Hair loss during cancer treatment

Dr Rakesh Newaj educates us on hair loss during cancer treatment and offers ways to prevent it, as well as hair growth options after treatment.

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Hair loss, medically known as alopecia, is a concerning issue for many, affecting both men and women. It’s characterised by a noticeable reduction in hair thickness compared to a regular growth pattern. Experts can verify this by measuring hair follicle density and the thickness of individual hair strands. Typically, scalp hair grows around 1cm monthly and follows in various stages described below.

Understanding hair growth stages

Anagen (active growth phase): Spanning two to seven years, it dictates hair length. Around 85% of all hairs are in this stage at any given time.

Catagen (transitional phase): Lasting roughly two weeks, the hair follicle contracts and detaches from the skin’s underlying layer.

Telogen (dormant phase): Over about three months, 10 – 15% of hairs remain inactive while new ones commence their growth cycle.

Exogen (hair renewal phase): During this phase, old hair sheds and new hair continues its growth. Losing 50 to 150 hairs daily is a typical shedding rate.

Hair loss types

There are two primary hair loss types:

  • Cicatricial (resulting in permanent loss)
  • Non-cicatricial (often temporary if addressed promptly)

Those with cicatricial alopecia have limited non-surgical treatment options. In contrast, non-cicatricial types like telogen effluvium, marked by a disruption in hair’s natural cycle, can be diagnosed when more than 25% of extracted hairs are in the telogen phase.

Telogen effluvium

Telogen effluvium can sometimes be a side effect of medications, including chemotherapy drugs. These medications primarily affect the hair growth cycle by prematurely pushing hair into the resting phase. Such a shift can lead to significant hair shedding a few months later.

Chemotherapy targets fast-growing cancer cells but inadvertently affects hair root cells, hastening their transition into the dormant phase. Consequently, patients might experience hair thinning or even total hair loss, impacting eyebrows, eyelashes, and body hair. Hair loss often commences a few weeks after the start of chemotherapy and can persist for several weeks post-treatment.

Thankfully, this hair loss is generally temporary. Growth usually resumes between three to six months post-treatment, though hair might return with a different texture or colour. For instance, it could be curlier or grey until hair pigment cells reactivate.

Radiation therapy is another cancer treatment affecting hair growth, but its effects are localised to the treated area. Hair loss on the scalp is common if the head is the target. Like chemotherapy, hair tends to regrow post-treatment, though the growth rate and potential for permanent loss depend on radiation types and doses.

Cold caps

Cold caps which cool the scalp during chemotherapy may reduce hair loss by limiting chemotherapy delivery to scalp hair follicles. However, effectiveness varies, and some patients report headaches, or a brain freeze sensation.

Hair growth treatments

Accelerating post-chemotherapy hair growth is possible using treatments like minoxidil, available at dermatology clinics. Starting at 5% concentrations, it might take a few months before effects are visible.

Other treatments include platelet-rich plasma, mesotherapy, and gentle laser procedures, all of which yield better results when combined with minoxidil. Those bothered by temporary baldness might consider wigs or other concealment methods during recovery.

Dr Rakesh Newaj is a specialist dermatologist with special interest in skin surgeries. Since qualifying in 2010, he practises in Waterkloof, Benoni, Kempton Park as well as Mauritius. His special interest lies in skin cancers, hidradenitis suppurativa and stem cell and fat grafting.

MEET THE EXPERT – Dr Rakesh Newaj

Dr Rakesh Newaj is a specialist dermatologist with special interest in skin surgeries. Since qualifying in 2010, he practises in Waterkloof, Benoni, Kempton Park as well as Mauritius. His special interest lies in skin cancers, hidradenitis suppurativa and stem cell and fat grafting.

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