Chemotherapy destroys tumor cells by preventing them from dividing, and normal cells that divide rapidly are also very sensitive to chemotherapy. The cells at the base of the hair follicle may become unable to divide to make new cells, weakening the hair shaft and resulting in hair loss. Some people experience only a thinning of their hair, but others lose all the hair on their head. Certain chemotherapy drugs are much more likely than others to cause hair loss. Your doctor or nurse can tell you if you are likely to lose your hair based on the type of chemotherapy drug that you are receiving.
If you are receiving chemotherapy drugs that are likely to cause hair loss, you might lose hair from other parts of your body. Hair anywhere on your body can be affected, including your eyebrows, eyelashes, and hair in your underarm and pubic areas. Hair loss usually begins about 3 weeks after chemotherapy begins. Sometimes people notice a gradual thinning and loss of hair, but with some chemotherapy agents the hair can come out in clumps over a period of only a few days.
If you are receiving chemotherapy that causes only a thinning of hair, you can reduce the amount of hair you lose:
- Use a mild shampoo, such as baby shampoo.
- Use a soft-bristled hairbrush.
- Avoid permanents and hair dyes.
- Avoid heated rollers and high-heat hair dryers.
If you are receiving chemotherapy with a high likelihood of causing complete hair loss, there is no way of preventing this. Doctors no longer use ice caps to prevent the chemotherapy from flowing to the scalp because they want to be sure the chemotherapy travels all over your body, not missing any area where there could be cancer cells.
If you are likely to lose your hair from treatment, you may find it helpful to purchase a wig or hairpiece beforehand. Some people like to match their own hairstyle to maintain their usual appearance; others like to try a new look. Wigs can be made with human hair or from synthetic fibers, and they vary considerably in price. Look for stores in your area that specialize in working with people who lose their hair from cancer treatment, or you can purchase a wig or hairpiece through the American Cancer Society. Your local American Cancer Society or hospital social work department may also have wigs and hairpieces available on loan. Your insurance company may cover the cost of the hairpiece. Check your policy, and, if it is covered, ask your doctor to write you a prescription for a “hair prosthesis needed for cancer treatment.” Costs that are not reimbursed are tax deductible.
Some people prefer to wear a turban, scarf, or cap to cover their heads, and some prefer to leave their head uncovered. Do whatever makes you feel the most comfortable. The important thing is not to let your changed appearance alter your willingness to interact with family, friends, and coworkers. Despite the loss of hair, you can take many steps to feel good about your appearance: for example, taking care in the clothes you wear, using makeup if you like, and wearing scarves or caps. The Personal Care Products Council, the National Cosmetology Association, and the American Cancer Society sponsor a free program, “Look Good, Feel Better,” that is dedicated to helping men and women being treated for cancer feel better about their appearance. The program offers beauty techniques that help restore your appearance and enhance your self-image, provides many tips on its Internet site, and presents group programs all over the country.