How to Prevent Hair Loss During Chemotherapy

How to Prevent Hair Loss During Chemotherapy

Alopecia is a pathological hair loss that leads to their partial or complete disappearance in certain areas of the head or trunk.

Alopecia with chemotherapy is a manifestation of toxic damage to the skin appendages when using some anticancer drugs. This complication occurs as a result of the suppression of the proliferation of the epithelium of the hair follicles.

Alopecia is a common side effect of cytostatic therapy and, at the same time, a psychological stress factor in patients undergoing chemotherapy. Even temporary hair loss has a negative impact on social activity, body image of patients and can cause emotional distress.

Why does hair loss occur?

Cytostatic drugs inhibit the process of dividing not only rapidly dividing tumor cells, but also cells of the hair follicle. This leads to hair loss, not only from the scalp, but also from other parts of the body. In some cases, eyebrow and eyelash loss may occur.

What determines whether the hair will fall out or not?

  • from age
  • from concomitant diseases of the skin and appendages
  • from drugs that are injected
  • on the dose of drugs and the route of their administration

The most serious factor in the likelihood of side effects is the total dose of the chemotherapy drug, as well as the duration of its use during the procedures. It is known that the increased toxicity of various medicines is characterized by their combination. For example, the use of platinum alone causes the development of grade II-IV alopecia in 25% of patients, and the addition of paclitaxel to platinum causes baldness in 86% of patients.

Most often, hair loss occurs during use:

  • cisplatin;
  • taxanes – paclitaxel and docetaxel;
  • topotecan; gemcitabine;
  • etoposide;
  • including oral dosage forms;

Against the background of combined chemotherapy, the risk of developing alopecia increases, and therefore such treatment, as a rule, leads to the development of baldness.

The chemotherapy regimens that most often lead to alopecia are:

  • taxol + doxorubicin (AT) – grade III – IV alopecia in 92% of patients;
  • 5-fluorouracil + doxorubicin + cyclophosphamide (CAF) – grade III – IV alopecia in 89.5% of patients;
  • doxorubicin + navelbine + cyclophosphamide – grade III – IV alopecia in 78% of patients;
  • Taxol + Navelbin – grade III – IV alopecia in 66% of patients.

Hair loss usually begins 2-3 weeks after chemotherapy.

It is also important to remember that alopecia can develop after radiation therapy, depending on the area of ​​exposure and the dose received.

Does the hair grow back after treatment?

After the final completion of all courses of chemotherapy, hair will usually grow back. The hair regrowth process can take 6 to 12 months. Unfortunately, hair does not always grow back completely after radiation therapy.


Hair loss cannot be completely prevented, but it can be somewhat reduced by following general recommendations. hair care and certain medical procedures.

Unfortunately, there are no drugs that would give a complete guarantee of hair preservation during chemotherapy. Nevertheless, the follicles after chemotherapy resume their growth, so hair restoration after chemotherapy will certainly happen – it’s only a matter of time.

General recommendations

  • Wash your hair with warm, not hot water and only if necessary, strictly not daily.
  • Gently towel dry your hair after washing, do not rub your hair intensively, do not twist it.
  • Use mild, normal pH, non-sodium lauryl sulfate shampoos and rinses for hair. baby shampoos work well.

It is recommended to make frequent nourishing masks, as well as greenhouse masks for hair from olive, nettle or burdock oils. Do not use a comb with fine, fine teeth, they will tear your hair. Comb your hair with a soft, wide-toothed comb. It is not recommended to comb wet hair, let it dry first.

  • Do not blow-dry your hair or other styling equipment, as they burn the roots and tear the hair. Let your hair air dry.
  • Do not dye your hair, do not use hairsprays, exclude chemicals.
  • Use only satin bedding. On a pillow made of this material, the hair almost does not rub.
  • Wear a special hat or scarf at night. This will help prevent your hair from rubbing against the bedding or tangling.
  • Hair loss is exacerbated by open sun and temperature extremes. Never go outside with a wet, dry head.
  • Wear a hat when outdoors, even if it’s warm. Be sure to wear a hat if the sun is shining brightly.
  • If your hair begins to fall out, cut it short.
  • In case of hair loss, patients find different ways out – a scarf, caps, shawl, wig, ladies’ hats without brim.

Cryotherapy in the prevention of alopecia on the background of chemotherapy. The goals of cryotherapy are to uniformly cool the scalp to 4 o C.

At the same time, the arterial vessels are sharply narrowed, the level of blood circulation in the scalp decreases. The cold prevents toxic drugs from penetrating the hair follicles and destructively affecting them. Deep cooling of the scalp provides the effect of protecting the scalp not only during the session, but also within 24 hours after its end, which is usually sufficient to remove most of the drugs that have a negative effect on the skin appendages.

  • The effect of preventing the toxic effect of cytostatics is the result of:
  • partial restriction of the delivery of cytostatics to the hair follicles;
  • violations of the processes of their accumulation in cooled areas;
  • reducing metabolic activity and reducing the binding of drugs to tissues.

How is the procedure performed correctly?

Pre-cooling. It is mandatory before the start of chemotherapy, it takes 20-30 minutes.

Cooling during the entire period of chemotherapy;

Cooling down after a chemotherapy session. Cooling continues for another 1 – 2 hours after completion of the administration of chemotherapy drugs. The duration depends on the aggressiveness of the treatment.

Typically, patients tolerate this procedure very well, with no pain or sudden cold.

During the pre-cooling phase of the scalp, after wearing the cap, you may feel a little discomfort and cold (similar to the sensation of being in cold air without a headgear). Sometimes, patients feel soreness in the forehead, ears, nape. These sensations will gradually disappear within 10-15 minutes after the start of the procedure – there is an addiction to the cooling effect.

Contraindications to cryotherapy:

  • tumors of the blood and hematopoietic organs (since the preservation of tumor cells is possible);
  • allergy to cold;
  • agglutination;
  • metastases to the scalp;
  • forthcoming radiation therapy to the skull.
  • Scalp care after hair loss

After hair loss, scalp burning should be avoided as it is more delicate on the scalp than on other areas of the scalp.

  • when going outside, always wear a hat (panama hat, stole, etc.);
  • use hats during the cold season;
  • use moisturizers and sunscreens on the scalp, even if the sun is not very bright. The scalp burns easily, this can damage hair regrowth;
  • sleep on satin bedding.
  • Self-massage of the scalp
  • Massaging the scalp with your hands also helps to warm up its skin.

During self-massage, stroking with fingers is performed in the direction from the forehead to the temples and to the back of the head. The impact should be more or less intense so that the skin turns pink. It is also recommended to move the skin slightly from place to place, acting in different directions.

Self-massage of the head should not be done if the alopecia is focal. In this case, the massage can immediately cause the remaining hair to fall out.

Laser therapy in the treatment of alopecia with chemotherapy

Laser therapy is performed using cold lasers that stimulate hair growth. Such therapy is based on the principle of photo-biotherapy – absorption of radiation by cells and stimulation of cellular metabolism, including protein synthesis.

Laser beams have a red light and are generated in a laser diode, its energetic strength is lower than the level of laser light that is used for cauterization. Low power of red radiation has a small ratio of penetration into human tissue, which means that it is safe for use, including in cancer patients.

Regrown hair care

Regardless of how a person cares for hair, the rate of hair growth after the complete cessation of chemotherapy is from 0.5 to 1.2 cm per month. When hair is just starting to grow back, it is very important to use moisturizers to help relieve the itching that occurs during hair growth.

The first hairs that can be seen tend to grow quite thin. In order to eliminate this problem, it is better to trim or shave them off. If the hair starts to grow unevenly in patches, shaving is also recommended to help achieve a more even distribution. Hair coloring after chemotherapy is possible not earlier than 6 months after the end of treatment.

To improve the quality of hair, you need to contact a trichologist. It helps to choose the right masks for the scalp and hair, vitamin complexes that improve the growth and condition of skin appendages, including hair.

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