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Coping with hair loss

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Coping with Hair Loss
Publisher   JASCAP, Mumbai 400 055

Printer     Surekha Press, Mumbai 400 019

Edition     October 2011
Contents

    Hair loss

    Emotional support

    Cancer treatments & hair loss

    Practical help

    Looking after your hair

    Looking after your skin

    After treatment

    Wigs & hairpieces

    Tips for wearing a wig

    Other types of headwear

    Diverting attention

    Children & teenagers

    Eyebrows & eyelashes

    Scalp cooling
Coping with Hair Loss

This section gives information and advice to help you to look after your hair if it becomes thinner or is in bad
condition during cancer treatment. It also gives information on how to cope emotionally if your hair is lost
completely and how to get, pay for and look after a wig. The alternatives to wearing a wig, such as hats,
headscarves, and turbans are also discussed.



Emotional Support to cope with Hair Loss
If your hair falls out or thins it can be very upsetting. Some people find that it is one of the hardest parts of having
cancer treatment. You may have many different emotions – ranging from anger to anxiety, to feeling low and
depressed. Some people worry about how their appearance will affect their relationships with family and friends.
You may also feel uncomfortable about socialising if you feel that you look different.

Most people find that their family and friends are very supportive and that it can help to talk through their feelings
about losing their hair.

At the hospital you will probably meet other people who have had hair loss and they can often give helpful advice
and personal hints on how they have coped. You can also meet other people whose hair has fallen out at cancer
support groups.

You can talk to the nurses if you find it difficult to cope with your hair loss or other aspects of your cancer and its
treatment. The nurses can give you information on how to contact a counsellor.

Many people see their hair as a very important part of their appearance. For some people, losing their hair can
cause very strong emotions, such as anger and depression. While you are going through treatment and having to
cope with many changes to your life, losing your hair may seem like the final straw. It can also act as a constant
reminder that you have cancer and may make you feel vulnerable and exposed. If your eyebrows and eyelashes
also fall out this can make you feel even more vulnerable. Losing a beard or moustache can really affect the way a
man feels about himself. These reactions are completely normal. It may take a while to come to terms with hair
loss.

"I have to confess the first sight of myself in the mirror did come as a horrible shock. In all the time I needed my
wig I never came to recognise that reflection as being me: a truly weird sensation."

Some people find that losing their hair is not as bad as they had expected. One person said:

"Losing your hair is not that bad really. I had lots of fun with different wigs and styles. In fact I got more
compliments than I ever had before. I was even asked by a stranger where I got my hair cut – I was wearing my
wig at the time."

In some cultures, hair is seen as a symbol of fertility and desirability, or a sign of health and status. Some cultures
believe that hair gets rid of impurities from the body. If hair has a special significance for you it can be even more
difficult to adjust to losing it.


Cancer treatments and Hair loss

Cancer treatments such as chemotherapy and radiotherapy can make your hair fall out. There are many ways of
dealing with this. You may not mind your bald head, but if you do want to cover up there are many types of wigs or
hairpieces, hats, turbans, or scarves that you can use.

Chemotherapy
Chemotherapy is a treatment which uses anti-cancer drugs to destroy cancer cells. The drugs work by attacking
the cancer cells and disrupting their growth. Unfortunately, they can also affect the normal cells in the body,
including the cells of the hair follicles. This causes hair loss, also known as alopecia. Unlike cancer cells, however,
the normal cells quickly recover, so if you lose your hair due to chemotherapy it will grow back when your

                                                            1
treatment is over. Before you start chemotherapy, your doctor or chemotherapy nurse will discuss the possibility of
hair loss and other side effects with you.
Not all chemotherapy drugs make your hair fall out, and sometimes the loss is so small it is hardly noticeable.
Some people, however, have temporary, partial or complete baldness. Some chemotherapy drugs make other
body hair fall out, such as eyebrows, eyelashes, beard, moustache, chest, underarm, leg and pubic hair. The
amount of hair that falls out, if any, depends on the drug or combination of drugs used, the dosage given and the
way that your body reacts to the drug.

"Think of the joy of several months free of the chore of waxing or shaving your legs, underarm or bikini line."

If your hair is going to fall out, it usually starts within a few weeks of starting the chemotherapy, although very
occasionally it can start within a few days. The first thing you may notice is that your hair starts to come out when
you brush, comb or wash it. You may also find hair on your pillow in the morning. We offer advice about looking
after your hair during this time.

For some people their hair may just thin and become dry and break easily. For other people the hair may carry on
falling out over a couple of weeks so that they become completely bald. Sometimes the hair comes out very
quickly over 1–2 days, which can be very shocking. Your scalp may feel tender or sore as the hair falls out.

Preventing hair loss during chemotherapy
By cooling the scalp it is sometimes possible to reduce the amounts of chemotherapy drugs that reach the hair
follicles. This reduces, and in some cases prevents, the hair from falling out. It is done by using a 'cold cap' or a
machine which cools the scalp. There are many different ways of cooling the scalp so the methods used vary from
one hospital to another. Some hospitals do not have facilities for scalp cooling.

Types of scalp cooling

Some commercially made 'cool caps' contain a gel that stays cold for a long period of time. The caps can be
applied easily and kept in place by Velcro. Usually the cold cap needs to be worn for some time before the
chemotherapy drugs are given. It is worn while the treatment is given and then for up to two hours afterwards. The
cap can be very uncomfortable and heavy and may give you a headache. However, the chemotherapy staff will do
all they can to make you as comfortable as possible. Some types of scalp cooling use a machine (like a
commercial hair dryer) that circulates a coolant through the cap.

Unfortunately cold caps are only effective when used with certain chemotherapy drugs. Also they may not be
advisable when treating some types of cancer. Your doctor or chemotherapy nurse will be able to tell you if scalp
cooling is available and whether it is appropriate for you.

How will my hair grow back after chemotherapy?

Your hair may begin to grow back before you finish your treatment. At first the hair is very fine but you will
probably have a full head of hair after 3–6 months. You may find that your new hair is curlier or finer than it was
before. It may also be a slightly different colour, or sometimes a mixture of dark and grey hair.

Very rarely, after high doses of chemotherapy the hair does not grow back, but this is unusual.



Radiotherapy

Radiotherapy treats cancer by using high-energy rays which destroy the cancer cells, while doing as little harm as
possible to normal cells.

Unlike chemotherapy, radiotherapy causes hair loss only in the area being treated. For example, if you have
radiotherapy to your head, you will probably lose some hair from your scalp in the area where the radiotherapy
beam goes into and out of your scalp. If you are having treatment for breast cancer, and the radiotherapy includes
your armpit, the hair under your arm is likely to fall out.




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Will my hair grow back after radiotherapy?

Your hair is likely to grow back after radiotherapy, although it may not be as thick as it was before. The time it
takes to grow back depends on the amount of radiotherapy that you have had and the length of your treatment.
On average it takes 6–12 months for your hair to grow back after you have finished your treatment.

Some people have permanent hair loss after radiotherapy, or find that the hair that grows back is patchy. If you
have patchy hair loss on your head you may want to continue wearing a wig or some other type of headwear. You
can also consider hair weaving. Your doctor or radiographer will discuss the possibility of permanent hair loss, and
other side effects, with you before you start your treatment.


Other treatments

Other types of cancer treatment including hormonal therapies or biological therapies can sometimes make your
hair thinner or dry and brittle.

Your doctor or specialist nurse, can let you know whether any treatment you are having is likely to affect your hair.


Practical help to cope with hair loss
There are several practical ways to cope with hair loss. They don’t make the problem disappear, but can make life
a little easier for you during this difficult time.

Some hospitals have staff that can show you how to wear different types of headwear and give you ideas and tips
You can ask your nurses whether anyone in the hospital can discuss this with you. Some hospitals run hair and
beauty programmes. Your nurses should be able to tell you if your hospital has such a programme. If not, you can
ask whether there is a programme at a nearby hospital.

Even if your hair does not fall out, treatment can make it dry and brittle.

Preparing for hair loss

You could think about having your hair cut short before your treatment starts. This may help to minimise hair loss
as it reduces the weight of hair pulling on the scalp. If you are used to long hair you might find it easier to have it
cut in stages to give you time to adjust to a new length. However, some people prefer to shave their heads
completely even before they start losing their hair. This can give a sense of control over what is going to happen
and you may prefer to do this, rather than wait for your hair to fall out.

Some people may not want to cut their hair for cultural or religious reasons, and may find alternative headwear
can be helpful.



Looking after your hair
If your hair is dry or brittle during or after cancer treatment:

         Use only gentle hair products, such as mild or baby shampoo, to prevent dryness of the hair and scalp.
         Brush your hair gently – using a soft baby brush, for example – especially if your scalp feels tender.
         Use wide-toothed combs.
         At night, wear a hairnet, soft cap or turban around your head to collect any loose hair.
         Don't use excessive heat from hairdryers or heated rollers, as this can over-dry the hair and make it
         break.
         Avoid plaiting your hair or wearing it in a tight band, as this can damage and break your hair.
         Avoid sleeping in hair rollers.
         A poor diet, stress and alcohol can make the condition of your hair worse. It is important to eat as well as
         you can (with plenty of fruit and vegetables), drink alcohol in moderation and avoid stress, if possible, to
         keep your hair in good condition.
         Gently massaging the scalp may improve the blood supply to the hair follicles.
         Avoid perming your hair as this can make the hair even more dry and brittle.
         Only use tints or hair dyes made of natural colourants.
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Looking after your skin
If your hair falls out, it's important to take care of the skin on your head and other places where you had hair, as it
may be more sensitive than skin elsewhere.

         Use a gentle unperfumed moisturiser on your scalp if it gets dry, flaky or itchy. Natural oils such as
         almond oil or olive oil are a good alternative. (If you are having radiotherapy to your head, always check
         with your radiographer or nurse before using any creams or oils).

         Use pillowcases made of 100% natural fibres, such as cotton or linen, as man-made fibres like nylon and
         polyester can irritate the scalp.

         If you decide not to cover your head, use a high protection factor sun cream (SPF 30) on your scalp
         whenever you go out.

         Avoid using perfumed deodorants if you have lost hair under your arms. Baby powder, or deodorants
         made from natural mineral crystals, can be used instead – these are available from chemists or health
         food shops.



Coping with hair loss after treatment has ended
Scalp care
When your hair starts to grow back the scalp can become scaly. This is due to dryness. If the hair is very short
you can wash the hair and scalp with aqueous cream, which can be used instead of soap to produce lather. This
moisturises the scalp at the same time. Your doctor can prescribe aqueous cream for you. It is also available from
chemists.



Hair products
It is best to avoid medicated shampoos as these are unnecessary and can irritate the scalp. As your hair gets
longer you can use very mild shampoos designed for frequent use – these clean the hair but do not contain
chemicals that dry the scalp and hair.



Tinting, colouring and perming

Once your hair is long enough, you can tint or perm your hair if you want, if it and your scalp are in sufficiently
good condition.

Do not use any chemicals such as perms or tints on your hair if:

         your scalp is scaly, sore, or irritated
         your hair is drier than usual
         your hair is rough to the touch
         your hair is lighter in colour than before your treatment
         Your hair appears to be breaking or not growing normally.

If you want to colour your hair, you can ask your hairdresser for advice on natural products such as henna or
vegetable-based colourants. It is best to try any colourant on a small, hidden area of hair first, to make sure that it
will not damage your hair. Henna is safe to use, as it conditions the hair; the colour the henna produces may be
more intense than before chemotherapy.

Hair weaving

Hair weaving is a way of adding hair to the scalp by weaving or braiding in extra human or synthetic hair. It is also
called hair integration or hair intensification. The hair is woven into the root area of your hair so that it grows
naturally with the hair. It is best to avoid hair weaving for a few months after chemotherapy and if you are taking
medicines that weaken the hair, such as hormonal therapies or biological therapies.

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Hair weaving is not suitable for people who have thin, weak hair because the process of hair weaving stresses
existing hair and may make it fall out.



Patchy hair
If you have patches of hair that will not grow back (for example, after radiotherapy), a very fine mesh can be
attached to your own existing hair. The mesh can then be filled with hair to cover the bald patch. The hair is mixed
to a good colour match and washed and styled as you like. The procedure can take from 1–5 hours. Once in
place, the net needs to be tightened every 6–8 weeks and this takes from 1–1½hours.



Fine or wispy hair
Hair extensions can thicken fine or wispy hair and can be clipped onto your hair. This is not suitable for weak or
thin hair so is not advisable for people who have just had chemotherapy or radiotherapy.



Wigs and hair pieces
One practical way of coping with hair loss is to wear a wig or hairpiece. Nowadays there are many different styles
and colours to choose from and they are very natural looking and comfortable to wear. Wigs can be made of
human or synthetic hair (monofibre), or a mixture of both.

Types of wigs

There is a more limited choice of styles for men, and it can be very difficult to find suitable wigs or hairpieces.

Real hair wigs can cost between a few hundred and a few thousand Rupees and are not normally available. They
often look more natural and last longer than synthetic wigs. However, a natural hair wig will need regular dry
cleaning, setting. It can help to have two wigs so that you can wear one while the other is being cleaned.

Synthetic (acrylic) wigs are cheaper than real hair wigs, and are lighter and easier to look after. They can cost
anything from fifty to several hundred rupees, but may be free. The style is heat-sealed into the hair so that they
can be hand-washed with shampoo, left to drip-dry overnight and are then ready to wear. They can be combed or
brushed through gently. They usually last for around 6–9 months. Hair spray can be used if necessary, but avoid
using too much as this can make the hair look dull and less natural.

All wigs come with instructions on how to look after them and you should follow these carefully.



Fitting your wig

The nurses on the ward can arrange for a wig-fitter to visit you and help you choose a style and colour that suits
you. Most hospitals will supply wigs to people having treatment as outpatients, but this does not happen in all
hospitals.

This can be an emotional time as you are forced to face up to the reality of losing your hair. The wig specialists will
understand your feelings and will do all they can to make you feel comfortable and at ease during your fitting. You
may want to have a relative or friend with you to help you make the decision. There is no pressure on you to
choose a wig immediately and you can always leave the decision until you feel ready. If you have a hairdresser
you trust you may find it useful to speak to them first.

Some people like to choose their wig before their hair falls out so that they can match the style and colour. The
advantage of this is that if you lose your hair more quickly than expected you will already be prepared. It also
gives you a chance to get used to the wig before you really need it. If your hair has not yet fallen out, the wig
should be quite tight so that it gives a good fit later on. Some wigs adjust to any head size.

If all your hair has fallen out and the wig is slipping, you can get sticky pads to hold it in place. Some pads are
hypoallergenic, which can be helpful if your skin is sensitive due to chemotherapy or radiotherapy.



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Choosing a wig
If you don’t want the wig to change the way you look:

         Choose the same volume of hair as you had before. Too much hair can make it look obvious that you are
         wearing a wig. If in doubt, choose a wig with very slightly less hair than you had before. Remember that
         the wig can be cut and styled to suit your needs by your hairdresser or the wig consultant.
         Choose your own colour or one shade lighter. If the hair is darker than your natural colour, it can look
         strange to your friends and draws attention to the change. Generally a change to a lighter colour will be
         less noticeable.
         Remember when choosing a wig or hairpiece that as your hair falls out you will need a smaller size. Try to
         get a wig which adjusts to any head size.
         If you have a good hairdresser, they could help you choose your wig and, if necessary, cut and restyle it
         for you.
         Wig manufacturers include the cost of styling the wig in their prices and will give instructions on how to
         look after your wig. If you have any questions, check with the manufacturer or your hairdresser.


Another approach is to treat this as a chance to try a completely different style or colour, to have a little fun and to
surprise your family, friends and colleagues. Wigs are available in various colours if you fancy being outrageous.



Tips for wearing a wig
Keeping your wig in place

One of the most common worries that people have about wearing a wig is how to keep it in place. There are
various ways of making sure that your wig is secure. Although a well-fitting wig should stay in place on its own,
you may feel happier using an extra type of attachment, such as double-sided tape. Wig specialists have
hypoallergenic tape which does not irritate the skin. The tape is attached to the underside of the wig and gives a
secure but comfortable bond. Surgical spirit can be used to remove any leftover adhesive. If your skin is very
sensitive due to your cancer treatment, you can ask your doctor or specialist nurse which tape you can use and
whether it is ok to use surgical spirit.

The wig specialist will discuss this and other ways of securing your wig with you, so that you can decide which
method you prefer. A simple way to check your wig is securely in place is to bend over and shake your head.

If you are going shopping and know that you will be trying on clothes or going to the doctor, it is a good idea to
wear something that is easy to slip off, such as a cardigan or a shirt, rather than something that goes over your
head and may pull your wig off.

Protecting your scalp

The lining of the wig can irritate the scalp, so it may be helpful to wear a thin cotton scarf or skull-cap underneath.
These are usually available from wig suppliers. They can make a wig slip though. You may need to experiment to
find out what works best for you.

Safety

Take care not to expose your wig to a flame, for example from a candle or gas cooker, as real hair will frizz and
synthetic hair can melt. Even the heat released when opening an oven door can make the hair frizzy. Do not use
the highest heat setting on your hair dryer as this can also melt the hair.

Other types of headwear
Wigs are not the only way of covering up hair loss.

Hats

Hats are a popular option and come in hundreds of different shapes, styles and colours. They are common
fashion accessories and are both practical – keeping your head warm – and attractive. Department stores usually

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have a good selection and there are also specialist hat shops. Try on a range of different styles, and you will
probably find one that suits you and feels comfortable.


Scarves

Scarves are another option. They are available in a wide variety of colours and materials, and are light and easy
to wear. Cotton, lightweight wool or blends are the best fabrics to use. Satin-type materials tend to slide off the
head too easily.

Scarves sometimes have instructions and suggestions on how to tie them. You may like to try the basic style
below.

How to tie a scarf

        Lay a square scarf flat; wrong side facing you. Fold the scarf diagonally into a triangle. For a basic
        headwrap you will need a scarf at least 75cm x 75cm (29.5inches x 29.5 inches); for more elaborate
        styles it needs to be 100cm x 100cm (39inches x 39inches).
        Place the scarf on your head with the folded edge about 2.5cm (1inch) below your natural hairline and the
        points at the back.
        Tie the ends into a double knot behind your head and over the triangle point (if you are doing more than
        the basic headwrap you may only need a single knot). The flap should be underneath the knot. Pull any
        excess scarf out from under the knot.

For variation you can try the following:

        Wear the ends of the scarf loose – particularly if it is sunny or you are going to wear a hat on top.
        Tie the ends of the scarf in a bow or gather all the ends in an elasticated ponytail band to help make
        loops and tails to form a bow. The bow also looks nice under a hat.
        Twist the three ends together to look like a twisted rope and wrap them tightly around the knot like a bun
        or rosette. Secure the loose ends by tucking them through the centre of the bun.
        For a different twist, pull all three ends together and tuck them securely over and under the knot to look
        like a French hair roll.
        Twist the long ends separately, bring them forward and tie them at the front of your head. Continue
        twisting and tucking the ends in around your head. At the back, twist the short end and tuck it in.
        You can vary this by twisting in coloured cord, beads or a contrasting scarf to match what you are
        wearing.

Tip: You may find that it helps to twist one end at a time and secure it with a hairgrip, paperclip or elastic band
while you twist the other one.


Turbans
Turbans are available in a range of materials such as velvet, silk, cotton and towelling. They are popular and
comfortable to wear, especially in hot weather. They are available at some chemists, department stores or
specialist wig shops and some of the listed organisations.

If you normally have a fringe, you can get one on a Velcro band from some wig suppliers. Some suppliers also
make turbans and scarves with optional fringes or headbands with hair attached.

Hats, headbands or bandanas with attached hair can be ordered from some of the listed websites.

Hair extensions can be attached to very short hair, but the hair needs to be in good condition, as if the hair is
brittle the extensions may make the hair break.

Proud to be bald

Although we have discussed various types of headwear, you may prefer not to wear anything on your head.




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Diverting attention from your hair loss
Listed below are some suggestions from people who have temporarily lost their hair, which you may find helpful:

        Draw attention away from your hair by highlighting other features. For women, wearing a little extra make-
        up around your eyes, cheekbones or lips will help to direct attention to your face.
        Jewellery can also change the focus – necklaces and chains emphasise your neckline while earrings look
        good with hats and scarves.
        Brightly coloured shirts, sweaters, ties or tops draw attention away from your hair.
        Some hospitals and support groups run programmes which give expert advice on make-up and skin care.
        Your nurses can let you know if there is a programme like this in your hospital or at a nearby support
        group.

At first you may feel reluctant to go out and carry on with your social life, but as you spend more time with other
people your confidence may grow and help you to cope with the situation.

As your hair grows back

When your hair first grows back it will be very fine but will gradually become thicker. As soon as it is long enough
to style, you may feel that you no longer want to wear a wig or other head covering. People who were used to long
hair often find a shorter style that suits them. Your hairdresser should be able to help you choose a suitable style.


Children teenagers and their hair loss
Many children are not too worried by their hair loss and may be proud of their bald heads. However, if they do
want to cover up, wigs can be very natural looking. There are many hats, caps, scarves or bandanas that they can
wear. If a child needs treatment from time to time over a few years, they will probably need a new wig every time
as their head grows. Their hair will grow back once their treatment has finished.

If you are a teenager, having a change in your appearance can be very upsetting. There are many natural-looking
wigs and other ways to cover hair loss.




Losing you eyebrows eyelashes and facial hair
Losing your eyebrows and eyelashes can really change your appearance. However, you can learn to create new
eyebrows with an eyebrow pencil if you wish, or can use false eyebrows and eyelashes.

Eyebrows

If you lose your eyebrows or find that they are thinner, you can redraw them with an eyebrow pencil that matches
your normal hair colour. Eyebrow pencils are available from any chemist or beauty shop. Beauty counters in
department stores can show you how to redraw your eyebrows as it can be daunting to try this at first if you are
not used to it.

To make the eyebrows as realistic and natural looking as possible follow the natural eyebrow arch and draw in
short feathery strokes that look like the normal eyebrow hair. Make the brow thicker on the inner end of the
eyebrow (nearest to the nose) and thinner at the outer edge.

You can also use false eyebrows. They need to be fixed with special adhesive, which is available from the false
eyebrow suppliers. Special solvent is used to dissolve the adhesive and remove the eyebrows.

Some people choose to have tattooing to create new eyebrows. This can be done in tattooing shops or cosmetic
salons. It should only be carried out by tatooists registered with a professional association.




                                                          8
Eyelashes

False eyelashes can be used to give a natural appearance. These are available from many beauty departments
along with the adhesive that is used to attach them. Many department stores have private rooms where staff can
show you how to apply the eyelashes.


Moustaches and beards
Losing a moustache or a beard can be very difficult to deal with. Facial hair can really be an important part of a
man’s identity. Some make-up shops or theatrical shops sell moustaches or beards. Some can be tailored
specially but this is very expensive.


Scalp Cooling
Scalp cooling is a method of reducing the loss of hair from the head, which occurs during treatment with
some chemotherapy drugs.

How it works
Each hair on our bodies grows out of a hair follicle. Small blood vessels in the scalp supply the cells of the hair
follicles with food and oxygen and carry away waste products. Any chemotherapy drugs in the bloodstream will
also be carried to the hair follicles.

When blood vessels in the scalp are cooled they become smaller, and so less blood flows through them. Cooling
the scalp during chemotherapy means that less of the chemotherapy drug reaches the hair follicles, and so the
hair is less likely to fall out.

Two methods are widely available for scalp cooling:

         One method uses a hat known as a 'cold cap', which is filled with a gel that can be chilled. The hat must
         be fitted snugly around the head to work properly.

         The other method of scalp cooling uses a small refrigerated cooling system to pump a liquid coolant
         through a cap that is attached to a specially designed refrigerator.



Who can have scalp cooling?

Scalp cooling is not suitable for everyone.

It is not suitable:

         When there is too high a risk that cancer cells could survive in the blood vessels of the scalp and could
         cause the cancer to come back after treatment.
         For some people needing very high doses of chemotherapy, as scalp cooling is less likely to work with
         very high doses of the drugs.
         For some chemotherapy treatments where the drug stays in the body for a long time: for example, if you
         are having continuous treatment through a pump. This makes it impractical to have scalp cooling.
         For some patients whose liver is not working as well as it should. This might lead to the chemotherapy
         drugs circulating in the body for longer than usual, and it may not be possible to keep the scalp cold for
         long enough.

Some doctors worry about using scalp cooling with treatment that aims to cure the cancer, as they fear that
cancer cells may be more likely to survive the chemotherapy than if it were not used. Some patients do not feel
comfortable with scalp cooling for the same reason. For other people not losing their hair may be the most
important aspect of their treatment.




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Some drugs for which scalp cooling may be used

Scalp cooling is most likely to be effective with:

         cyclophosphamide
         daunorubicin
         docetaxel (Taxotere®)
         doxorubicin (Adriamycin)
         epirubicin (Pharmorubicin®)
         paclitaxel (Taxol).


Having scalp cooling

For scalp cooling to work, your scalp needs to be cold for up to 30–40 minutes before your chemotherapy drugs
are given – and for some time afterwards. Your scalp temperature needs to be kept low for the whole time the
drugs are circulating in your blood.

If you are having your chemotherapy as an outpatient, you may need to spend up to one and a half hours longer
at the hospital for each treatment.

Some people find that the ice pack and gel-filled hats feel heavy to wear. When using this type of hat you are
usually free to walk about once your chemotherapy has been given. However, your hat will need to be changed
every 20–40 minutes to keep your scalp cool, so you cannot go too far from the chemotherapy department.

Caps attached to the cooling machines generally feel lighter than the frozen caps. You will need to sit by the
machine while the cap is in place, so you cannot walk about freely with this method; however, the cap can be
disconnected for short periods if necessary, for example if you need to use the toilet. These caps do not need to
be changed as the machine is continuously cooling the liquid circulating round your scalp.

You will probably feel chilly when having scalp cooling and may need to wear a warm jumper. Hot drinks will help
you to feel warmer. You may get a headache during scalp cooling, especially in hot weather.


How effective is it?

Scalp cooling can be very effective in preventing or reducing the loss of your hair. But you will not know how well it
will work for you until you try it. It can help not to wash your hair for at least 24 hours after having scalp cooling.

Despite scalp cooling, you may find that your hair thins slightly. Unfortunately, some people who have scalp
cooling will still lose their hair.

Scalp cooling protects only the hair on your scalp. Body hair (including eyelashes, eyebrows, beards and
moustaches, chest hair and pubic hair) may be lost.

Any hair loss caused by chemotherapy is temporary, and once the treatment is over, your hair will start to grow
back. At first, the hair is very fine, but you will probably have a full head of hair after 3–6 months. You may find
that your new hair is curlier or more coarse than it was before, or it may be a slightly different colour.

If you are interested in scalp cooling you will need to discuss this with your doctor or nurse, who can advise
whether it is suitable for you.




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Note for Reader

This JASCAP booklet is not designed to provide medical advice or professional services and is
intended to be for educational use only. The information provided through JASCAP is not a
substitute for professional care and should not be used for diagnosing or treating a health problem
or a disease. If you have, or suspect you may have, a health problem you should consult your
doctor.




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