What exactly is chemo-induced hair loss?  Does this affect every chemo patient?

Monika Dockendorf: My treatment plan included four rounds of adriamycin and cyclophosphamide and 12 rounds of paclitaxel chemotherapy, which are almost guaranteed to cause hair loss in chemotherapy patients. However, not all chemotherapies cause hair loss and every patient seems to respond differently.

Bethany Hornthal: Chemo-induced hair loss is hair loss that comes as a result of the unfortunate toxic effect a chemotherapy drug can have on a patient’s hair. As a side effect to poisoning and destroying cancer, chemotherapy is not targeted and will affect many other fast growing cells in the body — including hair, nails and mucosal linings. Hair loss depends upon the type of chemo primarily, and secondarily, the individual patient’s biology and hair condition.

Is there any way for patients to prevent chemo-induced hair loss?

MD: Absolutely. Patients can now use scalp cooling technology, also known as cold caps, to prevent chemo-induced hair loss. These scalp cooling systems keep the head cold and narrow the blood vessels beneath the skin, reducing the amount of chemotherapy drugs that reach the hair follicles.

BH: Now there is. Through the use of scalp cooling systems that reduce the temperature in the follicle so that the blood vessels constrict, and allow much less chemo to reach the follicle. The coldness also slows the metabolic rate of the follicle cell and therefore adds further protection from damage due to the chemo toxins.

Are there any treatments on the horizon for chemo patients when it comes to preventing chemo-induced hair loss?

MD: There are many scalp cooling options available. However, I used an FDA-cleared scalp cooling machine during my chemo infusions with great success.

BH: Technology will continue to improve and post-infusion cooling times will continue to be refined with scalp cooling systems. More and more medical centers will be providing this option for their patients.

Why does hair loss occur in so many who are going through chemotherapy?

MD: Chemo drugs work by damaging or killing cells that are rapidly dividing in the body. When the chemo drugs damage the bad cells, they also damage some good cells. This would include the hair follicles on the head and all other parts of the body.

BH: Chemotherapy drugs are designed to destroy rapidly dividing cancerous cells. One of the problems with chemotherapy is that it is a systemic treatment that will affect any aspect of the system — in this case the patient’s body, that consists of rapidly growing cells. Hair follicles are an example of a rapidly growing cell, as are nail and mucosal linings such as those in the nose and mouth.

What should patients recently diagnosed with cancer and facing chemotherapy know and expect from treatment?

MD: Patients now have more control than ever over chemo-related side effects. Many side effects can be managed with medication, diet and exercise. In addition, hair loss is no longer inevitable thanks to today’s advanced scalp cooling technology.

BH: Depending upon the type of chemotherapy, there will be a number of probable side effects. Most of these effects are well known to a patient’s medical team, and many — such as nausea can be treated and sometimes prevented. Hair loss has now joined the ranks of those side effects for which there may very well be a treatment — scalp cooling that can mitigate the problem.

Is there anything specific you wish more cancer patients and their loved ones were told as they embark on this journey?

MD: Cancer treatments can have many side effects but the psychological aspect can often be overlooked by patients and their doctors. Having a good support system is essential and patients should consider therapy and support groups. Thanks to social media, patients now have access to online communities that consist of cancer patients and survivors sharing their stories and supporting one another. Sharing my story via Instagram connected me with other young women just like myself battling breast cancer. This online community helped me realize I wasn’t alone in this journey.

BH: Cancer takes a physical, emotional, psychological and even financial toll on a patient and their family. For some patients in financial need who are interested in scalp cooling, there is the national nonprofit organization HairToStay, which provides subsidies for scalp cooling.