Chemotherapy Fact Sheet

The word 'chemotherapy' conjures up fear in patients but it should be looked upon as a course of treatment doing good and not harm.

Chemotherapy is a medical term for a course of treatment and is normally a combination of medication given to patients either in tablet form or by injections, which are prescribed by a specialist at a hospital.

While on the course of treatment, changes are taking place within the body. The main change that I deal with on a regular basis is the possibility of diffuse hair loss and in some cases total hair loss, including facial and body hairs.

When Your Hair Starts to Fall Out

It is usually after the second treatment, but this can vary from patient to patient and the hair loss is normally of a diffuse type. It is important to remember that, once the hair starts to shed, it will not be affected by handling, such as brushing or shampooing although some patients think that, if they do not handle their hair, it will not fall out. In fact this is not the case. This type of diffuse loss means general thinning all over the scalp and body and not in patches.

This diffuse hair loss can be upsetting - not only to the patient but also their close family and friends - and it has been my experience that the older the child in a family where hair loss occurs, the more they appear to be affected by the visual changes associated with hair thinning and total hair loss. Also at this time the patient may be having feelings of mixed emotions, such as anger, panic, fear and trying to keep things as normal as possible; when lots of things are going on around them and they are not feeling at their best.

Maintaining Scalp Cleanliness During Hair Loss

During the period of shedding it is best to keep the scalp clean by shampooing as normal, as hair may become entangled as it falls away from the hair follicles. Shampooing does not increase the hair loss but makes the scalp feel more comfortable and, when the hair starts to regrow, the scalp is also in the optimum condition.

The other reason that the hair or scalp should be shampooed regularly is that, if you decide to wear a hat or wig, then the scalp has a covering of sebum (sweat) and this can leave the surface sore along with an odour.

Many years ago I visited a patient in hospital who would not allow anyone to touch her hair, but she was in a lot of pain as the lost hair had become entangled with hair that was still securely anchored within the follicles.

I sat and spent an hour or more listening to her concerns; with the main one being that she felt that, if her hair was cut, she would never have it back and she would not feel feminine. I explained that she would feel more comfortable and there would be less chance of infection if the hairs that were under tension were removed. She agreed and I cut away the matted hair and fitted a wig, which was then cut and styled to suit her.

A few months later, the lady came to see me. Her hair had re-grown and she said that it had really helped to discuss her fears and that the wig helped her through a period of her life which was both physically and emotionally dfficult.

The Resting Phase and Regrowth

While on the chemotherapy treatment all the hair is put into its resting phase known as Telogen. Whatever their age, everyone has some proportion of their hair which is in its Telogen phase at any given time, which is why most people lose around 50-150 hairs per day. However, due to the medication, the hair follicles stay in this resting phase and remain dormant until the chemotherapy has been completed. Once you have completed your course of treatment you usually start to see fine white vellous hairs which can resemble soft baby like down approximately within 4-6 weeks.

When the course of treatment is completed, the hair will start to grow back. It is at this point that the hair is fine (vellous) and normally white in color, but very soon, maybe within 4-6 weeks, returns to its natural shade and texture (terminal) as it was before the treatment commenced. Some patients have reported that their hair is better than before their treatment started. Once the hair is in the terminal stage it will take 12 months for it to reach the length of 6 inches, as hair grows at ½ inch per month.

At the hospital you may be advised to consider wearing a wig by either the Doctor or the nursing staff. It is at this point that you may feel that you will never have your own hair back again. This is not so. The hair will re-grow after the course of treatment has been completed.

Wigs do look more natural if they are fitted correctly such as having alterations to the foundation, cutting and styling to the individual’s requirements. If you take time to chose the basic style and then have it altered to suit you it can be the most uplifting part of your treatment. Not only do you feel and look like you did before but your family and friends can also feel more at ease. Wigs look more natural if they are one shade lighter than your own hair color, as your skin tone does change while under going any intensive medical treatment.

Patients can also consider using the Intralace System™, which at first may act as a wig, but as soon as hair starts to regrow this system will allow full integration with the new hair coming through. This system or a wig would be used until the hair was long enough for a short hair style or patients can consider fine hair extensions to increase their newly re-grown hair length. Hair length needs to be 4 – 5 inches for the successful application of hair extensions.

However some patients are more at ease not wearing a wig. It must be said however that the head can suffer from direct sun light and in the cooler weather feel extremely cold and for this reason then it may be necessary to wear hats, turbans or scarves.

Finally, the wearing of Intralace System™, wigs, hats, turbans or scarves does not stop hair growth. In fact, keeping the head covered and warm encourages hair growth.

If you require any further help or advice please contact the Lucinda Ellery Consultancy by one of the methods below to arrange a consultation.