Dealing with Hair Loss

For patients who undergo chemotherapy as part of their breast cancer treatment, chances are pretty good that some, if not all, of their hair will fall out. The medical term for this condition is alopecia.

Many cancer drugs have this side effect when used alone. Also, some anti-cancer agents that don’t have this effect when used alone may still cause hair loss when used in combination with other drugs.

Additional factors that influence hair loss during treatment are the dosage of a given drug, and the physiology of the person undergoing treatment.

Why does hair loss occur? It happens because the drugs used in cancer treatment typically target cells that divide quickly. Cancer cells divide quickly. Unfortunately, so do the epithelial cells that surround your hair follicles. When these cells are killed, hair falls out at the root. The good news is that if your hair falls out, at least you know the chemotherapy you're receiving is busy fighting on your behalf.

Hair loss usually begins a couple of weeks into treatment. Although it doesn’t all fall out at once, it does fall out quickly. Many patients report waking up in the morning to find large amounts of hair on their pillow. Others talk about how disconcerting it is to brush or wash their hair and have patches of hair fall out.

Even patients who have anticipated losing the hair on their head are surprised when they lose hair from other areas of the body. Hair loss can and frequently does affect the arms and legs, underarms, and pubic area, as well as eyebrows and eyelashes.

Hair loss is disconcerting for a number of reasons. One is that many cancer patients prefer to keep their illness a private matter, sharing the battle only with close friends and family. But a head suddenly devoid of hair, particularly on woman, is a dead giveaway to all that the patient is undergoing chemotherapy.

Another reason that hair loss is so stressful involves the high degree of concern that most people have for the way they look to others. One of the quickest ways for a person to change or “liven up” their appearance is to try a new hairstyle. Over the course of a lifetime, people invest significant amounts of both time and money cutting, styling, coloring, curling and straightening their hair. With so much time and attention spent on hair, when the hair is suddenly gone, a patient can feel very exposed and vulnerable.

There are two pieces of good news in all of this. One is that although it may take 6 months or more, the hair lost during chemotherapy will grow back.

When cells important to hair growth are no longer subject to regular assault by anti-cancer agents, hair sprouts anew. The initial growth may be finer and more delicate, curlier, and of a different shade than before. But the hair soon returns to its normal pre-treatment appearance.

The second bit of good news is this: there are a number of attractive solutions available to those who wish to camouflage their hair loss until natural hair growth returns.

For patients who are about to undergo chemotherapy and have concerns about losing their hair, here are a few tips:

• First of all, it’s possible that your chemotherapy regimen will not have this side effect. Ask your doctor if the drug or drugs in your treatment plan typically cause hair loss.
• If hair loss is likely or certain, consider making a preemptive strike. Shave your hair off or cut it very short before it starts to fall out. Many patients say this allows them to feel more in control of their own destiny. Hair that has been shaved off voluntarily can’t fall out involuntarily in alarming clumps.
• If you choose to go “au naturel,” as some patients do, and adopt the bald look until hair growth returns, be sure to wear a hat or apply a healthy dose of sunscreen to your head when venturing outdoors. This area has been covered with hair for almost your entire life, and is very susceptible to sunburn. Also, be sure to wash your scalp thoroughly with a mild  shampoo, not body soap, to maintain healthy hair follicles.

If you don’t care for the bald look, visit a breast care boutique or wig shop to investigate the choice of wigs and other head covers. You’ll find that employees at these shops have assisted many cancer patients over the years, and can help you find a “look” that suits you.

For a more information on the variety of head coverings available to patients experiencing hair loss, along with a list of retailers, please see our related article “Hair Solutions During and After Treatment.”

The knowledge that hair loss is temporary doesn’t make it less any less awkward for many patients. But this fact, along with the knowledge that there are many temporary solutions to the hair loss dilemma, can go a long way toward giving patients some peace of mind, allowing them to focus their energy on more important battles.