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.
/ Should I Cut My Hair Short Or Shave It Before Chemotherapy
Cutting or shaving your hair is not essential but it is often recommended. Some people find it makes the transition from long hair to a bald head less abrupt if they cut their hair short just before chemotherapy. This also has a practical advantage: when your hair starts to fall out, you wont lose big, long chunks of hair but just short hair or stubble. Some people find this less confrontational. Others choose to cut their hair short because it makes them feel in control of the hair loss process themselves instead of being passively subjected to it. A tip: if you choose to shave off your hair, we recommend using an electric trimmer or clipper . Be careful to avoid cutting yourself. If you are not used to using these devices, go to the hairdresser or ask someone with experience.
Other Hair Loss Symptoms
Hair may fall out in clumps or seem like it is thinning as you lose a few strands at a time from all over your scalp. Depending on the type of chemotherapy used, you could lose the hair on your head only, or also on all parts of your body, including the eyelashes and eyebrows, arm, legs, underarms, and pubic area.
Other symptoms you may experience include:
- Scalp itching, tenderness, or dryness
- Scalp sensitivity
- Increased skin sensitivity to the sun
- Red or darkened skin or other pigment changes
- Remaining hair may be dull or dry
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Radiation Treatment And Hair Loss
Radiation therapy uses a high-energy beam to damage quickly growing cells in your body. The goal is to target cancer cells, but some normal cells get damaged as well.
Radiation only causes hair loss on the particular part of the body treated. If radiation is used to treat the breast, there is no hair loss on your head. But there might be loss of hair around the nipple, if you have hair there.
Radiation to the brain, used to treat breast cancer that has spread to the brain, can cause hair loss on your head. Depending on the dose of radiation, your hair may be patchier when it grows back or it may not grow back.
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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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.
Which Chemotherapy Drugs Cause Hair Loss
Your medical team will speak to you about your risk of hair loss before you begin treatment.
Lymphoma chemotherapy drugs that usually cause hair loss include:
- conditioning chemotherapy .
Hair loss is more common with intravenous chemotherapy. Whether or not you lose your hair also depends on the dose of your chemotherapy and how often you have it.
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Do All Chemo Patients Experience Hair Loss
The degree at which you may experience hair loss depends on a number of factors :
- The dosage of the medication.
- Frequency at which chemotherapy is given.
- Intravenous drugs are more likely to result in hair loss.
- Certain medicines used in combination can result in alopecia.
- Genes or your individual genetic makeup – some patients are not as prone to losing hair while others may experience major hair loss.
How Chemotherapy Affects Hair
Hair is made of a protein called keratin, and it grows from a hair bulb or root, located at the bottom of a hair follicle beneath the skin. Inside the bulb, blood vessels bring nutrients so the cells can multiply and build the hair. As it grows, the hair gets pushed up through the skin.
Hair grows in cycles. Approximately 80-90% of the time, hairs are in the growing phase. The cells are multiplying quickly, and the hair is growing about 0.3 millimeter a day . These growth cycles occur faster on the scalp, so the hair on your head grows faster than your body hair. On average, we have about 100,000 hairs on our head, and about 100 of them fall out every day.
Chemotherapy drugs identify and target cells that reproduce quickly, regardless of whether they are cancer cells or not. This is where we begin to see how chemotherapy causes side effects like hair loss.
Damage to these normal cells is usually temporary. Once the follicles are repaired, the hair grows back. Sometimes the new hair is quite different from the original hair in texture or color. It may even be more or less curly.
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/ How Do I Care For My Hair During My Chemotherapy
During chemo we recommend gentle care for your hair. Dont wash it too often and always use a gentle, mild shampoo. If you need to use a hair dryer, make sure you always use the lowest temperature setting. Try not to let your hair dry out due to sun exposure, colour treatments or perms. Hard brushes and curlers are definitely to be avoided as well.
Ways To Care For Your Hair When It Grows Back
- Be gentle. When your hair starts to grow back, you will want to be gentle with it. Avoid too much brushing, curling, and blow-drying. You may not want to wash your hair as frequently.
- After chemotherapy. Hair often grows back in 2 to 3 months after treatment has ended. Your hair will be very fine when it starts to grow back. Sometimes your new hair can be curlier or straighteror even a different color. In time, it may go back to how it was before treatment.
- After radiation therapy. Hair often grows back in 3 to 6 months after treatment has ended. If you received a very high dose of radiation your hair may grow back thinner or not at all on the part of your body that received radiation.
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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 chemotherapy, hair loss might make your scalp feel itchy, irritated, or sensitive. Shaving your head may help ease the discomfort. Many people also prefer the look of a cleanly shaved head to partial hair loss.
Hair Growth After Chemo
With most types of chemotherapy, the cells in the hair follicles will regenerate enough to resume hair growth. They normally go through a cycle of active growth, then rest. Chemotherapy sends more of them into the rest phase , which usually lasts for 100 days.
Some people will note hair beginning to come back even before the end of treatment, but it is more common to see it growing back after two to three months. At first, you may see light amounts of fuzz-like hair return, followed by thicker amounts of hair.
Still, some people do not see hair regrowth. Some types of chemotherapy have a higher risk of permanent hair loss.
The effects of chemotherapy on the hair follicles can result in the regrown hair being a different color or texture, and having different waves or curls than before. In the breast cancer treatment study, 53% said their hair became wavier or curlier, 58% reported thinner hair, 6% noted thicker hair, 38% said their hair was grayer or whiter, and 5% reported darker hair.
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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 .
When Can I Perm Straighten Or Dye My Hair
Ask your medical team how long you should wait after finishing treatment before you colour, chemically straighten or perm your hair. Traces of chemotherapy in your hair strands could react with the chemicals used in the styling processes.
Natural, temporary dyes might be better than permanent chemical products. If youd like to dye your hair, you could ask your clinical nurse specialist if a vegetable-based hair dye that you wash out is suitable for you. These are milder and less damaging to your hair and scalp than chemical ones.
Whichever treatment type youve had, your new hair might be fragile so you should wait for at least six months after your hair has started to grow back before you have woven-in or glued-in hair extensions.
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Coping With Your Emotions
While hair loss is not a specifically medically serious condition, it can have a significant psychological impact on an individual. Some people experience a wide range of emotions during and following hair loss.
When you are going through hair loss and chemotherapy treatments, it is important to talk about your feelings. Feeling angry and sad is a normal part of hair loss. Most cancer patients will go through the 5 stages of the grieving process as they begin to cope with their diagnosis. The stages of grief are: Denial, Anger, Bargaining, Depression, and Acceptance. Every person grieves differently. Be aware of your feelings and recognize that they are normal and expected.
It is especially important to build your support network and lean on others for support. Cancer support groups bring great comfort to many patients. It helps tremendously to share your experience with others who are also going through the same experience. You will gain insight and inspiration from those who are completing their journey. For more information on finding a support group, see our blog post on Cancer Support Groups.
Talk to your health care professional, minister or someone you trust and remember to turn to your support network as you face this challenge.
Your Scalp May Be Sensitive And You May Lose Hair Wherever It Grows On Your Body
When youre in chemotherapy, chemicals are introduced to your body to disrupt cancer cells, so that they cant multiply. This same disruption interferes with your hair follicles ability to produce new hair cells. The result is a sensitive scalp and, often, hair that falls out close to the root from wherever it grows on your body.
A 2019 survey indicated that participants saw hair loss, on average, 18 days after their chemo treatments.
If the medication used for your chemotherapy does make your hair fall out, your hair may grow back in a little differently than it did before.
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Why Do Not All Chemotherapy Patients Lose Their Hair Answering An Intriguing Question
Alopecia is one of the side effects of chemotherapy that patients fear most to the point that, just for that reason, up to 14% of women refuse chemotherapy. In fact, chemotherapy drugs destroy cancer rapidly growing cells, but do not spare other rapidly growing cells, including hair keratinocytes. In temporary alopecia, full regrowth is, however, possible. Within 96 h, DNA is repaired and hair bulb structures are restored , and within 36 months, new hairs are visible . In 65% of patients, they acquire temporary different features, including curliness in 35% of cases . Permanent or persistent alopecia is another possible outcome. High-dose busulfan and cyclophosphamide regimens, but breast cancer protocols as well, often including taxanes, are reported to cause it . Almost constantly, all hairy areas are involved. The severest forms occur in up to 10% of cases and seem to be associated with regulatory variants in the ABCB1 gene .
The current understanding of the problem takes into main consideration the high mitotic rate of hair keratinocytes, which, in fact, approach the maximum proliferative rate of keratinogenic epithelial cells . Hair keratinocytes are, just for that reason, particularly susceptible to any cytostatic insult. Stem cells are ordinarily spared, but in PA, they become the likely target of an undue antimitotic activity .
What Are My Options
There are many ways to cover up hair loss. Hats, scarves and turbans are popular options for men and women.
- hats there are many styles to choose from
- scarves versatile with many colour and fabric options, lightweight materials such as cotton are best
- turbans easy to wear and widely available
- wigs you can continue with a familiar style or try something new
Some hats, headbands or bandanas have optional fringe or hair attachments. If you still have some hair, changing your hairstyle can help cover up hair loss. Specialist hairdressers like mynewhair can offer advice.
In certain situations surgery to replace hair might be an option if your hair loss is permanent. This treatment is not available through the NHS.
You may not want to wear anything on your head. Accessories, clothing and makeup can express your style and draw attention away from hair loss.
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How To Prevent And Manage Hair Loss
If youre receiving treatment for breast cancer that can cause hair loss, its important to know you have options. Below, you can learn about ways to prevent and manage hair loss as a side effect of breast cancer treatments.
If chemotherapy medicines that will cause hair loss are part of your breast cancer treatment plan, there are steps you can take to prepare, possibly lessen hair loss, and protect your hair as it grows back. Learn more about Managing Hair Loss From Chemotherapy, including tips for hair loss on your head, eyebrows, and eyelashes.
Cold caps and scalp cooling systems are tightly fitting hat-like devices filled with a cold gel or liquid coolant. Cold caps and scalp cooling systems have helped many people keep some or quite a bit of their hair during chemotherapy. Learn more about Cold Caps and Scalp Cooling Systems
Many people find that wearing a wig is a good solution for them if they experience hair loss from breast cancer treatment. A wig can provide a sense of normalcy, consistency, and privacy during cancer treatment. Experimenting with different wig styles and colors can also be quite fun! Not sure if a wig is right for you or where to begin looking for one? Read more about wigs to learn about where to buy a wig or get one for free, how to choose one that suits you, how to care for a wig, and more.