When Hair Loss Starts After Chemo: Chemotherapy and Hair Loss

Cancer is considered the most important health problem. Due to the heavy treatment methods, it often strains both the body and the psychology of the patient. Physical side effects during cancer treatment also affect patients negatively. Hair loss during chemotherapy puts patients in trouble with more motivation. In fact, hair loss is one of the most common side effects in the treatment of patients receiving chemotherapy. Chemotherapy treatment affects hair cells along with cancer cells in patients. And it causes hair loss. So when does hair loss start after chemotherapy?

Hair loss due to chemotherapy varies depending on the type and dose of the drug in treatment. Hair loss in patients undergoing chemotherapy treatment usually starts after 15 to 20 days. Patients’ hair starts to grow again approximately 2-3 months after chemotherapy treatment ends. In this process, the growth process of the hair is completed in the first year in an average of 95% of the patients. The loss of hair and other hairs on the body also negatively affects the patient in terms of morale and motivation. However, all patients undergoing chemotherapy should remember that the hair loss they experience is a temporary side effect.

Hair Loss During Chemotherapy

Chemotherapy affects hair cells as well as cancer cells. As a result, your hair or other hair on your body may fall out. This shedding is called alopecia. Hair loss is one of the most common side effects of chemotherapy. However, some chemotherapy drugs shed hair, while others do not shed hair at all or a small amount of hair that is not noticed. While some drugs cause hair loss completely, some cause regional hair loss. Other hairs on the body such as eyebrows, eyelashes, beard, mustache, arms, and legs may also be shed.

However, shedding starts with the hair. These varying effects depend on the type and dose of the drug. Generally, hair begins to fall out 2–3 weeks after receiving chemotherapy. Hair loss can disturb you mentally; Many patients regret hair loss. Do not hesitate to share these feelings. Talking to people who have had this experience before will make you comfortable. Again, the hair starts to grow 2-3 months after chemotherapy ends. It should not be forgotten that hair loss is a temporary side effect. When the hair first comes out, it may be straight or curly, and its color may be different. However, it will revert later.

Measures to be taken before your hair falls out:

  • If the medications given to you will lose your hair as a side effect, you can cut your hair as short as possible before treatment.
  • You can shave your hair. If you use an electric razor for this, you will protect your head from cuts.
  • Avoid using chemicals such as perm and harsh shampoos. These products can make your scalp dry and itchy.
  • Wash your hair with a nourishing shampoo and dry with a soft towel.
  • Avoid excessive combing and brushing the hair. Choose soft brushes to prevent irritation on your scalp.
  • Do not use a hairdryer. If you are going to use a hairdryer, operate it at low temperatures. Curlers can increase damage to dry hair. Avoid sleeping with the curler.
  • If your hair falls out, you can use a wig to cover it. If you are planning to wear a wig, you can choose a wig in the color and shape of your own hair without losing your hair, you can go to the hairdresser and style the wig as you want. If the wig liner irritates your scalp, you can wear a thin cotton scarf under the wig.

Measures to be taken after your hair is shed:

  • During the period you receive chemotherapy, your skin will be sensitive. Therefore, it may be necessary to take protection measures against external factors.
  • Wear sunscreen or a hat when you go out.
  • Again, protect yourself from the cold by wearing a hat or scarf.
  • While sleeping, you can wear a soft scarf that will not harm your scalp.

Do not forget that hair loss is a temporary side effect of chemotherapy treatment.

Why Does Chemotherapy Cause Hair Loss?

Chemotherapy is a treatment that uses anti-cancer drugs to kill cancer cells. Drugs work by attacking cancer cells and preventing them from growing. Unfortunately, it can also affect normal cells in the body as well as hair follicles. This causes hair loss known as “alopecia”. Unlike cancer cells, normal cells renew themselves quickly. Therefore, when hair is shed as a result of chemotherapy, they grow back at the end of the treatment.

Sometimes this spill is so small that it is not even noticed. However, some people may experience temporary partial or complete baldness. Some chemotherapy drugs cause hair loss elsewhere in the body, such as eyebrows, eyelashes, chest, armpit legs, or pubic hair. The amount of hair shed depends on the drug used, the dose used, and the body’s response to the drug. Women undergoing certain cancer treatments may also experience hair reduction as “the joy of not removing hair from legs, groin or armpits for several months”. If hair loss is to occur, which usually occurs within a few weeks of starting chemotherapy, it rarely happens in the first few days.

It is first noticed when combing the hair, washing it, or by the hair spilled on the pillow in the morning. Some people’s hair just becomes thinner, dry, and brittle. Some people’s hair continues to fall for a few weeks until there is no more hair. Sometimes hair loss occurs within a day or two, but this is not a common situation. Hair may start to grow again even before the treatment is completed. At first, the hair will be very thin, but it will be restored in 3-6 months. It is possible that the hair is fuller or frizzy than before, and even the color may be slightly different. Sometimes this occurs as a mixture of dark color and white hair.

Radiotherapy is a treatment method that aims to destroy cancer cells with high energy beams and tries to damage normal cells as little as possible. Unlike chemotherapy, in radiotherapy, hair loss is seen only in the area where the treatment is applied. For example, if radiotherapy is applied to the head, there will probably be some hair loss. If treatment is being made for breast cancer and this includes the armpit, armpit hair will fall out…

Many people, men, and women perceive their hair as an important part of their appearance. For some, hair loss can cause feelings such as anger, sadness, and shame. During the treatment, patients have to cope with many changes, and hair loss may be the last drop. In addition, the loss of hair can make the person feel weak, helpless, and “stigmatized” by constantly reminding the person that they have “cancer”. If the eyebrows and eyelashes are also shed, this can be even more uncomfortable.

The reactions are completely normal and it will take time to accept the hair loss. Hair loss can be expressed as “shocking” for some people and “not as bad as I expected” for others. A woman using the phrase “It was not as bad as I expected” “hair loss is not such a bad thing, I can renew my appearance every day with different wigs and hairstyles, in fact, I get much more compliments than before, people can even ask where I got my hair done for my wig.”

The reactions of other people to hair loss can also make it difficult to deal with it. Sometimes when you are with people who are uncomfortable with their balding appearance and do not really know what to say, it may be helpful to raise this issue first for you. When they see that the person is speaking comfortably about this, they will probably try to be more helpful. Other people with hair loss can also be discussed and possibly people can make suggestions that work for each other. Support groups for people who have common problems due to cancer treatments can be attended.

Does Chemotherapy-Induced Hair Loss Always Happen?

Chemotherapy-induced hair loss is a side effect we often encounter. Partial or complete hair loss usually begins 15-20 days after chemotherapy, depending on the type of chemotherapy (not all chemotherapy drugs have the same effect) and the dose of medication given. In some patients, eyelashes, eyebrows, armpits, and pubic hair may also be shed in addition to the hair. Hair loss due to chemotherapy is a temporary side effect and it takes 3-6 months for the hair to grow back fully. In some patients, the hair may grow thicker and slightly different in color. However, it will take its previous form over time.

Chemotherapy drugs are effective in rapidly growing cancer cells. However, it has effects not only on cancer cells but also on healthy cells such as rapidly dividing hair root cells and blood cells. The chemotherapy drug, which comes to the hair root cells through the bloodstream, damages these cells, so hair loss occurs. When the effect of the drug wears off, the cells begin to regenerate and produce hair. The most preferred method for preventing hair loss caused by chemotherapy is hair cooling caps. Cooling starts with the cooling head placed on the hairy area 1 hour before chemotherapy starts, and the process continues for 1 hour after the chemotherapy is given and after the treatment is completed.

The working mechanism of the procedure is to reduce the amount of chemotherapy affecting the hair root cells by reducing the blood flow to the scalp, thus preventing the hair follicle cells from being affected by the drug. There is no guarantee that this method will prevent hair loss. Depending on the type and dose of chemotherapy given, and the patient’s own structural characteristics, there may be complete protection, or partial spillage may occur despite the cooling process. In addition, headache, neck pain, sinusitis development, or sinusitis exacerbation may occur due to hair cooling heads. It is inconvenient to apply in some types of cancer such as leukemia.

It has been determined that a drug named Minoxidil reduces hair loss due to chemotherapy by applying 2% creams to the hair and provides rapid growth of the shed hair. However, it has not been widely used due to its relatively low efficacy, side effects such as folliculitis called hair follicle infection, and 40% facial hair growth. Shortening the hair before starting chemotherapy, brushing the hair with a soft comb rather than hard are other applications that will have a reducing effect on hair loss.

How Long Does Hair Grow After Chemotherapy?

Not all chemotherapies shed hair, but most chemotherapy causes more or less hair loss. However, hair shed due to chemotherapy usually grows again after treatment. Chemotherapy can destroy cancer cells, but it can also damage normal “rapidly growing” cells such as hair follicles. This is why most people lose at least some of their hair after chemotherapy. After chemotherapy, the hair regrowth process is slow but steady, and hair loss is rarely permanent. Some information about hair regrowth after chemotherapy is as follows:

  • Hair loss may vary depending on whether the patient’s hair is thick or thin before treatment.
  • People whose hair grows rapidly before chemotherapy tends to grow rapidly in the post-chemotherapy period.
  • Hair growth can begin when chemotherapy no longer affects healthy cells; This time varies depending on the chemotherapy received and the duration of chemotherapy application.
  • Hair growth rates also vary based on other factors such as a person’s age, general health, and which race they belong to.

People with cancer who are given chemotherapy may lose their hair, eyelashes, eyebrows, and other parts of the body. Hair loss usually starts 2 weeks after the first treatment and continues to fall more within 1-2 months. Similarly, a person’s hair does not start to grow back immediately after the last chemotherapy treatment. The delay is due to the fact that chemotherapy drugs need time to leave the body and stop acting on healthy dividing cells. Most people receiving chemotherapy will begin to see a limited amount of fine, hairy hair a few weeks after the last treatment.

Real hair starts to grow properly within a month or two of the last chemotherapy. Only a very few of the people who have been given chemotherapy have hair not the same as before. Certain chemotherapy combinations increase the risk of permanent hair loss. For example, docetaxel chemotherapy used in the treatment of many cancers is known to cause permanent hair loss in some people. The following timeline shows the growth time of hair after chemotherapy:

  • 2-3 weeks: Light, vague hair forms.
  • 1-2 months: Thicker hair begins to develop.
  • 2-3 months: Hair may have grown by 2-3 cm.
  • 6 months: Hair grows 5-8 cm. In some parts of the scalp, hair may grow out more slowly.
  • 12 months: Hair grows 10-15 cm and becomes more resistant to hard styling tools such as brushes.

Especially for people who once had long hair, it may take several years for hair to revert to the previous style. Some hair follicles may be in the active growth period before others. When this happens, the hair length on a person’s head can make it difficult to reshape. Likewise, it may have an uneven or patchy appearance at first. Over time, the hair will have a more regular growth pattern. But the hair texture may differ from the previous one. It is observed that the hair structure of many people whose cancer treatment is finished has changed; For example, the hair may become curled, wavy, or more fragile. Even those whose hair color changes partially are not few.

Sometimes there is no way to predict whether a person will have a change in their hair. Good hair care can keep a person’s hair healthy while regrowing. It is advisable to avoid excessive brushing or treatment that can cause further hair loss. Styling with heating devices such as hot hair straighteners or blow dryers can damage the hair and cause it to look thin and brittle or break. The use of drugs to stimulate hair growth after chemotherapy is largely experimental, and a person should not expect a definitive result when using them. Most hair regrowth medications are designed to treat other causes of hair loss rather than chemotherapy.

If patients are concerned about this, it is recommended that they discuss the risks and benefits of hair growth/loss prevention treatments with their doctor. A 2004 mouse study found that estrogen applied to the scalp can increase the rate of hair regrowth. But this is a risky approach to recommend for breast cancer patients. A small study of 22 women from 1996 found that the well-known hair regrowth treatment called minoxidil could benefit chemotherapy-induced hair loss. A more recent study has suggested that minoxidil may accelerate hair regrowth and even reduce hair loss during chemotherapy.

Choosing the right wig, beanie or bandana can help while waiting for hair to regrow. Hair loss during chemotherapy can be uncomfortable, but this hair loss is almost always temporary. There is also an FDA-approved cold cap system for both men and women that prevents or reduces hair loss during chemotherapy. This device, known as DigniCap, works by cooling the scalp to reduce the possibility of alopecia (baldness) in cancer patients.

Ways to Cope With Hair Loss in Chemotherapy

Chemotherapy creates a hair loss problem and this is not a situation that can be prevented, but it is possible to minimize the psychological negativity caused by this situation. As in any treatment, keeping morale and belief high is an important factor for the person. Let’s explain the steps to be taken during hair loss: First of all, it should be known that the loss is temporary and the hair will return to its original state after treatment.

In order to protect the health of the scalp, the use of shampoos containing harsh chemicals should be avoided, if possible, the pillow covers used should be chosen soft enough not to damage the skin. The comb or hairbrush used should be chosen soft enough not to damage the skin.

If it is known that hair loss will occur during chemotherapy and this situation will cause discomfort to the person, it should be explained with the help of a specialist in a way that does not hurt the person. If the person does not want to witness the moments when his hair will fall out, he should have his hair cut or shaved. Upon request, solutions that will cover the scalp such as wigs can be used.

Hairdryers should be avoided as much as possible, if not possible, they should be used at low temperatures. Because the hairdryer can cause drying, itching, and scaling on the scalp. It should be noted again that hair loss is a temporary condition and the person will regain their old hair after treatment. Health is always important.

To give a ratio, it has been observed that approximately 60% of the patients receiving chemotherapy experience hair loss. This rate varies according to the type of treatment and it is not observed in some patients at all. Hair loss begins with chemotherapy and is noticeably shed within three weeks. After the last chemotherapy, hair growth starts again and within 1 year, the hair is restored.

Hair Loss After Chemo and Prosthetic Hair

Hair loss due to the drugs used in the chemotherapy process is one of the expected side effects of the treatment. This condition, which is a temporary side effect, may cause further deterioration of the mood of the patients during the treatment. Knowing that most of the hair will come back after chemotherapy treatment does not prevent this process from being difficult for the patient. In the second month after the chemotherapy treatment, hair grows normally and starts to grow. Since the first hair will look like a very fine feather, it is generally recommended to scrape the hair again.

It is a known fact that keeping the patient’s mood high during the chemotherapy process helps strengthen the immune system and helps the treatment to be overcome more easily. Although wigs, bonnets, or bandanas are generally used to provide morale to the patient, such solutions can turn into a complete torment for the person. Wearing a wig continuously can cause itching, redness, and irritation in the sensitive scalp of the person. In addition, the person may feel uncomfortable due to the difficulty of use or unnatural appearance. The wig can give a feeling of slipping, weight, and unnatural look on the head. It can make the person feel worse.

As soon as hair loss begins during the chemotherapy process, a more comfortable solution can be provided with prosthetic hair. To solve the problem of hair loss during the treatment, using a hair prosthesis can be a good, useful, and most importantly, a healthier decision for the person. The application of prosthetic hair without any surgical intervention is of great importance in chemotherapy treatment. Prosthetic hair is the healthiest, most natural-looking, and most useful solution option for people who experience hair loss during chemotherapy. It helps the patient to pass the 2-3 months period required for hair to regrow after treatment with high morale.

It is very important for the person to maintain his private and social life during chemotherapy. During the chemotherapy process, “how do I look” becomes more sensitive. Due to hair loss, some people receive psychological support during the chemotherapy process. They have a self-esteem problem. The person feels happy during chemotherapy with prosthetic hair. With hair prosthesis, the patient does not get away from social life, can continue his daily life, and can help to overcome both the treatment and the process much more easily. To benefit from this procedure, it will be sufficient to plan it concurrently with chemotherapy treatment.

For the application, support can be obtained from hair prosthesis specialists who have received special training for patients experiencing hair loss in chemotherapy. It should be ensured that products that are fully compatible with human and skin health are used in all applications of the chosen clinic. Specially equipped centers can offer healthy and safe solutions for temporary hair loss during chemotherapy and radiotherapy. Prosthetic hair systems provide the opportunity to have natural-looking hair instead of shedding hair without any medical intervention to provide the support that the patient needs in this period. It is a cosmetic option with high patient satisfaction. A specialized and reliable clinic should be selected for more information.

A Scientific Approach to Chemo and Hair Loss

The term chemotherapy was first used by the famous German chemist Paul Ehrlich, who developed drugs for the treatment of infectious diseases in the early 1900s. Paul Ehrlich named chemicals used in the treatment of diseases as chemotherapy. The beginning period of chemotherapy dates back to the 1940s. During World War II, mustard gas was spilled from a bombed ship in the Bari Port of Italy, and it was found that those exposed to this gas had damaged both bone marrow and lymph nodes. Later, this gas was used in the treatment of acute leukemia and it was found that folic acid antimetabolite (5FU) has antitumor activity.

While it was used as single-drug therapy in the 1950s, combined chemotherapy was used and developed in the 1960s. Today, chemotherapy is used in the treatment of many solid tumors and is accepted as the primary treatment for leukemia and some lymphomas. With this treatment method, it is aimed to prolong the life of the patients and to live more qualified. However, depending on the method used, there are difficulties and toxic effects related to the treatment. During chemotherapy, many side effects arise due to the fact that healthy cells are affected as well as cancer cells that are desired to be controlled or destroyed.

For example, bone marrow suppression is one of the most important side effects of chemotherapy, and the leukopenia, thrombocytopenia, and anemia caused by it are uncomfortable conditions for the patient. In addition, unwanted symptoms such as pain, fatigue, alopecia, nausea and vomiting, sleep disturbances, mucositis, constipation, depression, and anxiety may occur. Emotional problems that develop as a result of these disorders are other side effects of chemotherapy. As a result of the diseases caused by cancer, along with the side effects of the treatment, patients; They experience symptoms such as anxiety, depression, pain, sexual dysfunction, fatigue, change in self-concept, their usual adaptation mechanisms are shaken, their expectations and plans for the future are impaired, thus the quality of life of patients is negatively affected.

Despite advances in the treatment of many chemotherapy-related side effects, alopecia remains a difficult issue to resolve. Alopecia can result in anxiety, depression, negative body image, low self-esteem, and decreased well-being. Patients may refuse treatment due to fear of alopecia. Therefore, it is stated that effective new approaches are needed in the resolution of alopecia. In hair loss due to chemotherapy, the hair follicle is damaged due to a pause in the anagen phase. When a dose of chemotherapy agents is given, some of the medicine is absorbed by the hair buds. This situation suppresses or stops cellular division and protein synthesis.

If cellular activity stops completely, hair enters the early telogen (resting) phase. Narrowing of the hair shaft and weakening of the hair occurs. These structural abnormalities cause hair to break off spontaneously during normal activities such as washing and brushing the hair. Chemotherapeutics that cause hair loss are especially antimetabolites, alkylating agents, and antimitotics. Diffuse hair loss occurs in the first 4 weeks following these treatments. The bristles are very thin and break easily. The hair follicle regains its normal activity by opening the treatment intervals or discontinuing the treatment. There is no question of permanent damage to the hair.

Best Caps for Women Experiencing Hair Loss After Chemo

Savaş Ateş

I'm a hair loss expert. The picture was taken 10 years ago :) I have been losing my hair. So I started to learn everything about hair loss and hair transplants. I contacted a lot of hair transplant doctors. We shared our experiences. I'm writing blog posts for people who have the potential of losing their hair. I give some tips about hair transplants and medical issues too.

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