Losing hair is a common side effect of chemotherapy and radiation therapy. This is due to the effect of the therapy that targets the cancer cells affecting the hair growth cells. The thinning of hair starts from 7 to 10 days after the first treatment. Some people prefer to cut their child’s hair short or shave off their hair completely. The risk of hair loss varies from treatment to treatment and it can be different for each patient. The hair loss due to the chemotherapy treatments is only temporary and they tend to grow back once the treatment ends. Some changes might be visible that are quite lasting once the hair grows back after the therapy. Hair loss can be highly worrying and distressing in children and teens. Their healthcare team will help them guide them on how to overcome this and assist the families with the knowledge of the specific families that can cause hair to fall and what to expect.

Hair Loss as a result of chemotherapy

Hair Fall is not consistent with all chemotherapy methods. Some medications administered during chemotherapy can cause high risks of hair loss while some cause hair to fall out less often or the hair loss may not even be noticeable. The degree of hair fall depends on the type, schedule, and dosage of the medication being used. 

It is first visibly seen on the scalp toward the front of the head due to the hair naturally not being thick in that area. Some patients experience gradual thinning or patchy hair loss while some develop complete baldness. Chemotherapy affects hair all over the body including eyebrows, eyelashes, and body hair.

Why does hair fall occur during chemotherapy treatment:

The place where hair grows takes place under the surface of the skin. The process of hair growth is a cycle where it starts from active growth to shedding. The locations that are administered during chemotherapy treatment can sometimes harm the cells that control air growth and the follicle where the hair develops. This is the reason why hair falls out and why it prevents new hair from growing back. 

What are the factors that increase the risks of Hair Loss during chemotherapy

Dosage: The higher the dose of chemotherapy edition administered, the higher the risk of hair fall

Route of administration: The medication has a greater risk when taken orally

Frequency: The hair loss in patients getting chemo every 2-3 weeks is higher when compared to those getting a weekly regimen of chemotherapy.

Singular medical administration or combination: Combination chemotherapy also increases the risk of hair loss

Other factors that cause severe hair fall conditions are in patients who have already been under chemotherapy treatment, performed radiation therapy to the scalp, and those having Graft versus host disease (GVHD).

How to cope with Hair Loss

Hair loss can indeed be upsetting and it is also a visible reminder that an individual is sick. Children and teens trying to fit in can find it difficult as it affects their well-being and their quality of life. Understanding such emotional and psychological difficulties the child is facing, we offer assistance through our social workers, child life specialists, and psychologists. These professionals not only provide the necessary help for the children but also prepares the families of the child to provide resources. Hearing from other people undergoing the same condition also helps.

What should be discussed with the physician before treatment?

The side effects of the treatment plan should be discussed with your child’s healthcare team. Whatever the side effects, plan it with the healthcare team accordingly. One can’t predict the possibility of hair loss, however, the specialists will determine whether any particular treatment will cause hair loss or not. 

Be prepared: 

Losing hair during treatment can be sudden or gradual. It can be both surprising and scary when it happens. You will notice that your hair will just fall out in the shower while you take a bath or brush your hair. The specialists will take it upon themselves to make it clear and help prepare the parents and the children under such circumstances using age-friendly information. 

Make a plan: 

Be prepared with the next step on what to do after your hair falls out. Some of them cut it short or shave their head before their hair starts to fall out while others wait to see what happens. Though it may seem the right time to check out a crazy cut or a hair color, you need to talk to your specialist before you start using any kind of chemical product for your hair. It is also necessary to remember that the chemical components in the hair dye can also lead to hair damage.

Headcovering option: 

You can think about using hats, head scarves, and wigs before your hair starts to fall. Going for head accessories shopping can give the patient personal control and have a choice on the matter. There are various options to choose from. A variety of style hats and wigs are available and are socially designed for children too.

Hair Loss during treatment

Hair should be treated gently:

If you have decided to wash the hair, use a mild shampoo to clean the hair and scalp. Avoid aggressive rubbing and wash gently. Dry the hair by patting gently with a towel. The hair should not be washed every day and the accessories used to brush can harm, it should be either a soft brush or a wide-toothed comb. Avoid using hair accessories that tend to get tangled or pull on the hair. 

Skin protection: 

The skin that is exposed to radiation therapy is quite sensitive. The scalp can become flaky, tender, and red following the instructions of your healthcare specialist for ideas on how to take proper care after the patient has undergone radiation therapy. Additional measures can be taken by limiting the sun outdoors, using sunscreen, and wearing a hat. 

This can be quite a difficulty for them to deal with. Therefore, talk to them and have an open conversation about how they feel. Hair loss can especially be difficult for children who are going back to school or social activities after treatment. Teach children how to respond to situations that might occur or even bullying that might likely occur. Do not worry as in most cases, kids are just curious. So it is better to be prepared with any likely questions that your child might face as this might lessen the chances of not spoiling your child’s mood.

Children and teens are quite conscious of their body image concerns during and after cancer. Though some try to cope as effectively as possible, some experience anxiety and depression. They tend to avoid social activities and stay away from their friends. If there is no improvement in your child’s behavior, talk to a mental health professional. 

After treatment

• The hair and scalp should be taken great care of. Continue the handling of their scalp and treat their hair gently. Avoid exposure to the sun
• Let the hair grow well before you start using any coloring or chemical products.
• Never use any supplement or topical hair treatments for hair regrowth. If you intend to do so, talk  to your doctor before you start using them
• Seek professional help from a hairstylist who has worked with cancer patients, with regard to treating the hair during the growing-out process. 

The coping of each patient during the entire process can be different. The advice and coping methods of what is suitable for one might not be suitable for another. A common example is that, in some cases, the friends and the family of the patient will shave their heads in support to show that the child is not alone, but for some, it might make them feel worse. Looking at their family members without hair is yet another constant reminder of their condition and makes it difficult to go about their everyday life. To avoid such situations, the family and friends can ask the child what they prefer and express their support in such a way.

The recovery process is never smooth, they may have ups and downs. Sometimes going out for gatherings or any events can be embarrassing. The process up until hair regrowth can cause the child to experience a roller coaster of emotions. They feel self-conscious and anxious and frustrated, sad and angry. All of these are quite common and that surface at any time. Encourage them to open up to someone trustworthy, a friend, or a fellow patient who will provide them the support they need. It all narrows down to coping. If the negative emotions are overwhelming and interfere with the efficient functioning of the child, the time has come to seek help from a professional. There are various resources and specialists ready to help your child. 

Questions frequently asked:

Does chemotherapy cause Hair Loss?

Well, it depends on the type of chemo medications used and the dosage amounts. Not all chemotherapy causes hair fall. Though some may cause thinning hair, it is quite natural that a patient undergoing chemotherapy will lose all the hair in their body including the eyelashes, eyebrows, and body hair. The type of chemotherapy administered is what determines hair loss and how it occurs.

Once the chemotherapy starts, how long until the hair falls?

Most commonly, Hair will start falling after 2-3 weeks of starting the therapy. It can be sooner or later depending on the type of the medication and the dosage amount. 

How long until my hair grows back?

The hair loss that occurs due to chemotherapy is just temporary but once the treatment ends, the hair starts to grow and the baby hair will look like a ‘peach fuzz’, and once the cycle becomes normal the hair growth also resumes to be normal. It can take up to 6-12 months for the hair to reach its full thickness. The caregivers need to make the child understand that it is quite common and regarding the hair length, it can take quite a long time. Let them know that hair grows about 6 inches per year.

Does hair loss happen after graduation therapy?

The hair loss after graduation therapy is limited to only the area where the treatment is being administered. The hair on the head will not be lost unless radiation therapy is done to treat any tumor in the head region. However, if they take chemo medication in addition to radiation therapy, hair loss does happen. 

Is it possible to prevent Hair Loss during chemo?

There are no safe and effective chemo practices currently available. However, the scalp cooling method can be done and the cooling cap that is used to do so has proven to be highly effective in preventing hair loss in both children and adults. Research is yet to be done on the matter.