Personal Story: Coping with chemotherapy-induced hair loss
|Chemotherapy and hair loss||Clinical trials|
|Coping with hair loss||Questions for your doctor|
|Treating hair loss||Resources|
When Stephanie Hess was diagnosed with III ovarian cancer, she knew what to expect. She had watched her mother and other family members cope with the side effects of chemotherapy.
“Because my mom had passed away from cancer, I knew what it felt like. The thought of losing your hair, that’s the ultimate indicator of being a cancer patient.” she says. “I didn’t want to be bald.”
Hair loss is often the most common and visually striking side effect of chemotherapy, especially for women with cancer. Many different types of chemotherapy drugs cause hair loss.
Both men and women report that hair loss is one of the side effects of chemotherapy they fear most. Studies show that 58 percent of patients consider hair loss the worst side effect of chemotherapy, and that up to eight percent consider not having treatment for fear of losing their hair. Chemotherapy may also cause changes in hair texture, quality, amount and color.
Studies show that women undergoing chemotherapy more often have hair loss than men. For women, hair can represent their identity, personality, sexuality and femininity. Women also report a more negative body image as well as lower psychological, social, physical and emotional well-being than women who do not lose their hair.
Chemotherapy does not discriminate
Chemotherapy drugs are powerful. They attack any rapidly growing cells. While cancer cells usually grow quickly, some normal cells, like hair cells, do as well.
Because hair cells are present all over the human body, chemotherapy can also lead to loss of eyebrow, facial and pubic hair. The type and amount of chemotherapy affects how much hair is lost during treatment.
Usually, hair begins falling out two to four weeks later after chemotherapy begins. It may fall out in clumps or may gradually thin. Your scalp may also be tender. Hair loss usually continues throughout chemotherapy and may continue up to a few weeks after treatment ends. Hair typically grows back once chemotherapy is over. However, hair that returns is likely to have a different texture or color than the hair you lost. This difference is usually temporary.
Like Hess, some cancer patients choose to embrace their new look. And sometimes, like Hess’s family members, loved ones show support by going bald too.
Hess said, “My cute seven-year-old son shaved his head about two weeks after I shaved mine. I had a nephew that was living in Las Vegas at the time, and he had shaved his head for me.”
Her nieces also shaved their heads. “I hadn’t asked them to. I had no idea,” she recalls. “I got a text with their shaved heads, and I just cried and cried because it was so freeing.”
Hess went out to dinner with her niece and her newly shaved head. “She didn’t wear a hat or a scarf or anything. She was completely bald. Walking into that restaurant with my niece who was bald helped me to be less afraid.
Several hair loss treatments have been studied, but none has proven to completely prevent hair loss during or after chemotherapy.
Scalp cooling caps
Scalp cooling, sometimes called scalp hypothermia, is a treatment given while a person receives chemotherapy. A cap that is cooled by liquid is placed on your head. Scalp hypothermia works by slowing blood flow to the scalp and reducing the effect of chemotherapy drugs on rapidly growing hair cells. Scalp cooling may be more effective for certain types of chemotherapy.
Studies of scalp cooling show that it helps to reduce hair loss in most people who try them. Side effects of scalp cooling include being very cold and headaches. Two scalp cooling caps, DigniCap and Paxman Cooler, are approved by the .
Scalp cooling costs between $1,500 and $3,000 per treatment. While insurance companies often partially cover the costs of wigs and other head coverings, they do not currently cover the cost of scalp cooling.
To learn more about scalping cooling read our XRAY review.
Rogaine is an FDA-approved drug approved for hair loss. It is a cream that is applied to your scalp before and during chemotherapy. While Rogaine is unlikely to prevent hair loss, some research has shown that it may speed hair regrowth.
Bimatoprost, like Rogaine, is a cream that is applied to eyelashes. Bimatoprost has been shown to be effective in treating chemotherapy-induced eyelash loss.
Giving a face to chemotherapy-induced hair loss
The impact of hair-loss is often underestimated by healthcare providers. New research from the Netherlands may help. It shows that patients’ drawings of their chemotherapy-induced hair loss may better portray their feelings before, during and after the experience than traditional methods like questionnaires. The drawings may be a way for healthcare providers to better understand their patient’s knowledge and understanding of chemotherapy-induced hair loss and how they cope with the experience.
For many, hair loss can be frustrating and stressful. Hess felt that by embracing her hair loss it empowered her. She sees her hair loss as a temporary setback rather than a permanent problem and hopes that her story can help some women make peace with their own experience.
Hess’s advice, “Find a support group. Talk to a group of people who understand what you are going through.”
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van Alphen K, Versluis A, Dercksen W, de Haas H, Lugtenberg R, Tiemensma J, Kroep J, Broadbent E, Kaptein AA and van den Hurk C. Giving A Face to Chemotherapy-Induced Alopecia: A Feasibility Study on Drawings by Patients. Asia Pac J Oncol Nurs. 2020. 7(2): 218-224.
FORCE receives funding from industry sponsors, including companies that manufacture cancer drugs, tests and devices. All XRAYS articles are written independently of any sponsor and are reviewed by members of our Scientific Advisory Board prior to publication to assure scientific integrity.
This article is relevant for:
People who receive chemotherapy for cancer treatment
This article is also relevant for:
People with ovarian cancer
People with breast cancer
People with colorectal cancer
People with prostate cancer
People with endometrial cancer
People with metastatic or advanced cancer
People newly diagnosed with cancer
Be part of XRAY:
- Will my treatment result in temporary hair loss?
- Will my hair likely grow back the way it was before?
- Are there any treatments to reduce hair loss during chemotherapy or to help hair regrow after chemotherapy?
- What is scalp cooling?
- What side effects can occur after scalp cooling?
- How much does scalp cooing cost? Will it be covered by my health insurance?
- What other side effects should I expect from chemotherapy?
The following studies are looking at management of treatment side effects:
- NCT05227898: RESTORE: A virtual study comparing 2 digital apps to improve mental and physical well-being of patients with I – 3 cancer. The goal of RESTORE is to test how effective two different apps are at improving physical and mental health. Participants use their smartphone or tablet to download and access their assigned treatment app without ever needing to visit a clinic in person.
- NCT03581357: Mobile Mindfulness Meditation to Improve Neuropathy in Cancer Survivors. The studies a mobile app for cancer-related neuropathy in people with breast, colorectal, endometrial, pancreatic, and other cancers, who have finished treatment and are experiencing neuropathy.
- NCT01802346: Low Calorie Diet to Reduce Side Effects and Increase Response to Chemo in People With Breast or Cancer. This studies a low calorie diet to reduce side effects and increase response to chemotherapy in patients with breast or cancer.
- NCT02296450: Quality of Life (QoL) Assessment in Cancer Patients and Survivors With Dermatologic Conditions Using Dermatologic QoL Instruments. This large study is designed to see how skin conditions that are related to different kinds of cancer or cancer treatments affect a patient's overall well-being.
- NCT04586530: Telehealth and Memory Study (TAMS). The overall purpose of this trial is to confirm the effectiveness of Memory and Attention Adaptation Training (a cognitive-behavioral therapy) as a treatment for chemotherapy-related dysfunction among breast cancer survivors.
- NCT02290834: Chemotherapy-induced and brain changes in older adults with breast cancer. The study will investigate abilities and brain images before and after chemotherapy to identify people at risk for side effects, and to better understand the effects of treatment on brain structure and function.
- NCT02793921: Exercise Program in Cancer and Cognition (EPICC). This trial will study whether exercise, initiated before beginning aromatase inhibitor (AI) therapy, improves function in postmenopausal women with breast cancer.
- NCT04906200: Web-Based Symptom Monitoring and Self-Management Portal for Adolescent and Young Adult Breast Cancer Survivors. This compares a web-based patient-reported symptom monitoring and self management portal to standard therapy in young breast cancer survivors.
- NCT04049695: Improving Cognition After Cancer (ICAN). This study will test whether physical activity can improve cognition in breast cancer survivors and help the development of physical activity guidelines for cognition in breast cancer survivors.
- NCT04086875: A Text-based Tool to Improve Adherence to Hormone Therapy in Patients With Hormone Positive Breast Cancer. This trial studies how well text messaging works to improve adherence to hormone therapy in people with breast cancer.
- NCT04837820: The Effect of Acupuncture on Cancer-Related Difficulties. This study will test whether acupuncture can improve thinking and insomnia in breast cancer survivors. This study will also look at insomnia's link to difficulties.
- NCT03996265: Bupropion in Reducing Cancer Related Fatigue in I-III Breast Cancer Survivors. This will study how well bupropion works in reducing cancer related fatigue in I-III breast cancer survivors. Giving bupropion may improve cancer related fatigue in breast cancer survivors.
- NCT02831582: Omega-3 Supplementation to Prevent Aromatase Inhibitor-Induced in Patients With I-III Breast Cancer. This study looks at omega-3 fatty acid supplementation to prevent aromatase inhibitor-induced side effects in patients with I-III breast cancer.
- NCT03879629: TrAstuzumab Cardiomyopathy Therapeutic Intervention With Carvedilol (TACTIC). Breast cancer patients receiving Herceptin or other HER2-directed therapy are at risk of heart damage. This study is looking at whether drugs called beta-blockers could help.
- NCT02666378: Imaging Markers of Subclinical Cardiotoxicity in Breast Cancer. This research study is evaluating the use of Cardiac Magnetic Resonance Imaging (CMR) as a method of detecting early signs of damage to the heart that can be associated with anthracycline-based chemotherapy for the treatment of breast cancer.
- NCT04763174: An mHealth Symptom Management Intervention for Colorectal Cancer Patients (mCOPE). The study will look at a mobile health tool to meet the multiple symptom needs and stage-of-life challenges faced colorectal cancer survivors.
- NCT04713618: Changes in Pelvic Health, Sexual Function, and Quality of Life in Women With Pelvic Cancer Undergoing Radiation Therapy. This study looks at changes in physical measures and patient-reported outcomes of sexual function, intimacy, and quality of life.
- NCT04298827: Gyn Onc Prehab Study. This will study physical therapy, nutritional counseling, behavioral therapy versus physical therapy alone as part of a prehabilitation program. We will measure return of function after surgery, quality of life, patient satisfaction, and compliance.
- NCT04533763: Living WELL: A Web-Based Program for Ovarian Cancer Survivors. This studies a group-based and web-delivered tool for ovarian cancer survivors in increasing quality of life and decreasing stress, depressive mood, anxiety, and fatigue across a 12-month period.
- NCT05047926: Prehabilitation for Advanced Ovarian Cancer Patients. Prehabilitation may improve peri-operative outcomes in patients undergoing cancer surgery. This study will look at structured activity for women undergoing chemotherapy to improve their physical state prior to surgical intervention and thus improve outcomes.
- NCT04262336: Evaluating Safety and Efficacy of DB-020 to Protect Hearing in Cancer Patients Receiving Cisplatin. This study will look at whether DB-020 administered via an injection in the middle ear prevents hearing loss in people who will receive high doses of cisplatin.
- NCT03971591: Men Moving Forward: A Lifestyle Program for African-American Cancer Survivors (MMF). This study will look at Men Moving Forward (MMF), a community-based lifestyle intervention that supports adherence to nutrition and physical activity guidelines to promote improved body composition and lessen side effects of treatment.
- NCT05155501: Pelvic Fascia spARing Radical Prostatectomy TrIAL (PARTIAL). This clinical trial is studying whether pelvic fascia-sparing radical prostatectomy will have similar cancer control and sexual function outcomes; and significantly better urinary function, less penile deformity and inguinal hernia risks as compared to radical prostatectomy.