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How To Minimize Hair Loss During Chemotherapy

Emotional Support During Hair Loss

Preventing Hair Loss During Chemotherapy

Our hair can be an important part of our appearance and identity. It may be a way we express our personality. Often, when our hair looks good, we feel good. For some, losing their hair is one of the hardest parts of having treatment. For others, it is not as bad as they expected.

You may feel low in confidence, anxious or depressed. You may feel angry that the hair loss is a visible reminder of the cancer for you and for others. It may feel like you have to tell people about your cancer diagnosis when you dont want to.

All these different feelings are completely normal. Our information about the emotional effects of cancer suggests different ways to manage difficult feelings.

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?

Who Can Use Scalp Cooling

Scalp cooling is currently approved for women and men of any age being treated with chemotherapy for most cancers. However, scalp cooling isnt recommended if you have leukemia or other certain blood-related cancers.

Most people can use it with few side effects. Common side effects are headaches and feeling cold. If cold temperatures really affect you, then the therapy may not be right for you. Talk with your doctor about any questions you may have about hair loss and scalp cooling before and during treatment.

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Dealing With Cancer Therapy Hair Loss

Hair loss can be one of the most difficult side effects of cancer treatments to deal with for both women and men. Talk with your doctor or nurse about your treatment plan and whether it may cause hair loss.

Hair loss occurs because many cancer treatments affect cancer cells and normal cells. This includes the cells that make hair grow.

Hair loss from cancer treatment is most often not permanent. Hair loss may affect all the hair on your body. Hair grows back once therapy has been completed. The amount of hair loss depends on the cancer treatment, the dose of treatment, and how it is given. If your treatment affects the hair, your hair may start falling out between seven to 21 days after you start your treatment.

In radiation, only hair that is in the area of radiation will be affected by hair loss. Only if radiation is given to the head will one lose hair on the head. Radiation given to other parts of the body will not cause hair on the head to fall out. Very rarely with radiation there might be an area where the hair is permanently thinner.

Chemotherapy And Hair Loss: What To Expect During Treatment

Cooling Caps May Reduce Chemo Hair Loss

Medically reviewed by Drugs.com. Last updated on Feb 28, 2020.

You might not think about how important your hair is until you face losing it. And if you have cancer and are about to undergo chemotherapy, the chance of hair loss is very real. Both men and women report hair loss as one of the side effects they fear most after being diagnosed with cancer.

For many, hair loss is a symbol to the world that you have cancer. If you aren’t comfortable sharing this information with others, you may fear this side effect more than other chemotherapy complications. Talking to your cancer care team about your concerns and preparing for the possibility of hair loss may help you cope with this difficult side effect of treatment.

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What Does The Research Show

Controlled studies of older forms of scalp hypothermia have had conflicting results. However, some studies of newer, computer-controlled cooling cap systems have shown benefits. Recent studies of women getting chemo for early-stage breast cancer have found that at least half of the women using one of these newer devices lost less than half of their hair. The most common side effects have been headaches, neck and shoulder discomfort, chills, and scalp pain.

The success of scalp hypothermia may be related to the type of chemo drugs used, the chemo dosage, and how well the person tolerates the coldness.

Some research has also suggested that people with a thicker hair layer might be more likely to lose hair than those with a thinner layer of hair. This might be because the scalp doesnt cool down enough due to the insulating effect of the hair.

Cooling caps that are not fitted tightly have also been linked with more hair loss, often in patches where contact with the scalp is poor.

There remain some unanswered questions about the safety of scalp hypothermia. Some doctors are concerned that the cold could keep chemo from reaching any stray cancer cells lurking in the scalp. Some believe that the scalp cooling might protect cancer cells there and allow them to survive the chemo and keep growing. But in people who have used scalp hypothermia, reports of cancer in the scalp have been rare. More studies are needed to answer questions about long-term safety.

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Like many cancer patients facing chemotherapy, Jessica Heline of Tinton Falls was concerned about side effects, including a telltale one: hair loss. So, when an oncology nurse at Monmouth Medical Center mentioned that a scalp cooling system could help counteract that problem, Jessica figured it was worth a try.

It appealed to me because I learned I might keep my hairand if I did lose it, it would likely grow back faster afterward, says Jessica, 31, an engineer and mother of a 3-year-old boy.

Jessica was diagnosed with stage 2B invasive ductal carcinoma in her left breast in April 2019. Since cancer had spread to a few of her lymph nodes, her doctors recommended chemotherapy before surgery. While Jessica was primarily concerned with surviving the disease, she wanted to look as normal as possible.

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A Variety Of Head Coverings Are Available

If you feel self-conscious about hair loss, wearing a head covering might help. From wigs to scarves to hats, there are many options. Such coverings can also protect your head from sunlight exposure and cold air.

If you think you might want a wig that matches your natural hair color, considering buying it before you begin chemotherapy. This may help the wig shop to better match the color and texture of your hair. Try on different styles until you find one you like.

Can Scalp Cooling Stop Hair Loss From Chemotherapy

Best Ways To Reduce Hair Loss During Chemotherapy

Prema P. Peethambaram, MD, is a medical oncologist and Associate Professor of Oncology at the Mayo Clinic in Rochester, Minnesota. She has a passion for treating womens cancers and providing compassionate cancer care.

Charles L. Loprinzi, MD, FASCO, is the Regis Professor of Breast Cancer Research at the Mayo Clinic in Rochester, Minnesota, where he is an emeritus chair of the Division of Medical Oncology and an emeritus vice-chair of the Department of Oncology. He is also the Cancer.Net Associate Editor for Psychosocial Oncology.

Ashley* had breast cancer and needed several rounds of chemotherapy to improve her chance of being cured. Her oncologist described the potential side effects, including hair loss. Ashley didnt want her colleagues to know she had cancer, and she worried that losing her hair would make it obvious. She shared this concern with her oncologist, who talked with her about trying to prevent hair loss with scalp-cooling therapy. Fortunately for Ashley, the therapy worked. She didnt lose significant amounts of hairor her privacyduring her chemotherapy treatments.

Could this story be possible? Yes. By cooling the scalp, scalp blood vessels narrow, which results in less chemotherapy reaching the hair follicles. In addition, cooler hair follicles become inactive, making them less susceptible to the treatment. The result can be reduced hair loss.

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Tips For Possible Complete Hair Loss

  • Ask about a wig before you start treatment, so you can match the colour and texture of your real hair.
  • If you are feeling adventurous, choose a wig for a whole new look why not try the colour and style you’ve always wanted!
  • Think about having your hair gradually cut short before your treatment starts – this might help you get used to seeing yourself with less hair.
  • Some people shave their hair off completely to avoid the distress of seeing their hair fall out.
  • Wear a hair net at night so you won’t wake up with hair all over your pillow, which can be upsetting.
  • Keep your head warm in cooler weather – some people wear a soft hat in bed.
  • Rub in oil or moisturiser if your scalp feels dry and itchy, try unperfumed products such as Epaderm, Hydromol or Doublebase.
  • Try a moisturising liquid instead of soap if your scalp is dry, for example aqueous cream, Oilatum or Diprobase.
  • Protect your scalp by covering your head in the sun – your scalp is particularly sensitive to the sun.

Who Experiences Hair Loss

Not every person will lose his or her hair during cancer care. In fact, two patients taking the same medication may experience different hair-loss side effects. One patient may lose hair, while another doesnt. If alopecia does occur, the extent of hair loss varies widely depending on the type, dosage, frequency and method of treatment, as well as other individual factors.

In some cases, the hair may fall out, but become thin, dull and dry. When hair loss occurs, hair may fall out gradually, quickly, in clumps or entirely. The scalp may also feel tender or itchy beforehand.

Most hair loss is temporary, and hair will grow back after cancer treatment ends. Hair generally grows back within three months after chemotherapy ends and three to six months after radiation ends. Sometimes hair re-growth begins even before therapy is complete. Its common for hair to grow back a slightly different color and texture at first.

Baldness drug treatments, such as minoxidil, are not proven to be consistently effective to reduce or prevent hair loss caused by cancer treatment. In some cases, cooling caps, approved by the U.S. Food and Drug Administration for some patients, may help to protect hair cells from chemotherapy drugs. Cooling caps are designed to work by constricting cells, making it more difficult for the drugs to penetrate, and by reducing cellular activity in the hair follicles, making them a less likely target for chemotherapy drugs.

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Caring For Hair That Grows Back

When your hair begins to grow back, it will be much thinner and more easily damaged than your original hair. It may also be a different texture or color. The following tips may help you take care of the hair that grows back.

  • Limit washing your hair to twice a week.

  • Massage your scalp gently to remove dry skin and flakes.

  • Use a wide-tooth comb instead of a brush for your hair. When styling your hair, limit the amount of pinning, curling, or blow-drying with high heat.

  • Avoid permanent or semi-permanent hair color for at least 3 months after treatment ends.

  • Avoid curling or straightening your hair with chemical products such as permanent wave solutions until it all grows back. You may need to wait up to a year before you can chemically curl or straighten their hair. Before trying chemical products again, test a small patch of hair to see how it reacts. You can also ask your hairdresser for suggestions.

How To Use The Paxman Scalp Cooling System

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If youre interested in using the Paxman Scalp Cooling System, talk with your healthcare provider before your first chemotherapy treatment. They will sign you up and Paxman will send you your cooling cap and kit. You will receive it in 3 to 4 days.

Its important that you get ready for your scalp cooling treatment before your first appointment. Your nurse will connect your cap to the cooling machine, but you will need to prepare your hair and fit your cap on your head.

To learn how to get ready for your Paxman scalp cooling treatment, watch the videos on the Paxman website at www.coldcap.com.

After you watch the videos, practice getting your hair ready and fitting your cap. You may need some help from a caregiver, friend, or family member. You may also bring someone to your appointment with you.

Remember to bring your cap and kit with you to your appointment.

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Cdk4/6 Inhibitor Protected Hair Cells

For the new study, Purba and colleagues focused on two taxanes paclitaxel and docetaxel that doctors use in the treatment of solid tumors, such as in the breast and lung.

The team tested the drugs on hair follicles they cultured in the laboratory under conditions that were as natural as possible. The hair follicles came from the scalps of consenting patients.

The hair follicle is a mini organ that is easy to remove whole and readily lends itself to laboratory experimentation.

The team found that paclitaxel and docetaxel induced massive damage to cell division processes and triggered cell death in follicle cells that are essential for hair production.

The follicle cells that underwent damage included transit amplifying cells, which divide rapidly, and their progenitor, or stem cells. Impairment of this cell population likely explains the severity and permanence of taxane chemotherapy induced alopecia.

When they administered palbociclib, a CDK4/6 inhibitor to the organ cultured hair follicles before exposing them to paclitaxel, the researchers found that it protected without inflicting further damage.

Some Health Insurance Plans Cover Wigs

If you have health insurance, it might partially or fully cover the cost of a wig. Consider calling your insurance provider to learn if the cost is covered. In order to receive reimbursement, you will probably need to ask your doctor for a prescription for a cranial prosthesis.

Some nonprofit organizations also help fund the cost of wigs for people in need. Ask your cancer care center or support group for more information about helpful resources.

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Radiation Therapy Also Can Cause Hair Loss

Radiation therapy also attacks quickly growing cells in your body, but unlike chemotherapy, it affects only the specific area where treatment is concentrated. If you have radiation to your head, you’ll likely lose the hair on your head.

Your hair usually begins growing back after your treatments end. But whether it grows back to its original thickness and fullness depends on your treatment. Different types of radiation and different doses will have different effects on your hair. Higher doses of radiation can cause permanent hair loss. Talk to your doctor about what dose you’ll be receiving so that you’ll know what to expect.

Radiation therapy also affects your skin. The treatment area is likely to be red and may look sunburned or tanned. If your radiation treatment is to your head, it’s a good idea to cover your head with a protective hat or scarf because your skin will be sensitive to cold and sunlight. Wigs and other hairpieces might irritate your scalp.

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