Will I lose my hair?
Many people find hair loss the most upsetting side effect
of chemotherapy. The rapidly growing cells that make up
the hair roots (follicles) are sensitive to chemotherapeutic
drugs. Not all drugs cause hair loss, however. There are
several important things to remember. The hair loss is temporary.
Body hair generally returns once the chemotherapy
drug is stopped. Occasionally, the hair will begin to regrow
while you are still being treated with the chemotherapy
drug. Complete baldness occurs generally within two to
three cycles of the drug. When your hair begins to regrow
it will be thick and soft and sometimes even better than
before.
If I am bald to begin with, will I grow hair when chemotherapy
stops?
No. If you are already bald before starting your chemotherapy
treatments, there will be no new hair growth.
Will I lose my hair in places other than on my head?
The hair follicles of the beard, eyebrows, mustache, eyelashes,
armpits, legs, and pubic area are all rapidly growing cells and are sensitive to some of the drugs used in chemotherapy.
Sometimes the loss is partial, but many times
there is a complete loss of scalp and body hair.
What should I do to prepare for the hair loss?
You should buy a hairpiece, a wig, or a toupee before you
start the treatment. Eyebrow pencil and false eyelashes may
be needed. Some people find that horn-rimmed glasses or
other glasses that are fitted with rims coming just in front
of the eyebrows can conceal this hair loss. Turbans, hats,
or scarves can be used instead of a wig, but most patients
feel more comfortable if they have made the effort to buy
a wig before their hair starts to fall out. Wigs are tax-deductible
medical expenses and may be covered by some
medical insurance policies. Some hospitals and some American
Cancer Society units have wig banks where you can
get them free.
If you have long hair, cut it short before it begins to thin.
If you buy a hairpiece, use it as the hair begins to thin out.
Some black patients find they can delay hair loss by braiding
their hair instead of vigorously combing it.
Cold caps for chemotherapy
What is a cold cap and how does it help to prevent hair
loss?
Researchers are investigating ways to prevent hair loss
through the use of scalp hypothermia the cooling of the
scalp with a cold cap. The cap is usually put on the head
about 10 minutes before the drug is given and is left on
during the treatment and for 30 to 50 minutes afterward.
The cold cap causes a narrowing of the blood vessels of the
scalp, lessening the amount of drug that reaches the hair
follicles. The cap does not prevent hair loss in all patients.
The best protection seems to be obtained in those receiving
low drug doses.
Can the cold cap be used for all cancer patients?
The National Cancer Institute researchers caution that cold
caps should not be used in patients with cancers that might
spread to the scalp, such as leukemia, lymphoma, and mycosis
fungoides. The use of a cold cap in treating these cancers could prevent the skull and scalp area from receiving
necessary treatment. Additional studies of scalp hypothermia
are being done. You should discuss the pros and
cons of cold caps with your doctor.
Are there any side effects to using the cold cap?
Some patients have complained of headaches, a sensation
of cold, and a feeling that the cap was heavy.
When hair falls out from radiation or chemotherapy treatments,
does it fall out gradually or all at once?
Though hair loss differs from patient to patient, and from
drug to drug, don't be surprised if your hair falls out in huge
hunks, and your head becomes sensitive. Your scalp may
also become flaky and irritated. A mild dandruff shampoo
or some olive oil rubbed into the scalp may help.
Do you have any general hints about buying wigs and hairpieces?
Yes, we have a few hints.
• Buy the wig before you start losing your hair. This is
very important. It is really best to get the wig before you
start having the chemotherapy treatments if at all possible.
• Buy the wig yourself. Bring a friend with you if you like,
but don't send someone else to do it for you. It is essential
that the wig or hairpiece fits you well, looks nice
on you, and pleases you.
• The less expensive wigs tend to look synthetic. If this
is the kind you are buying, dust it with a little baby
powder to take away the shiny look.
• Get your first wig the same color as your hair. You can
start wearing it while you lose your hair.
• Many people find it useful to buy more than one wig.
Having a second wig is especially helpful if you tend to
perspire.
• Buy a good synthetic, rather than a real hair wig, because
it washes better, is less expensive to maintain, is cooler,
and is cheaper than the real hair wigs.
Is there any kind of wig that is better if I am only going to
have partial hair loss?
If your doctor expects you to have only partial hair loss, it
is better to get a capless wig.
Will it be hard to hold the wig on my head if I have complete
hair loss?
It may be. It is generally recommended that you use beautician's
tape folded upon itself to hold the wig in place.
Tape it to the crown and the temple areas of the wig. There
is a company that makes wig retainer pads, which can be
attached to any wig by a simple basting stitch. The pads
cushion the scalp by conforming to the natural contour of
the head. You should also have the wig styled to fit your face. Styling
is usually included in the cost of the wig, but if it isn't,
you can have it done at a beauty parlor. If you are expecting
complete hair loss, make sure that the inside of the wig is
smooth.
Can I wear a headband underneath my wig?
Yes, if you prefer. People who wear headbands under their
wigs usually like cotton scarfs instead of silk or synthetic
scarfs. Cotton is cooler and helps keep the wig from sliding.
Are there any special scarfs or turbans made for women
with hair loss?
There are several manufacturers of special scarfs and turbans.
One style, called Hide & Chic, is a combination scarf
and hat of light cotton and polyester that has body and shape
to disguise the lack of hair beneath. There is also a child's
version. The Sweetie Cap is a comfortable, inexpensive cover up
complete with bangs, which can be used as a cool, featherweight
alternative to a wig. A lightly padded headband,
called Scarf Shapers, gives height and shape to scarfs.
It is made of soft poly cotton and padded with batting; it fastens at the back with velcro and is washable.
How often should I wash a wig if I am wearing it every
day?
People who wear wigs all the time usually wash them every
week. Wigs tend to trap dust, and then they become hotter
to wear. You should use shampoo to wash your wigs. Deodorant
soaps will leave a coating on them.
Scalp Cooling for Reducing Chemotherapy Hair Loss
Are there specific things I can do while losing my hair?
You can wear a soft fabric nightcap to catch the hair. If you
use a nightcap, make sure it is a soft one, not a stiff netting
type. Check the elastic on it so it will be comfortable for
your head size.
What about when my hair starts growing in again?
As your hair starts growing in, shampoo it often. You might
also want to go back to a hairpiece rather than wearing your
full wig while your hair is growing back.
Will coloring my hair or having a permanent while I am
having chemotherapy make my hair fall out?
It does not seem so. There has been some limited research
done on this subject, and the women who colored their hair
or had permanents during chemotherapy did not seem to
have any more or any less hair loss than those who did not.
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