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Chemotherapy & Hair Loss

Anagen effluvium is a type of reversible hair loss that can occur within a couple of weeks of initiating certain types of chemotherapy. Read more...



chemotherapy hair loss

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Why does chemotherapy cause hair loss?

There are various types of hair loss that can occur in the setting of chemotherapy for cancer. Anagen effluvium is a type of reversible hair loss that can occur within a couple of weeks of initiating certain types of chemotherapy. When certain types of chemotherapy are initiated, there is an abrupt disruption in the growth phase of the hair that can result in hair shedding.

What happens to hair follicles during chemotherapy that triggers hair loss?

At any point in time, each individual hair may be transitioning through one of three main stages: Anagen, Catagen, and Telogen. The Exogen phase referenced by some publications is a shedding phase that overlaps with the telogen phase and potentially anagen phase of new growth in the follicle.

Anagen is the active growth phase of hair. Catagen is a transitional stage that lasts only a few weeks where the hair follicle has stopped growing and separates from its blood supply. Telogen is a resting phase where the hair is sitting in the follicle, not actively growing. Telogen can last a few months. The Exogen phase is when these resting follicles are shed from the follicle.

Since anagen is the active growth phase for hair, when certain types of chemotherapy are initiated, there is an abrupt disruption in this phase resulting in shedding.

How long does it take after chemotherapy is started to lose hair?

Due to the fact that chemo is directly disrupting the active growth phase of the hair, hair can start to shed almost immediately. Most often we see it occur within a few days to weeks of the onset of chemotherapy followed by potentially complete loss by 2-3 months.

How long does it take for hair to grow back once chemotherapy is stopped?

Once chemotherapy ends, the hair can start to reenter its traditional cycles for growth. Usually, over 3 to 6 months hair regrowth is noted. However, it is important to note that it may feel a little different at first. Often the hair as it grows back will initially have a combination of soft fine hair and a curly or wavy look. The color may be grey or light at first before it darkens.

How can people undergoing chemotherapy deal with the stress and emotional impacts of hair loss?

There can be significant psychologic distress that accompanies hair loss of any type. Although there are not many therapeutic interventions shown to have significant benefits, it is important to remember that some insurance carriers may allot coverage for high-quality wigs if this is desired. Referred to as a cranial scalp (or hair) prosthesis, a letter from your doctor or dermatologist may be needed for your insurance to consider this coverage.

Are there any other types of hair loss that can occur during chemotherapy?

Although anagen effluvium is the type of a hair loss most are familiar with, the reality is that with newer immunotherapies available, anagen effluvium is not necessarily seen as often with these. However, telogen effluvium, a form of stress induced hair loss can occur as a result of the stress of the diagnosis, stress on the body from undergoing therapeutic intervention, or as a result of any emotional, physical, or psychological stress from other triggers. The nature of the hair loss varies however. Anagen effluvium can start almost immediately after the onset of therapy however there is often a delay of 3 to 6 months for telogen effluvium to occur.

What should a letter to my insurance company state for consideration of coverage for a wig?

Although many carriers can request specific details or documentation, a basic letter to consider for submission to insurance for considering coverage for a cranial scalp prosthesis (also known as a wig) for medical reasons:

To whom it may concern, [Patient name] has been under my care for alopecia as a result of anagen effluvium secondary to chemotherapy. This can be accompanied by significant psychological distress during the course of therapy. Please approve her for a cranial/scalp/wig prosthesis given the significant psychological distress this has caused. Please call with questions, [Physician name]

chemotherapy hair loss


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