About Hair Loss Or Hair Thinning
Hair loss is one of the most well known side effects of cancer treatment. For many people losing their hair can be distressing and devastating.
It can be a constant reminder of your cancer and what youre going through. But for most people, their hair will grow back once treatment has finished.
Cancer drugs can cause:
- mild thinning of your hair
- partial hair loss, or loss of patches of hair
- complete hair loss
Chemotherapy is the type of cancer drug treatment most likely to cause hair loss.
Complete hair loss is very unlikely with any other type of treatment. But some other cancer drugs can cause hair thinning. It is not possible to tell beforehand who will be affected or how badly.
Hair loss also depends on factors such as:
- the type of drug or combination of drugs you are taking
- the dose
- the route
- how sensitive you are to the drug
- your drug treatment in the past
The Stage That Is So Ridiculous Its Hilarious
I cant tell you how hilarious it is to pull out fistfuls of hair and let the wind take it away, like it would dandelion fuzz, whilst on a walk with your best friend. Like, it truly made me laugh. Its also super fun to lint roll your head. Or to have your infant daughter playfully pull out chunks of hair while drinking a bottle in your arms. To finally see that you need to shave your head, lest she drown in a sea of your fallen hair, while she crawls around on the living room floor.
What Causes Hair Loss In Cancer Patients
Chemotherapy targets cancer cells that divide rapidly. But some healthy cells in the body also divide rapidly, like those lining the mouth and stomach, and in the hair follicles. When cancer treatments, especially certain chemotherapy drugs, damage the healthy, fast-growing cells responsible for hair growth, alopecia may result. Radiation therapy may also cause hair loss in the specific area of the body being treated.
Although hair loss does not always happen right away, it usually begins within two weeks of starting chemotherapy treatment and progresses over the following two months. Hair loss in the area being treated with radiation treatment usually begins up to three weeks after the first treatment. Hair loss may continue throughout treatment and up to a few weeks afterward.
Hair loss may occur on the head and/or elsewhere on the body, including the face , hair on the arms, underarms and legs, and pubic hair.
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How Long Do Side Effects Last
Remember that the type of radiation side effects you might have depends on the prescribed dose and schedule. Most side effects go away within a few months of ending treatment. Some side effects may continue after treatment ends because it takes time for the healthy cells to recover from radiation.
Side effects might limit your ability to do some things. What you can do will depend on how you feel. Some patients are able to go to work or enjoy leisure activities while they get radiation therapy. Others find they need more rest than usual and cant do as much. If you have side effects that are bothersome and affecting your daily activities or health, the doctor may stop your treatments for a while, change the schedule, or change the type of treatment youre getting. Tell your cancer care team about any side affects you notice so they can help you with them.
Chemotherapy And Hair Loss
Certain chemotherapy medicines used to treat breast cancer can cause the hair on your head to become thin or to fall out completely. Some chemotherapy medicines can also cause hair loss on other parts of your body, such as your eyebrows and eyelashes, pubic hair, and hair on your legs, arms, or underarms.
Whether you lose your hair and how much you lose depends on a variety of factors. This includes the type, combination, and dose of chemotherapy medicines you get, as well as other medical conditions , nutrition status, and stress. The timing of chemotherapy treatments also affects hair loss. Some types of chemotherapy are given weekly and in small doses, which may minimize hair loss. Other types of chemotherapy are scheduled every 3 to 4 weeks in higher doses and may be more likely to cause more hair loss.
Talk with your doctors before chemotherapy begins so you know what to expect in your individual situation. If you find out that you will be receiving chemotherapy medicines that are likely to cause hair loss, you may want to look into the possibility of using a scalp cooling system or manual cold caps during your infusion sessions to help limit the amount of hair you lose. Read more about preventing hair loss with Cold Caps and Scalp Cooling Systems.
Some of the chemotherapy medicines used to treat breast cancer that can cause hair loss are:
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Looking After Your Scalp After Hair Loss
Remember to protect your scalp from the sun. Cover your head when in the sun or use a high protection factor sun cream at all times, as the scalp is particularly sensitive.
We lose a lot of heat from our heads so cover your scalp in colder weather.
If your scalp is dry, flaky or itchy you can use unperfumed moisturiser or natural oils such as almond or olive oil to help with this. Some people use aromatherapy oils, but it is best to consult a trained aromatherapist as the oils can be very strong.
Can Cold Caps And Scalp Cooling Prevent Hair Loss During Treatment
Cooling the scalp can sometimes prevent or reduce hair loss from the head for both men and women having chemotherapy. This technique works by reducing the blood flow to the hair follicles, which means that the amount of drugs reaching the hair follicles is also reduced.
The effectiveness of scalp cooling varies depending on the drug and dose used, and from person to person. If you do keep your hair, you may find that its patchy or thinner. Scalp cooling is often less effective on African and Caribbean hair, so increased cooling times may be recommended.
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.
You can ask your specialist or chemotherapy nurse if scalp cooling is available and whether it would be suitable for you. The condition of your hair and any previous use of chemicals on it may affect how well scalp cooling works. Your chemotherapy nurse will discuss this with you.
Some doctors have been concerned that scalp cooling may increase the risk of developing secondary cancers in the brain or scalp due to the possibility of constricted blood vessels limiting the amount of chemotherapy reaching the area.
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How I Dealt With Permanent Hair Loss And Other Side Effects
When I first lost my hair due to breast cancer treatment, I often heard people say, Dont worry. Its only hair. The implication was that it would grow back eventually. But after a while, I began to notice that it was always the people with a full head of hair who said it. And I am one of the very small percentage of women whose hair didnt grow back after chemotherapy. So, I am still bald to this day.
It doesnt feel like just hair when youre the only one who doesnt have any especially when youre a woman, and you realize that yours is probably never going to grow back. But Im OK with being bald now, three years after my breast cancer diagnosis. Because I am cancer-free, too, and that matters far more to me than having hair.
Most unexpected treatment side effect: permanent hair loss
At first, I couldnt believe I had to give up both my right breast and my hair to be free of cancer. Because here I was, thinking at least I was going to get my hair back, and it turns out the regrowth Id experienced after treatment was only due to the steroids Id been taking. It was totally temporary.
I sat in my dermatologists office and cried when she told me.
It turns out Id developed alopecia areata, a condition that makes hair fall out in patches. It can be caused by chemotherapy, but its usually reversible. Ive tried a few things since then to get my hair to grow back, but nothings really worked. So, Ive accepted the fact that Im probably always going to be bald.
Studies Of Hair Loss Or Thinning With Femara
Studies conducted by the manufacturer of Femara were evaluated to assess hair loss compared with other breast cancer treatments.
Femara vs. tamoxifen
- In a large study of women with early breast cancer using either Femara or tamoxifen , the median treatment time was 60 months and the median time women were followed for side effects was 96 months.
- Hair loss or thinning was reported in 3.4% of women taking either Femara or tamoxifen. However, no cases were rated as serious .
Femara vs. anastrozole
- When Femara was compared to anastrozole , another aromatase inhibitor, hair loss or thinning was reported in 6.2% of women taking Femara compared to 6.5% of women taking anastrozole.
- The median duration of treatment was 60 months for both treatment arms. Most reactions were reported as mild to moderate, with only 0.1% of women taking Femara having hair loss that was graded as serious .
Aromatase inhibitors in general
- A survey-based, retrospective research study was conducted in 851 female breast cancer survivors who had taken aromatase inhibitors . Women were asked about their hair thinning or hair loss, health habits, use of AIs, and demographic data such as age.
- The results showed that 22.4% of the breast cancer survivors reported hair loss and 31.8 % reported hair thinning. Use of an AI at the time of the survey and prior use were significantly associated with hair thinning, but not hair loss.
- These results were found to be independent of use of chemotherapy and age .
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Can Chemotherapy Affect Pregnancy
If you happen to be pregnant at the same time chemotherapy is given and you did not know about it then that could have a very serious affect for the embryo. If the woman is of child bearing age before we give the first dose of chemotherapy you make sure that she is not pregnant. If a person finds out they have breast cancer late in the course of the pregnancy actually certain drugs can be given that dont affect the baby, and can treat the mother until the time of delivery. So the issue really is the kind of drugs that you are going to give and the time in the pregnancy. If its the first trimester you cannot give any drugs. If its in the third trimester you can give most of the drugs.
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.
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Bone Thinning Bone And Joint Pain
A group of estrogen-blocking breast cancer drugs called aromatase inhibitors may turn your bones more brittle. That may cause bone and joint pain.
Certain types of chemotherapy can also cause bone thinning. If you arent already in menopause, it may start prematurely.
Breast cancer itself can cause pain if it spreads to your bones. A specialized radiation treatment called radiotherapy can sometimes help. Ask your doctor about other treatment options like pain medications.
If The Tumor Is Large Why Does Chemotherapy Have To Be Administered Instead Of Just Being Removed
The larger the tumor the greater chance there is that a tumor cell escaped from the tumor and is circulating in a persons body. So tumor size is associated with risk of recurrence, for example microscopically. So as a tumor goes from a very small to a much larger size it has a greater chance of spreading through the lymph or blood system to get to another location in the body. Large tumors can be removed but that does not reduce the chance of a cancer coming back because that cell already has escaped. Its a matter of time before it can recur. Chemotherapy is aimed at trying to kill those cells before they are visible and there is a small number of them.
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/ When Will My Hair Start To Grow Back After Chemotherapy
Your hair will start to grow back after your chemotherapy treatment. Some people will notice immediate growth, and in other cases it might take a month or two. But it is equally possible for your hair to start growing back during your treatment. This usually happens just before or during your last chemo treatment. Its also worth remembering that it is a myth that wearing a wig, hats or scarves after chemo prevents your hair from growing back. Your hair will grow back just as quickly with or without headwear. Its up to you to decide when you feel your new hair is long enough to start walking around without a wig or a headscarf.
Why Does Radiation Therapy Cause Hair Loss
Radiation therapy not only destroys cancerous cells, but may also affect healthy cells in your body. The healthy cells that are most at risk for being damaged by radiation therapy are those that tend to grow at a fast rate, including hair cells. Thinning of hair and, in some cases, complete hair loss may result.
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When You Have Hair Loss
- If youre going to buy a wig, try on different styles until you find one you really like. Consider buying 2 wigs, one for everyday use and one for special occasions.
- Synthetic wigs need less care and styling than human hair wigs. They also cost less and may be easier to manage if your energy is low during cancer treatment.
- Some people find wigs are hot or itchy, and use turbans or scarves instead. Cotton fabrics tend to stay on a smooth scalp better than nylon or polyester.
- If your hair becomes very thin or is completely gone during treatment, be sure to protect the skin on your scalp from heat, cold, and the sun. Use a broad-spectrum sunscreen with a sun protection factor of at least 30 and a hat. In cold weather, wear a hat or scarf to cover and stay warm.
- Your scalp may feel itchy or sensitive. Be gentle when brushing and washing your hair. Using a wide-toothed comb may help.
- Hair loss might be somewhat reduced by avoiding too much brushing or pulling .
- Wear a hair net at night, or sleep on a satin pillowcase to keep hair from coming out in clumps. Be gentle with eyelashes and eyebrows, which might also be affected.
- When new hair starts to grow, it may break easily at first. Avoid perms and dyes for the first few months. Keep hair short and easy to style.
- Your new hair may be curlier or straighter, thicker or fineror even a new color. Usually this change is short term with time your hair will very likely go back to the way it was before treatment.
Will I Lose My Hair
Not all chemotherapy drugs will cause you to lose your hair. Some may have no effect on your hair at all, while others may thin your hair, but not cause it to fall out completely. Your medical oncologist will be able to tell you if the chemotherapy you are receiving might make your hair fall out.
Hair loss from chemotherapy usually involves most hair on your head and body, including eyelashes and eyebrows, pubic hair and nasal hair. If you want more information on hair loss, please read our Hair loss fact sheet. It has a list of common chemotherapy drugs and their likely effects on your hair.
Prolonged or permanent hair loss has been reported in a very small number of cases. Talk to your medical oncologist if you have concerns about hair loss and chemotherapy.
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Chemo More Likely To Cause Hair Loss
Chemotherapy medications with the highest risk of causing hair loss in many people include:
- Alkylating agents:Cytoxan or Neosar , Ifex , Myleran or Busulfex , Thioplex .
- Antitumor antibiotics: Cosmegen , Adriamycin or Doxil , Idamycin
- Topoisomerase inhibitors: VePesid , Camptosar
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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.
See Fertility and Men With Cancer to learn more.
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