Hair loss after chemotherapy

Hair loss during cancer is often the result of chemotherapy treatment.

Chemotherapy molecules are powerful drugs that destroy fast-growing cancer cells. Unfortunately, these drugs also affect other fast-growing cells in the body, including the hair follicle cells responsible for hair formation.

Chemotherapy triggers an abrupt halt in the hair growth phase (anagen phase), followed by rapid hair loss over most of the scalp: this is called anagen effluvium. Hair loss under chemotherapy usually begins 1 to 3 weeks after the first session.

Chemotherapy can cause hair loss all over the body, not just on the scalp. Sometimes the hair on the eyelashes, eyebrows, underarms and other parts of the body will also fall out.

The severity of chemotherapy-induced alopecia depends on different factors:

• the molecule(s) used; some chemotherapy drugs are more likely than others to cause hair loss;
• the doses used; depending on the doses used, hair loss can be more or less severe.

Fortunately, most of the time, hair loss due to chemotherapy is temporary and reversible. After the final chemotherapy session, hair usually grows back within 3 to 6 months. In some cases, it may temporarily have a different color or texture.

For some types of cancer, chemotherapy may be combined with radiotherapy to the head and neck. Hair loss from radiotherapy is a different kind of hair loss that can occur in addition to hair loss from chemotherapy.

Hair loss due to chemotherapy is difficult to avoid because it is linked to the desired effect of the treatment: to stop the proliferation of cells that multiply rapidly. Depending on the molecule(s) used in the treatment, chemotherapy-related alopecia will be more or less severe: it can range from simple thinning to complete baldness.

Hair generally begins to fall out 2 to 4 weeks after the start of treatment. It can fall out very quickly in clumps or gradually. Hair loss may be accompanied by increased sensitivity of the scalp.

Hair loss due to chemotherapy will continue throughout treatment and up to a few weeks afterwards. It may take several weeks after treatment for hair to start growing again.

There is no treatment that can prevent hair loss from chemotherapy. Several treatments have been studied to prevent hair loss, but none have proven to be 100% effective. They can, however, reduce the severity of hair loss, such as the cooling helmet: a cold helmet is placed on the head during chemotherapy infusions to slow down the blood flow to the scalp and thus reduce the action of chemotherapy molecules on the hair follicles. This rather uncomfortable technique has proven to be successful for some patients.

During the entire period of chemotherapy treatment, it is important to take care of your scalp and hair:

• Wash hair gently. It is preferable to use mild shampoos, adapted to fragile hair, from the beginning of the treatments. Application is done by gently massaging the scalp with the fingertips. It is recommended to wash the hair the day before a chemotherapy session and to wait 3 to 7 days after the session to wash it again.
• Avoid damage to the hair. It is important not to further damage the hair and scalp already weakened by the treatments: dry the hair without rubbing it too hard or avoid using hair dryers, straightening or curling irons, coloring, perms and curlers...

Take care of the scalp. When the hair has fallen out, it is essential to protect the exposed scalp from external damage (sun, pollution, cold, wind, etc.). As for the face, you can apply a sun cream when exposed to the sun and a moisturizer every day. This will help soothe the itching that can accompany the wearing of a wig, turban or scarf.