Hair loss occurs because some drugs that treat cancer or radiation treatments can affect normal cells. This includes the cells that make hair grow. The hair loss with cancer treatment is not permanent. Hair grows back once the therapy has been completed. The amount of hair loss depends on the cancer drug, the dose of chemotherapy or radiation, and how it is given. In radiation, only hair that is in the area of radiation will be affected by hair loss. Only if radiation is given to the head will one lose hair on the head. Radiation to other body parts will not cause scalp hair loss. Radiation given to other parts of the body areas will not cause hair on the head to fall out. Very rarely with radiation, there might be an area where the hair is permanently thinner.

Patients often ask if there is anything that can be done to prevent the hair loss of chemotherapy. Generally, there is nothing to stop hair loss if the drug used is one that causes hair loss. With some chemo drugs, hair loss is a certainty.

To avoid hastening hair loss:

• Use mild shampoo and conditioner to less pull on hair while combing.
• Brush hair rollers and sleeping in hair curlers can cause pulling on the hair and cause it to fall out quicker.

When hair is falling out:

• Consider getting a shorter hair cut. Shorter hair is easier to manage under a wig. A shorter style will make your hair look thicker and fuller. It may also make your hair loss less upsetting.
• Some people choose to shave their head once hair starts falling out.
• Wear a hair net, soft cap or turban around your head at night to collect any loose hairs.

Be aware that during the period of time you lose hair, the scalp may be tender or sensitive. Some people tell of having a tingling feeling of the scalp during hair loss.

To lessen scalp irritation:

• Use a soft hair brush to lessen scalp irritation and pull on the hair shaft.
• Permanent wave solution may irritate the scalp and hasten hair falling out.
• Use hair dryer on low heat to lessen dryness and irritation of the scalp.
• Use a satin, polyester, or cotton pillow case, rather than a nylon pillow case, which can cause irritation.
• Wear sun screen on scalp with thinning/no hair. Cover the scalp with a hat when out in the sun.

Caring for new hair:

• Shampoo twice a week.
• Thoroughly massage scalp to remove any scaling.
• Avoid high heat from hair dryers.
• Keep hair styling to a minimum, as new hair is prone to breaking.
• Avoid vigorous brushing, hair pins, curlers, curling irons.
• Use wide tooth combs.
• Chemical curling is best avoided until hair is 3 inches long. Many people cannot tolerate permanent wave solution on their scalp for up to a year following chemo or radiation.
• Hair coloring can be irritating to the scalp. Permanent hair coloring is the most damaging to the hair shaft. Semi-permanent hair coloring products—those that wash away—may be less harsh to the hair shaft. Most experts recommend waiting at least three months after the last treatment before using any type of hair coloring products.

Wigs

Many people say buy a wig before you lose your hair. However, the wig may not fit as well when your hair is completely gone, if fitted while hair is still present. Shop for the wig while you still have hair, but have it fitted after the hair has been lost.

• There are full service wig salons that fit and style wigs.
• Wig salons also sell turbans and scarves that come in a variety of colors and fabrics so that you can look good even when you are lounging at home or at bedtime.
• The lining of a wig can sometimes irritate the scalp. It may be helpful to wear a thin cotton scarf or skull cap under the wig. These are usually available from wig suppliers.
  • The American Cancer Society (800-227-2345) and Cancer Care, Inc. (800-813-4673) are organizations who assist those with cancer therapy hair loss to obtain wigs at no cost.
  • Patients at University of Iowa Hospitals and Clinics who can not afford a wig should contact the Fourth Floor Salon. Staff of the Fourth Floor Salon are trained Look Good Feel Better consultants. Look Good Feel Better is a free program that helps cancer patients improve their appearance and self image by teaching hands on techniques to over come appearance related side effects of chemotherapy and radiation treatments. To make an appointment, call 319-356-1996 or 6-1996 within the hospital. The Fourth Floor Salon is located in E424 General Hospital.
  • Some insurance plans cover the cost of wigs. Check with your particular insurance company.
  • If you buy a wig, save the receipt. It can be a medical tax deduction

Drugs that usually cause hair loss:

• Adriamycin
• Daunorubicin
• Etoposide (VP-16)
• Irinotecan
• Cyclophosphamide (Cytoxan)
• Epirubicin
• Docetaxel (Doxil)
• Paclitaxel (Taxol)
• Ifosphamide
• Vincristine
• Vindesine

Drugs that sometimes cause hair loss or thinning:

• Amasacrine
• Cytarabine (ARA-C)
• Bleomycin
• Busulphan
• 5-Fluorouracil (5-FU)
• Melphalan
• Vinblastine (Velban)
• Lomustine (CCNU)
• Thiotepa
• Methotrexate
• Mitoxantrone
• Mitomycin C

Drugs that usually do not cause hair loss:

• Carmustine (BCNU)
• Carboplatin
• Cisplatin
• Procarbazine
• 6-Mercaptopurine
• Streptozotocin
• Fludarabine