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Hair Loss
Ernest H. Rosenbaum, MD and Isadora Rosenbaum, MA

Losing your hair (alopecia) can be an upsetting experience. It is one of the most visible side effects of cancer treatment. The amount of hair loss varies from hair thinning to baldness. You may find it helpful to have your partner, a close friend or a relative with you when you talk to your doctor about hair loss.

Chemotherapy stops cell division of the more active cells in the body including those of the bone marrow, the gastrointestinal lining and the scalp (hair) cells. About 85-90 percent of hair cells are in the growth phase at any one time and therefore can be affected by by drugs. Many drugs, including bleomycin, Cytoxan, Adriamycin, etopside(VP-16), vinctistine, Velban, 5-fluorouracil (5-FU), methotrexate, and taxanes can cause partial or total hair loss.

Scalp tourniquets and ice caps have been used with limited success, especially for drugs that remain in the circulation for many minutes or hours. However, because these methods reduce the delivery of drugs to the scalp, cancer cells in the scalp are not treated and the cancer could recur locally.

Hair loss usually occurs about two to three weeks after the beginning of treatment. Hair may come out in large clumps. Hair regrowth usually begins about four to eight weeks after chemotherapy ends, and sometimes hair begins to grow back, during treatment. The new hair may have a changed color or texture.

How to Care For Your Hair
Gently shampoo to avoid drying out the hair and scalp. Avoid over brushing or over combing. Use a wide-tooth comb or vent-style hairbrush gently to avoid pressure or damage to the hair roots. Also avoid heat generating hair appliances such as dryers, hot rollers, and curling irons. Use styling aids such as sprays, mousses and gels to give the appearance of fullness and volume.

Although many patients avoid permanents and coloring, no relationship between hair loss and perms and coloring is proven. But it is wise to avoid permanents and hair coloring early in chemotherapy, since if hair loss occurs, you have wasted money.

Wigs can boost your morale, improve your appearance and improve your self-confidence. Purchase a wig before you start treatment so that a good match to your natural hair color and texture can be found. Purchase a wig can be styled and shaped to fit your personality and may be individualized. For more information, Makeup, Wigs and Quality of Life

Wig prescriptions are not always covered by health insurance. Contact your local cancer center or the American Cancer Society for information about where to get a free or low cost wig.

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