Hair Loss and Chemotherapy

The anticipation of possible hair loss (the medical term is alopecia) can be one of the most difficult and stressful aspects of cancer diagnosis and treatment. A cancer diagnosis robs us already of so much of our "normal" life- to have our outward appearance radically altered, especially in societies that place such a premium on physical appearance, can be devastating.

The good news is that most of the chemotherapy drugs used to treat appendiceal cancer do not usually cause complete hair loss. FOLFOX, the combination of the three chemotherapy medications oxaliplatin, 5-FU and leucovoran commonly used to treat appendiceal cancer, rarely causes complete hair loss though they may cause thinning of the hair. Irinotecan, another drug that may be used in combination with 5-FU and leucovoran for those who cannot tolerate oxaliplatin can cause complete hair loss in approximately 30-35% of those receiving it, but more commonly also causes only thinning. Intraperitoneal hyperthermic chemotherapy also does not commonly cause hair loss, though in some cases complete hair loss may occur.

In the past, techniques such as icing the scalp or wearing a constrictive cap or band on the head have been tried in an attempt to prevent chemotherapy from circulating to the scalp and causing hair loss. These techniques have not been proven to work and have pretty much been abandoned.

Some things about chemotherapy-related hair loss that you should know know:

If hair loss occurs, the loss of hair may possibly include loss of eyebrows, eyelashes, underarm hair, pubic hair...ALL hair.
Hair loss does not usually begin to occur until after the second or third chemotherapy treatment, though it may begin to occur a week or two after the first treatment. Hair may come out in large clumps when it does start to come out. At this point some choose to shave their heads versus having areas of patchy baldness.
Hair usually begins to grow back at 6-8 weeks after chemotherapy ends.
When hair grows back, it may come back a different color, texture or may grow back naturally curly even if it was straight prior to chemotherapy. These changes may last a year or two or may be permanent.

Suggestions for dealing with potential hair loss:

See a wig specialist or go to a salon that offers wigs prior to starting chemotherapy. At that time your hair color, fullness and texture can be matched with existing wig samples.
The stylist can also see your normal hair style. If you lose you hair you will be prepared ahead of time and no one will see a drastic change in your appearance. If you purchase but do not cut the wig, you may be able to return it in the event you do not lose your hair.
cut your hair short if you expect to lose your hair, as it will take less amount of time for you to look "normal" again when your hair begins to grow back
Wig prices vary. Wigs can cost under $50 for synthetic hair, or over $300 for human hair. Insurance may cover the cost of your wig if you have your doctor write a prescription for it. The prescription needs to be written for a "Cranial Prosthesis" or "Hair Prosthesis". Check with your insurance company to be sure of the wording required for coverage.
Even if you get a wig, you may want some scarves or turbans to wear at home or at night.
While on chemotherapy, be gentle with your hair. Avoid perms, blow drying with excessive heat and chemical treatments. Use a gentle shampoo.

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This website is for informational and educational purposes only. Readers are encouraged to confirm the information contained herein with other sources. The information on this website is not complete and not intended to replace medical advice offered by physicians or health care providers. Patients and consumers should review the information carefully with their professional health care provider.

Last Updated 05/05/2008 12:17:25 PM