feel after a cancer diagnosis. But it also presents an opportunity to emotionally prepare for losing your hair and take steps to deal with it before it happens. It helps to understand why hair falls out and how to handle it if it occurs.
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How To Cool Your Scalp After Chemo
There are two widely available ways of cooling the scalp. One method uses a cold cap, which is a hat filled with a gel that can be chilled. The other system uses a small, refrigerated cooling machine to pump a liquid coolant through the cap. In both cases the cap is worn before, during and after chemotherapy, so scalp cooling can mean youre at the hospital for longer.
If Youre Having Radiation Therapy To The Pelvis
Radiation therapy to the pelvis can cause side effects such as:
- Bladder problems
- Fertility problems
- Changes in your sex life
You might also have some of the same problems people get from radiation to the abdomen, such as nausea, vomiting, diarrhea, or constipation.
Radiation to the pelvis can cause problems with urination, including:
- Pain or burning sensations
- Blood in the urine
- An urge to urinate often
Most of these problems get better over time, but radiation therapy can cause longer-term side effects as well:
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External Beam Radiation Therapy
EBRT is the most common type of radiation therapy for women with breast cancer. A machine outside the body focuses the radiation on the area affected by the cancer.
Which areas need radiation depends on whether you had a mastectomy or breast-conserving surgery and if the cancer has reached nearby lymph nodes.
- If you had a mastectomy and no lymph nodes had cancer cells, radiation will be focused on the chest wall, the mastectomy scar, and the places where any drains exited the body after surgery.
- If you had BCS, you will most likely have radiation to the entire breast . An extra boost of radiation to the area in the breast where the cancer was removed is often given if there is a high risk of the cancer coming back. The boost is often given after the treatments to the whole breast have ended. It uses the same machine, with lower amounts of radiation aimed at the tumor bed. Most women dont notice different side effects from boost radiation than from whole breast radiation.
- If cancer was found in the lymph nodes under the arm , this area may be given radiation, as well. Sometimes, the area treated might also include the nodes above the collarbone and the nodes beneath the breast bone in the center of the chest .
How To Stop Hair From Irritating
Do not over-wash the scalp and hair to avoid irritation. Use a mild, moisturizing, glycerin-based shampoo or baby shampoos. Avoid products with harsh irritants, such as alcohol, parabens, perfumes, and artificial dyes. Always wash your hair with warm water, as hot or cold showers may irritate the scalp.
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How To Treat Hair After Chemo
The following tips may be helpful for all hair types during treatment: 1 try not to wash your hair for about two days after chemotherapy, especially if having scalp cooling 2 use a mild, unperfumed shampoo and conditioner 3 try not to wash your hair more than twice a week 4 use warm rather than hot water 5 pat your hair dry rather than rubbing it 6 brush or comb your hair gently with a soft hairbrush or wide tooth plastic comb 7 avoid plaiting or braiding it as this may damage your hair 8 avoid using elastic bands to tie back long hair 9 avoid any hair colours and dyes, perms, relaxers and other products containing strong chemicals 10 avoid products containing alcohol, such as hairspray, which can irritate the scalp 11 avoid excessive heat from hair straighteners, hairdryers, hot brushes and heated rollers 12 massaging the scalp may help by improving the blood supply to the hair follicles 13 avoid hair extensions and weaves as these can also weaken the hair
Radiotherapy And Hair Loss
Key things you need to know about radiotherapy and hair loss:
- your hair will only fall out from the area being treated
- hair usually starts to fall out 2 to 3 weeks after your first treatment session then takes about a week to fall out completely
- you might also lose hair on the opposite side of the area treated, where the radiotherapy beam passes through your body this is called the exit site
- how your hair is affected depends on various factors including the dose, number of treatments and which part of your body is treated
- it can take 3 to 6 months, or occasionally longer, for your hair to start growing back it might grow back patchy at first, or stay patchy
- it usually grows back, but radiotherapy hair loss can sometimes be permanent this is more likely with high doses. Your doctor or radiographer can advise about if and when your hair will grow back
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Managing Ongoing Hair Thinning
Breast cancer treatments such as hormonal therapy, targeted therapy, and chemotherapy can cause some people to have ongoing mild to moderate hair loss. If youre concerned that your hair isnt growing back or is noticeably thinner than in the past, its a good idea to see a dermatologist. If possible, seek out one who specializes in hair loss or an onco-dermatologist who focuses on problems with the hair, skin, and nails that can develop during cancer treatment. The dermatologist will order blood tests to check whether there are other reasons for your hair loss besides the effects of breast cancer treatments. Thyroid problems, nutritional deficiencies, and other factors can play a role in hair loss.
For mild to moderate hair loss, dermatologists often recommend Rogaine , an over-the-counter medication that promotes hair growth. Its safe for people with a history of breast cancer and moderately effective. But check with your oncologist before you start using minoxidil. In most cases, you can use it while you take hormonal therapy or targeted therapy, but not during chemotherapy treatment. Look for products labeled 5% minoxidil foam that you apply to your scalp when your hair and scalp are dry. Its ok for women to use minoxidil products labeled for men. Minoxidil is thought to stimulate hair growth by, among other things, improving blood flow in the scalp and prolonging the growth phase of each hair follicle.
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Help With The Cost Of Wigs
You can get free synthetic wigs on the NHS if:
- you’re under 16, or you are 19 or under and in full-time education
- you’re a hospital inpatient
- you or your partner are getting Universal Credit, Income Support, Income-based Jobseekers Allowance or the guarantee credit of Pension Credit
- you have an NHS tax credit exemption certificate
- you are named on a valid HC2 certificate
Cancer Research UK has more information on getting a wig on the NHS.
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If Youre Getting Radiation Therapy To The Head Or Neck
People who get radiation to the head and neck might have side effects such as:
- Soreness in the mouth or throat
How to care for your mouth during treatment
If you get radiation therapy to the head or neck, you need to take good care of your teeth, gums, mouth, and throat. Here are some tips that may help you manage mouth problems:
- Avoid spicy and rough foods, such as raw vegetables, dry crackers, and nuts.
- Dont eat or drink very hot or very cold foods or beverages.
- Dont smoke, chew tobacco, or drink alcohol these can make mouth sores worse.
- Stay away from sugary snacks.
- Ask your cancer care team to recommend a good mouthwash. The alcohol in some mouthwashes can dry and irritate mouth tissues.
- Rinse your mouth with warm salt and soda water every 1 to 2 hours as needed.
- Sip cool drinks often throughout the day.
- Eat sugar-free candy or chew gum to help keep your mouth moist.
- Moisten food with gravies and sauces to make it easier to eat.
- Ask your cancer care team about medicines to help treat mouth sores and control pain while eating.
If these measures are not enough, ask your cancer care team for advice. Mouth dryness may be a problem even after treatment is over. If so, talk to your team about what you can do.
How to care for your teeth during treatment
Radiation treatment to your head and neck can increase your chances of getting cavities. This is especially true if you have dry mouth as a result of treatment.