Lymphoma Treatment And Hair Loss
Hair loss is a side effect of some chemotherapy and radiotherapy treatments. Less commonly, it can be a side effect of antibody therapy.
Lymphoma treatment works on cells that divide rapidly, which includes lymphoma cells and hair cells this is why treatment can cause changes to your hair.
Not everyone who has treatment for lymphoma experiences changes to their hair. Whether youre affected or not depends on lots of factors, including: your treatment , your age, and your overall health, including any other conditions you might have.
Effects on your hair are usually short-term and can include:
- slight thinning
- changes in colour, which could include a streak or band of white hair
- changes in texture, such as hair being thinner, coarser or more curly than before treatment.
Mostly, hair eventually goes back to how it was before treatment for lymphoma.
Science Behind Hair Loss Simplified
Hair is made of keratin, a structural protein that is also found in your skin and nails too.
Produced in the hair follicles right at the outside layers of your skin, a hair strand is a product of hair follicles lifecycle.
A hair follicle is produced, then it grows for a while, then it slowly dies and new hair replaces it.
So around 50-100 hair follicles in your scalp die every day and are replaced with new ones. That much loss is unnoticeable since the average person has 100,000 hairs on the head.
When a hair follicle on your head dies, it falls out, which is what you see when you comb through your hair. Your hair falling out is the most natural thing in the world, and as long as the new hair grows to replace the lost ones, youre OK.
You only go bald if one of these two situations are present:
1 Youre losing more hair than you can reproduce
2 Youre reproducing less hair than you lose
I know these two sound like the same thing, but theyre not.
You can either be losing hair fast or producing new hair slowly, which both result in a number of hair follicles permanently reduced.
And all the reasons behind hair loss cause either of these two situations. Identifying what it is is up to you or your dermatologist.
Now lets see all the reasons that might be causing the gap between dead and born hair follicles:
Can Skin Changes Be Treated
If you have skin changes, your doctor will need to check your skin fairly often to figure out the problem, the best course of action, and whether treatment is helping. Youll probably need extra doctor visits while the problem is being brought under control.
Mild changes: Patients with mild skin changes may not need treatment. These changes include rashes that are only in a limited area, that are not causing any distress, and are not infected. Heavy skin creams or ointments that contain no alcohol, perfume, or dye can sometimes help with dryness. Be sure to talk with your cancer care team before using anything on your skin.
The doctor may prescribe a mild corticosteroid cream or antibiotic gel to put on the rash.
If your eyelids are crusty or swollen, careful cleansing and clean, warm, wet cloths laid over your closed eyes may help.
For mild skin problems, the dose of the targeted drug usually does not need to be changed. Youll be watched closely to see if the rash gets better or worse.
Moderate changes: These include a rash over a larger area of the body or skin changes causing mild distress from itching or soreness, but with no signs of infection. The skin may be treated with a prescription cream or gel. The doctor may also prescribe an antibiotic you take by mouth. Drops or ointments may be prescribed to help with eye problems.
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Hair Loss And Regrowth After Chemotherapy
Losing your hair during chemotherapy is not easy, but it can be easier to cope with if you have a better idea of what to expect.
Heres what cancer medical professionals and survivors told The Patient Story worked for them.
Contributing perspectives in this resource come from multiple cancer patients as well as Dr. Doug Blayney of Stanford Medical Center.
Hair Loss Background
When does hair fall out after chemo and how long does it take to grow back?
This varies person to person. Generally speaking, hair loss caused by chemotherapy happens around two to four weeks after the start of treatment or around the start of your second chemotherapy cycle. Often people may find they start losing their hair in clumps during a shower, while brushing hair, or discover it on their pillow after sleep.
The extent and pace of hair loss depends on a number of treatment factors, such as the type of chemo drug, dosage, frequency of treatments, and how the chemo is administered.
Be sure to ask your doctor and/or nurse about your chemotherapy regimen and whether its known to cause hair loss.
For the most part, thankfully, chemotherapy does not cause permanent hair loss. In rare cases, however, some higher-dose radiation therapy targeting the head may result in permanent hair loss.
Will hair look the same when it regrows after chemo?
Styling & Solutions
When should I cut my hair or shave my head?
Can cold caps or cooling caps prevent or lessen hair loss?
What kind of wigs are there?
Chemo Less Likely To Cause Hair Loss
Some chemotherapy drugs result in only minimal hair loss, though these are often combined with drugs that cause more hair loss. These include:
- The platinums: Paraplatin , Platinol , Eloxatin
- Antitumor antibiotics: Bleo 15K , Mutamicin , low doses of epirubicin or doxorubicin
- Antimetabolites: Trexall, Otrexup, Rasuvo
- Oral cyclophosphamide
- Topoisomerase inhibitors: Novantrone , Hycamtin or Potactasol
- Alkylating agents: Hexalen
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Why Does Chemotherapy Cause Hair Loss
The reason chemotherapy can cause hair loss is that it targets all rapidly dividing cells healthy cells as well as cancer cells. Hair follicles, the structures in the skin from which hair grows, include some of the fastest-growing cells in the body. If you’re not in cancer treatment, cells in your hair follicles divide every 23 to 72 hours. But as chemotherapy does its work against cancer cells, it also damages hair follicle cells. Within a few weeks of starting certain chemotherapy medicines, you may lose some or all of your hair. The hair loss can happen gradually or fairly quickly.
Why Does Chemo Make Your Hair Fall Out
It’s the chemotherapy stereotype: hair loss.
Loss of hair can mean patients feel a sense of identity loss, and for friends and family it is a physical sign of just how sick their loved one is. But why does it happen?
A feature of cancer cells is that they divide rapidly, Dr Schneider said. So chemo drugs are designed to target cancer cells by destroying rapidly dividing cells.
Unfortunately, cancer cells aren’t the only cells that rapidly divide. Cells in our immune system, gut, and crucially, our hair follicles, all rapidly divide.
Chemo can damage cells in the hair follicles, hair growth can slow, and hair falls out.
The impact of hair loss on someone’s emotional wellbeing is often underestimated, according to Laura Kirsten, a clinical psychologist who specialises in working with cancer patients, from the Clinical Oncology Society of Australia .
“Hair loss is not just an issue for women it’s also an issue for men,” Dr Kirsten said.
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Hair Loss And Cancer Treatment
If treatment will cause hair loss, try wearing fun scarves and earringsor a cap, from time to time.
Some types of chemotherapy cause the hair on your head and other parts of your body to fall out. Radiation therapy can also cause hair loss on the part of the body that is being treated. Hair loss is called alopecia. Talk with your health care team to learn if the cancer treatment you will be receiving causes hair loss. Your doctor or nurse will share strategies that have help others, including those listed below.
What Will I Learn By Reading This
When you have chemotherapy to control your prostate cancer, you may have side effects or unwanted changes in your body. Side effects are different from person to person, and may be different from one treatment to the next. Some people have no or very mild side effects. The good news is that there are ways to deal with most of the side effects. You will learn:
- Why you may lose your hair
- When you will start losing your hair
- When your hair will start growing back
- How to manage your hair loss
It is important for you to learn how to manage the side effects you may have from chemotherapy so that you can keep doing as many of your normal activities as possible.
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Use Hot Oil Treatments
We recommend using the ST.TROPICA Beach Goddess Hot Oil Hair Treatment once a week or once every two weeks to help nourish the scalp, encourage hair growth, and strengthen your hair.
To enhance your treatment, you can gently massage the hot oil treatment onto the scalp. This will stimulate blood flow to the scalp which encourages new hair growth.
Why Does Chemo Make You Tired
Fatigue, like nausea, can be caused by a variety of factors.
As chemotherapy kills off cancer cells, other process in the body get disrupted, causing tiredness, Dr Schneider said.
“Drugs that combat other chemo side effects can cause drowsiness,” she said.
“The body is also dealing with the cancer itself, and this can cause fatigue.”
Anxiety can also be big energy drain. The stress of diagnosis and treatment can wear people out and lead to disrupted sleep.
“If they can, getting some physical activity can actually help with that fatigue,” Dr Schneider said.
Feeling fatigued may last longer than the chemo treatment itself.
It’s important for friends, family and colleagues not to expect them to fire on all cylinders as soon has chemotherapy as stopped, Dr Kirsten said, instead, give them time to recover from the treatment.
“When someone’s no longer able to participate in their usual roles that can also impact on their sense of self and self-worth,” she said.
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Managing Your Hair Loss
Losing your hair can cause more than a change in your physical appearance. It can be an emotional challenge that affects your self-image and quality of life. It is important to be kind to yourself during this stressful time.
People cope with hair loss in different ways. Thinking about how you feel most comfortable in managing hair loss before, during, and after treatment may help. And, your choices may change over time.
Cold cap therapy
Wearing a cap that cools the scalp can help prevent hair loss from drugs given through a vein. This treatment is called scalp cryotherapy. You wear the cap before, during, and after chemotherapy.
The cold makes the blood vessels in the skin of your head narrower. Less blood and less of the chemotherapy drug reaches your hair follicles through the blood vessels. Keeping your scalp very cold also helps prevent damage to the hair follicles. Talk with your health care team to learn if cold cap therapy is available and might work for you.
An over-the-counter medication called minoxidil may help thinning hair from hormonal therapy or targeted therapy. It may also help if your hair does not grow back completely after chemotherapy, radiation therapy, or a stem cell/bone marrow transplant.
There are also other medications you can take by mouth. These include spironolactone and finasteride .
On The Hunt For New Drug Targets
Very little is known about how chemotherapy drugs cause CIA. Most information stems from studies using mouse models.
Here, research has shown that programmed cell suicide, or apoptosis, is the most likely cause of cell death in the hair follicle, causing the hair to fall out.
Researchers in the Department of Medicine at the University of Chicago, IL, used genome-wide association studies to compare the genetic signature of breast cancer patients who had experienced CIA with that of those who had not.
They found several candidate genes that might be implicated in the loss of functional hair follicles. One of these, CACNB4, is part of a calcium channel that plays an important role in cell growth and apoptosis. Another gene, BCL9, was active in a subset of CIA patients and is known to play a role in hair follicle development.
Armed with this knowledge, scientists are continuing their quest to develop effective inhibitors of chemotherapy-induced hair loss, hoping to reduce the burden that this unwanted side effect has on cancer patients.
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Questions To Ask The Health Care Team
You may want to ask your cancer care team the following questions.
Is my specific cancer treatment plan likely to cause hair loss?
If so, when will my hair loss happen? Will I lose hair over time or all at once?
How should I care for my hair and scalp during hair loss?
When will my hair grow back? What can I expect when my hair does return?
Is there a counselor, oncology social worker, or other team member who can help me cope with hair loss?
Are there any programs that provide free or low-cost wigs or other head coverings?
Be Gentle With Your Hair
Once you’re done with your chemotherapy treatments, continue being gentle and careful with your hair. Continue avoiding heat tools, damaging hair treatments, and hairstyles that tug on the root of your hair. The kinds of treatments and hairstyles can pull or damage the hair which can cause hair loss or hair breakage.
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Chemo Hair Fall Timeline
Patients undergoing a chemotherapy treatment will notice different levels of hair loss depending on the pattern of medication, dosage and type of cancer.
- A lot of patients experience hair fall within the first 1 or 2 weeks of treatment itself.
- Hair loss usually tends to begin from the side of the ears and top of the head. However, it varies for each individual.
- By about 3 months, complete balding may occur.
- Patients tend to notice their hair regrowing after 1 to 3 months. A change in hair color and texture may be evident but are usually not permanent.
- 60 percent of patients have reported a change in their color and hair type.
Did You Know?
- About 65 percent of patients undergoing chemotherapy experience alopecia .
What Kinds Of Skin Changes Should I Watch For
Changes in how your skin feels: Your skin may start to feel like its sunburned, before any redness or rash shows up. Even though it doesnt look different, the sensation can be disturbing. You may notice this change on your face as early as the first week of treatment.
Your skin will likely become much more sensitive to light and more easily damaged by UV rays during treatment. It may very easily be burned and blister, even after very little sun exposure or exposure to sun coming through windows.
Rash: This is the most common skin change from targeted drugs. The risk of getting a rash and how bad it gets depends on the type and dose of the targeted drug. In most people, the rash is mild. It often looks like acne and shows up on the scalp, face, neck, chest, and upper back. In severe cases it can affect other parts of the body.
The rash most often starts as skin redness and swelling. Its often worst within the first few weeks of treatment. By about a month into treatment, the skin usually crusts and gets very dry and red. In the weeks after that, round, flat or raised red spots and pimples with pus in the center often appear. In some people this can lead to skin infections. The rash can itch, burn, or sting, and may be painful. It may get better on its own or stay about the same during the rest of treatment, but it should go away completely about a month after treatment is stopped.
Itching: Many skin changes, like rash or dryness, can cause itching.
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