Hair loss during Cancer Treatment and its Regrowth
Alopecia or hair loss is the side effects of cancer treatments like chemotherapy, targeted therapy, radiation therapy, or bone marrow/stem cell transplants. This hair loss occurs due to the medication and treatments that affect or harm the cells that help hair grow two or three weeks into the treatment cycle and the intensity of fall tends to increase after a month. Not all cancer treatments cause hair fall and rarely is there a permanent hair loss due to cancer treatment. Usually, the hair falls and regrows and the situation is temporary, as long as the treatment goes on. In some cases, the hair grows thinner and drier or may not fall out completely or permanently.
The intensity and interval of hair fall depend on various factors and varies from person to person as no person undergoes same treatment plans, the dosage varies, side effects may cancel out the impact of the treatment, acceptance of the treatment by the body may differ.
The Chemo drugs that have been known to cause hair fall are
1. Altretamine (Hexalen)
2. Carboplatin (Paraplatin)
3. Cisplatin (Platinol)
4. Cyclophosphamide (Neosar)
5. Docetaxel (Taxotere)
6. Doxorubicin (Adriamycin, Doxil)
7. Epirubicin (Ellence)
8. Fluorouracil (5-FU)
9. Gemcitabine (Gemzar)
10. Idarubicin (Idamycin)
11. Ifosfamide (Ifex)
12. Paclitaxel (multiple brand names)
13. Vincristine (Marqibo, Vincasar)
14. Vinorelbine (Alocrest, Navelbine)
Radiation Therapy: In this treatment method the hair fall is seen in the regions that are exposed to radiation.
Targeted Therapy: The following are the therapy drugs used that cause alopecia in patients
1. Afatinib (Gilotrif)
2. Cetuximab (Erbitux)
3. Dabrafenib (Tafinlar)
4. Dasatinib (Sprycel)
5. Erlotinib (Tarceva)
6. Ibrutinib (Imbruvica)
7. Imatinib (Gleevec, Glivec)
8. Nilotinib (Tasigna)
9. Panitumumab (Vectibix)
10. Sonidegib (Odomzo)
11. Sorafenib (Nexavar)
12. Trametinib (Mekinist)
13. Vemurafenib (Zelboraf)
14. Vismodegib (Erivedge)
Hormonal Therapy: This treatment method doesn’t lead to hair fall until some months or a year into the treatment cycle. This method doesn’t cause complete hair loss. The following are more likely to cause hair fall
1. Tamoxifen (Nolvadex)
2. Anastrozole (Arimidex)
3. Letrozole (Femara)
4. Fulvestrant (Faslodex)
5. Octreotide (Sandostatin)
With effects like hair fall making cancer obvious in patients, they resort to measures like prevention and management of the hair loss. Although there are only therapeutic methods available like decreased drug delivery it leads to adverse side effects like headache, nerve compression, claustrophobia.
Scalp cooling/Scalp hyperthermia is one way to reduce the effect of chemo on the hair. A closely fitted cap with chilled liquid is worn during chemotherapy. As the temperature of the cap is low this helps reduce the effect of chemo on hair.
Minoxidil (Rogaine) is a drug that helps hair regrowth after the hair loss cycle stops during chemotherapy. The drug is proven to work and is applied before and after the chemo sessions.
There are no clear methods to prevent hair loss in cancer patients who undergo treatment but there are methods offered to manage hair loss.
1. Avoid trauma to the hair like bleaching, using hair dryers at high temperatures, curling irons, and other hair styling accessories.
2. Use gentle hair care products on hair throughout chemo
3. Use satin pillow while sleeping as it doesn’t affect or break the hair strands like regular cotton pillows
4. Cut hair short
5. Shaving the head may help in getting a wig or hairpiece
6. Use sunscreen, hat, scarf to protect the scalp from sun and external environmental factors that could cause more harm to the head
Before, during and after the treatment sessions can include the use of gentle hair care products, consuming a healthy diet, taking protective measures for hair, scalp, and head.