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What Chemo Drugs Cause Hair Loss

Effect Of Other Cancer Therapies

Chemotherapy Hair Loss During Breast Cancer Treatment

The newer targeted therapies for cancer don’t usually cause total hair loss like chemotherapy drugs but can result in changes such as thinning of the hair and dryness, as well as changes in texture similar to chemo curls. Some targeted therapies may also affect the pigmentation of hair, often causing the hair to become darker.

Some of the targeted therapies that have been linked with hair changes or hair loss include:

  • Cyclin-dependent kinase 4/6 inhibitors such as Ibrance , Kisqali , and Verzenio
  • VEGF inhibitors such as Nexavar
  • BRAF inhibitors such as Zelboraf and Tafinlar
  • Bcr/Abl inhibitors such as Tasigna and Gleevec

Some of the hormonal therapies commonly used for breast cancer have been associated with thinning of the hair for some people. Unlike chemotherapy, people may be using the drug for many months or even years before they notice the changes in their hair. Hormonal therapies more often linked to hair loss include:

  • Tamoxifen
  • Aromatase inhibitors: Hair loss appears to be more common with Arimidex and Femara than with Aromasin .
  • Faslodex

Immunotherapy drugs for cancer, at least checkpoint inhibitors, do not usually cause hair loss, though oftentimes these drugs are used along with chemotherapy. Researchers are looking at ways of harnessing the gene involved in autoimmune alopecia to improve the effectiveness of chemotherapy.

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.

A Short Haircut Might Make A Difference

Shorter hair often looks fuller than longer hair. As a result, hair loss might be less noticeable if you have a short hairstyle. If you typically wear your hair long, consider cutting it before you begin chemotherapy.

After you start chemo, hair loss might make your scalp feel itchy, irritated, or sensitive. Shaving your head can help ease the discomfort. Many people also prefer the look of a cleanly shaved head to partial hair loss.

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Coping With Hair Loss When You Have Cancer

Despite the difficulty facing hair loss when you have cancer, some things can help you cope with the loss of your natural hair. Try to remember some of the following:

Dont assume you will experience permanent hair loss.

Some cancer patients take comfort in the fact that hair loss is usually temporary, and they can begin to see new hair growth soon after the end of their treatment cycle.

Dont assume your hair loss will be total.

Others find relief when they realize they might not experience complete hair loss. These patients might be very happy to have thin hair instead of no hair.

Not all chemotherapy drugs cause hair loss.

Speak to your doctor or another member of your health care team about what to expect regarding hair loss. The more you know, the more prepared you can be. Ask if you will lose all your hair or some of your hair. Find out how soon after you start treatment you can expect to begin losing your hair.

There might be ways to reduce the trauma of hair loss.

Sometimes, feeling like you have control can help you cope with hair loss. For example, some people take steps to minimize the anxiety of hair loss by cutting their hair short before starting treatment.

Others make sure they stock up on gentle hair products like a soft baby brush, wide-toothed comb, and mild shampoo so they can protect their remaining hair.

Inquire about methods of minimizing hair loss.

Consider head coverings.

Get support.

I Started My First Round Of


I started my first round of chemo in May of ’08 – taxol – and I think I lost my hair within a few weeks. It was also supposed to “thin”, but it was coming out at amazing speed! I had long hair since I was a little girl, but I shaved my head bald when it started falling out, it was freaking me out so much. I was upset when I first lost my hair, but I was prepared. I had a wig for work, and scarves & hats for play. So when it happens make sure you are ready!That’s a big thing – be prepared! The bright side? Wait til you see how little shampoo you use, how quickly you are out of the shower, how quickly you can get ready for work or whatever when all you are doing is putting on a wig .And you have less makeup to put on due to no eyelashes…I found most people understood and were very sensitive and sympathetic to the situation. And now when I think about the women who have lost their hair in their valiant fight…it’s a badge of honor.

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Hormone Therapies And Hair Loss In Men

As with women, men on hormone treatments may also experience miniaturization and notice the onset and worsening of androgenetic alopecia.

Testosterone replacement therapies used for people with low levels of this hormone have hair loss as a side effect. The use of anabolic steroids, to increase muscle mass can in turn lead to the onset of these problems.

Which Medications Can Cause Hair Loss

There are numerous reasons as to why you might be experiencing a seemingly sudden bout of hair loss. It could be anything from a change in your diet or exercise routine, to a hereditary condition, to a natural age-related issue. In some cases, even the medications that your doctors prescribed to you could include hair loss as one of their main side effects. If this is a possibility, then its not only important that you discuss all possible side effects of your medications with your doctor prior to commencing treatment, but also that you do your own research. You should also ask your doctor or pharmacist about feasible substitute medications that will accomplish the same goals as your original prescription. Another option is to consult a hair restoration expert in Toronto regarding the type of hair loss youre experiencing and how to remedy the problem.

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When Hair Is Falling Out:

  • Consider getting a shorter hair cut. Shorter hair is easier to manage under a wig. A shorter style will make your hair look thicker and fuller because it does not lay as flat against the head. It may also make your hair loss less upsetting.
  • Some people choose to shave their head once hair starts falling out. If so, do not use a razor. A razor may cause nicks and cuts, which may lead to infection.
  • Wear a hair net, soft cap or turban around your head at night to collect any loose hair.
  • Be aware that during the period of time you lose hair, the scalp may be tender or sensitive. Some people tell of having a tingling feeling of the scalp during hair loss.
  • If the eyebrows start to thin, try using a clear or colored brow gel. These can be found at any discount or department store. A brow pencil can also be used to fill in gaps. Another option is to use eyeglasses with heavy colored frames. You can find these with or without a prescription.

After Treatment / New Hair Growth

Hair Loss During Chemotherapy
  • Continue to treat hair and scalp gently. Protect scalp from the sun while hair grows in.
  • Wait until hair has grown in before coloring hair or using chemical products.
  • Do not use vitamins, supplements, or topical hair growth products without talking to a doctor.
  • Find a professional hair stylist who has worked with cancer patients and can give advice during the growing out process.

Each patient copes with hair loss differently. What is helpful for one person may not be helpful for another. For example, friends and family often wish to shave their heads in support of the patient. For some patients, this can help them feel like they are not alone. But for other patients, this can make them feel worse. Some patients say that seeing their family or friends without hair is just another reminder and further reduces the normalcy in their lives. Family and friends can ask the patient directly about what they find supportive.

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Try Hair Regrowth Treatment

Some drugs encourage hair regrowth after chemotherapy, but the results vary. Most hair regrowth drugs aim to treat hair loss resulting from causes other than chemotherapy.

Some research has suggested that minoxidil might speed up hair regrowth or reduce hair loss during chemotherapy.

Doctors may, for example, recommend Rogaine for people who have had tamoxifen therapy for breast cancer. However, it can be messy and expensive. Pharmacies usually offer other forms of minoxidil that are cheaper.

A person should discuss the risks and benefits of hair regrowth treatments with their doctor before using them.

Eyebrows Eyelashes And Make

With some chemotherapies, people might also lose their eyebrows and eyelashes. Make-up, eyebrow pencil, eyeliner or false eyelashes can help, and many cancer support groups have workshops to help patients learn these techniques.

For example, the charity Look Good Feel Better holds free skincare and make-up workshops and masterclasses across the UK for women undergoing treatment for cancer.

Find cancer support services near you.

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Cutting Hair Off Prior To Or During Hair Loss Due To Chemotherapy

In our section about the Hair growth cycle, we understand that the hair root sits underneath the skin surface. This is where the three phases of the growth cycle occur with each and every individual hair. Therefore cutting hair short prior to or during hair loss cannot affect the hair growth function that takes place underneath the skin. If cutting hair short is something you decide to do we recommend that you avoid shaving with a bare razor. This is simply due to the possibility of infection if you cut yourself and not to do with affecting hair re-growth. Do use clean clippers/scissors and take a look at our section Cutting hair before hair loss.You can also read more in-depth information in our New hair growth section.

Chemo Less Likely To Cause Hair Loss

The Chemotherapy Drugs That 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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Preparing For Changes To Your Hair

Many people say that the possibility of losing their hair is one of their biggest worries about having treatment. Understandably, the thought of it can cause a great deal of stress and anxiety.

Hair loss can be an important part of self-identify, so unwanted changes to it can significantly affect self-esteem and confidence. Its a visible side effect of treatment, and can make it obvious to other people that youre having treatment, including those you might not have chosen to tell. This loss of control and privacy can be very challenging to cope with.

Prepare yourself mentally keep in mind that youll come across people you know who dont recognise you anymore. I lost the hair on my head, as well as my eyelashes and eyebrows, which made me look very different. I found that tough to cope with, but I did get used to it after about a month, and my hair grew back very quickly. People did look but I just assumed that they were good-natured people and probably guessed that I was having chemotherapy and hoped that I was recovering OK.

Speak to your medical team for advice specific to your situation if your hair is likely to be affected, you might want to ask where from and how quickly you could expect it to grow back. Getting an idea of what to expect can help you to prepare for changes to your hair and give you time to consider what approach you might like to take.

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?

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To Avoid Making Hair Fall Out Faster:

  • Use a gentle shampoo and conditioner to lessen the pull on hair while combing. Try to stay away from shampoos with lots of chemicals that can dry out your scalp. Avoid shampoos and conditioners with strong fragrances, alcohol or salicylic acid.
  • Using or sleeping in hair curlers can pull on the hair and cause it to fall out quicker.
  • Try to avoid coloring, bleaching or perming your hair at this point–it could weaken it and make it fall out faster.
  • Lower your use of hair dryers, straightening irons and curling irons. Try air-drying your hair.

How Will Eyelashes Brows & Facial Hair Be Affected

Patients Say Chemotherapy Drug, Taxotere, Caused Permanent Hair Loss

If chemotherapy causes your scalp hair to fall often other body hair can also be affected. Your facial hair, including eyebrows and lashes are also likely to fall out. This is also the case if you are having scalp cooling because scalp cooling only helps to reduce hair loss on the scalp.

Read more in our entire section dedicated to Eyebrows & eyelashes.

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