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Chemo-induced hair loss- alopecia therapies

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Alopecia aka baldness, runs in my family. So when I began chemotherapy treatment after my cancer diagnosis and my hair fell out, it was no big deal for me. I looked like Michael Jordan…kinda. My wife said I looked like Powder.

No only did the hair on my scalp fall out but so did my eyebrow hair, chest hair… every hair fell out. That is why I posted that image of the kid in the upper right corner. That is me before and after chemotherapy.

Now that I’m studying the short, long-term and late stage side effects of chemotherapy and radiation, I’m learning that chemotherapy-induced alopecia is a very big deal for some newly diagnosed cancer patients. And that there are therapies that can reduce/prevent hair from falling out or therapies that can speed the regrowth of hair once it does fall out.

To learn more about chemotherapy-induced alopecia please read the two studies linked and excerpted below.

The takeaway for anyone diagnosed with cancer who is confronting chemotherapy and radiation is that just about every side effects I’ve studied has evidenced-based therapies shown to either minimize, prevent or possibly health the specified side effect.

Are you a cancer survivor? Are you dealing with short, long-term or late stage side effects? If you would like to learn more about your side effects and therapies shown to heal them, scroll down the page, post a question or comment and I will reply to you ASAP.

Thanks and hang in there,

David Emerson

  • Cancer Survivor
  • Cancer Coach
  • Director PeopleBeatingCancer

Chemotherapy-induced hair loss aka alopecia

Managing hair loss: Effective treatment strategies to restore patient confidence

“Key Takeaways

  • Hair loss can cause considerable distress in patients and negatively affect body image, self-esteem, and well-being.
  • Interventions to mitigate hair loss or its impact depend on etiology; eg, scalp cooling may be prescribed as a preventive measure before chemotherapy, or minoxidil may be prescribed for chronic telogen effluvium.
  • Because effective treatment options are limited, physicians can advise patients on various coping strategies.

Whatever the etiology, hair loss can be severely distressing to patients. The sociocultural importance of hair cannot be downplayed, with even limited hair loss resulting in negative mental health effects and loss of psychosocial function in some patients.

It’s important for physicians to address these effects of hair loss, as well as impact on quality of life. In writing for the journal Skin Appendage Disorders, Cameron Moattari, MD, and Mohammad Jafferany, MD, recommend that dermatology and psychiatry residents specifically learn how to manage psychodermatology and psychotrichology issues via dermatology-psychiatry liaison clinics.[1]

Although the psychological impact of hair loss is uniformly detrimental, strategies to combat hair loss in patients ultimately tie back to etiology…

Moattari and Jafferany wrote that complete hair loss manifests between 2 and 3 months following chemotherapy. (Some evidence shows that hair is lost in an androgenic pattern.) Hair typically regrows between 1 and 3 months following the discontinuation of the therapy, but 65% of patients regrow hair of a different color, thickness, or texture.

The prospect of chemotherapy-induced hair loss can be so distressing that 8% of women consider foregoing chemotherapy altogether. Moreover, Moattari and Jafferany noted results of a cross-sectional study indicating that 55% of women felt severe psychological distress due to anagen effluvium, which was negatively linked to lower body image, decreased well-being, and depression.

There are limited treatment options for patients with chemotherapy-induced hair loss. Medications like minoxidil have not been shown to be beneficial in these patients. Results from Moattari and Jafferany’s meta-analysis suggest that preventive scalp cooling may help mitigate hair loss by vasoconstricting scalp vessels and decreasing hair-follicle biochemical activity.

The American Cancer Society (ACS) noted potential treatment options that work by cooling the scalp.[3] “Controlled studies of older forms of scalp hypothermia (such as using ice packs) have had conflicting results. However, some studies of newer, computer-controlled cooling cap systems have shown benefits.”

“Recent studies of women getting chemo for early-stage breast cancer have found that at least half of the women using one of these newer devices lost less than half of their hair,” the ACS said in the online report. “The most common side effects have been headaches, neck and shoulder discomfort, chills, and scalp pain. The success of scalp hypothermia may be related to the type of chemo drugs used, the chemo dosage, and how well the person tolerates the coldness.”

Of note, a handful of scalp cooling devices like Paxman and Amma are FDA-approved for chemo-induced hair loss.

Providers should note that wigs or other scalp coverings may be covered by insurance. When prescribing, use the term “cranial prosthesis” and not “wig,” the ACS advised…

Diagnosing and treating: Alopecia areata

This hair-loss disorder is marked by temporary, nonscarring alopecia secondary to an autoimmune cause, with stress also playing a role. Hair loss can be in circumscribed patches or total…

Standard treatments for alopecia areata are topical or injected corticosteroids. Patients with alopecia areata should be screened for mental health concerns. Psychosocial interventions include antidepressants, psychotherapy, hypnosis, and the use of synthetic wigs…

Diagnosing and treating: Telogen effluvium 

Telogen effluvium occurs between 2 and 3 months following a triggering event, with remission in 95% of cases. The chronic form affects middle-aged women and exhibits a fluctuating clinical course that lasts greater than 6 months and may not be linked to an inciting event…

Triggering events include comorbidities, major emotional stress, nutritional deficiencies, hormonal imbalances, and drugs. 

As for treatment, minoxidil may help stimulate hair growth—especially in those with chronic telogen effluvium—as well as discontinuing any medications causing hair loss…

A randomized trial of minoxidil in chemotherapy-induced alopecia

Background: Hair loss is a side effect of many chemotherapeutic agents, and patients have even refused possibly palliative or lifesaving drugs because they could not accept temporary or prolonged baldness. Topical minoxidil has been shown to be effective for androgenetic alopecia and alopecia areata…

Results: There was a statistically significant difference (favoring minoxidil) in the interval from maximal hair loss to first regrowth. Thus the period of baldness was shortened (mean, 50.2 days) in the minoxidil group.

Conclusion: Minoxidil decreased the duration of alopecia caused by chemotherapy. There were no significant side effects.



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