Hair Loss Treatment

Hair loss in cancer chemotherapeutic patients

Chadha V, Shenoi SD

Abstract

The hair loss in 8 cancer patients aged between 18 and 60 years on chemotherapy was studied. All had diffuce moderate hair loss within 1 month of starting treatment. Of the 8, 3 had only telogen hairs and 3 had high dystrophic hair count. Both anagen and telogen effluvium are implicated.

Discussion

All patients had hair loss within 1 month after the onset of chemotherapy which suggested anagen effluvium. The trichogram results in 3 patients suggested a telogen effluvium either due to the stress of the disease or due to chemotherapy. It is also possible that anagen hairs were already shed, leaving telogen hairs. Three cases showed a high dystrophic hair count. The fall which was initially severe continued during the course of treatment.

Alopecia is one of the most traumatic side effects of cancer chemotherapy and changes in self-concept and body image can develop. Hair loss following chemotherapy is termed 'anagen effluvium' and is defined as the loss of dystrophic anagen hairs within several days of a metabolic insult due to abrupt decrease or cessation of reproduction of matrix cells.

Various measures have been tried to prevent hair loss. Topical minoxidil has been found to decrease the duration of alopecia by chemotherapy.[4] Cooling the scalp immediately before and for a long tine after administration of drug bolus is another common approach and found effective.[5] However it may not work when multiple drug regimes or very high doses of individual drugs are used. In animal models, topical agents such as Imuvert,[6] cyclosporin A[7] and 1,25­dithydroxyvitaminD3[8] have prevented chemotherapy-induced alppecia.

Dr Proctor: The key point here is that it has been generally-assumed that chemotherapy-induced hair loss is from the anagen (growth) phase. Hwever, it appears that much is from the loss (telogen) phase. This means that chemotherapy induces anagen hair to go into the loss phase.