Hair Loss and Cancer: Understanding the Connection

Hair loss, also known as alopecia, can be a distressing experience, particularly when associated with cancer. While hair loss is not always a direct symptom of cancer, it can be a side effect of cancer treatments or, in rare cases, a symptom of certain types of cancer. This article explores the relationship between hair loss and cancer, the various types of hair loss, and strategies for prevention and management.

What is Alopecia?

Alopecia is the abnormal loss of hair. On average, the scalp has 100,000 hairs that cycle through periods of growing, resting, falling out, and regenerating. A hair growth cycle consists of three phases:

• Anagen: Hair grows actively. This phase may last for years.
• Catagen: Hair stops growing and separates from its follicle. The catagen phase lasts about 10 days.
• Telogen: The follicle rests for two or three months, and then the hair falls out.

Most people lose 50 to 100 hairs per day as part of this natural cycle. Hair loss occurs when this cycle is disrupted, or if a hair follicle is damaged.

Causes of Hair Loss

Hair loss can be caused by several factors, including:

• Genetics
• Hormonal changes
• Autoimmune disorders
• Stress
• Nutritional deficiencies
• Infections
• Certain medications
• Cancer
• Cancer treatments, such as chemotherapy and radiation therapy

Hair Loss and Cancer: Is There a Connection?

While many people worry about hair loss after a cancer diagnosis, it is essential to understand the connection between the two.

Read also: Lasting Hair Graft Results

Hair Loss as a Symptom of Cancer

In most cases, hair loss is not a primary symptom of cancer itself. Tumors do not typically cause hair loss directly. However, there are exceptions.

• Cutaneous Lymphoma: Hair loss happens in about 2.5 percent of people with cutaneous lymphoma, a type of lymphoma that affects the skin. It’s more common in people with mycosis fungoides (MF) and Sézary syndrome. These are the most common types of cutaneous lymphoma and affect about 34 percent of people. Hair loss is most likely in those with folliculotropic MF (FMF), where it develops in about 65 percent of people. These are all types of non-Hodgkin lymphoma. The immune system may attack hair follicles, causing patchy hair loss in people with FMF, and more generalized alopecia in people with Sézary syndrome. Hair loss, including body hair loss, can be an early sign of cutaneous lymphoma.
• Hormone-Related Cancers: Cancers that affect hormone levels, such as ovarian or adrenal tumors, can indirectly cause hair loss.
• Hematologic Cancers: In some hematologic cancers, particularly lymphomas and leukemias, hair loss may occur due to the body’s systemic response to malignancy or as part of a paraneoplastic syndrome.
• Hodgkin Lymphoma and DLBCL: Hair loss from Hodgkin disease, or Hodgkin lymphoma, is considered rare. Hair loss has also been seen in cases of diffuse large B-cell lymphoma (DLBCL), although it also appears to be a rare occurrence.

Hair Loss as a Side Effect of Cancer Treatment

The most common cause of hair loss in cancer patients is cancer treatment, including chemotherapy and radiation therapy.

• Chemotherapy: Chemotherapy drugs are designed to kill rapidly dividing cancer cells, but they can also damage healthy cells in the body, including hair follicles. Chemotherapeutic agents target rapidly reproducing cells, like cancer cells. Unfortunately, these agents do not know the difference between a cancer cell and the rapidly reproducing cells of the germinal matrix in a hair bulb. They stop cell division, or mitosis, in matrix cells, just as they do in cancer cells. The anagen phase comes to a stop, and in many cases, all the hair that is in the anagen phase is shed. At least some degree of hair loss is likely with many forms of chemotherapy. Certain drugs or combinations of drugs are virtually certain to cause some degree of hair loss. A few drugs cause nearly complete hair loss.
• Radiation Therapy: Radiation therapy is another standard cancer treatment, and it can also cause hair loss. People undergoing radiation therapy usually lose hair at the radiation site. Radiation therapy also stops the reproduction of rapidly dividing cells, but in higher doses, radiation can damage the hair follicles it touches, preventing regrowth of hair.

Types of Hair Loss

There are several types of hair loss, each with its own causes and characteristics.

• Androgenetic Alopecia: Also known as male or female pattern hair loss, this is the most common type of hair loss and is hereditary. In men, hair loss can begin any time after puberty and progress over the course of years or decades. It starts above the temples and continues around the perimeter and the top of the head, often leaving a ring of hair along the bottom of the scalp. In women, hair slowly thins all over the scalp, but the hairline usually doesn’t recede.
• Telogen Effluvium: This type of hair loss occurs when large numbers of follicles on the scalp enter the resting phase of the hair growth cycle, called telogen, but the next growth phase doesn’t begin. A medical event or condition, such as a thyroid imbalance, childbirth, surgery, or a fever, typically triggers this type of hair loss.
• Anagen Effluvium: This is rapid hair loss resulting from medical treatment, such as chemotherapy. These potent and fast-acting medications kill cancer cells, but they may also shut down hair follicle production in the scalp and other parts of the body.
• Alopecia Areata: This is an autoimmune condition in which the body’s immune system attacks healthy tissues, including the hair follicles. This causes hair to fall out and prevents new hair from growing.
• Tinea Capitis: Also called scalp ringworm, this is a fungal infection of the scalp that’s a common cause of hair loss in children. This condition causes hair to fall out in patches, sometimes circular, leading to bald spots that may get bigger over time.
• Cicatricial Alopecia: Also known as scarring alopecia, this is a rare type of hair loss in which inflammation destroys hair follicles and causes scar tissue to form in their place. After scar tissue forms, hair doesn’t regrow. Types of cicatricial alopecia include: lichen planopilaris, discoid lupus erythematosus, folliculitis decalvans, dissecting cellulitis of the scalp, frontal fibrosing alopecia, and central centrifugal cicatricial alopecia.
• Hair Shaft Abnormalities: Several types of hair shaft abnormalities can lead to hair loss. These conditions cause strands of hair to thin and weaken, making them vulnerable to breaking. Types of hair shaft abnormalities include: loose anagen syndrome, trichotillomania, traction alopecia and hypotrichosis.

Coping with Hair Loss

Losing hair can be emotionally distressing, but there are ways to cope with hair loss associated with cancer.

Planning Ahead

If you know you’ll be undergoing treatment for lymphoma that may cause hair loss, plan ahead so that you’re prepared for changes in your appearance. You may want to:

Read also: Managing Chemo Hair Loss

• Avoid perms, chemical products, curling irons, and other harsh treatments that may damage your hair more.
• Use gentle shampoos and conditioners that moisturize your hair.
• Cut your hair short or shave your head. This can help you feel more in control of your changing appearance.
• Purchase a wig or have one made out of your hair. Some people like to have several different wigs in different colors and styles.
• Choose head wraps that you love. These can cover either patchy hair or baldness.
• Use makeup to fill in your eyebrows or to compensate for other hair loss.

Scalp Cooling

Cold caps may help prevent hair loss in some people undergoing cancer treatment. By keeping the scalp cool, it’s possible to reduce blood flow to the scalp and decrease the amount of chemotherapy drugs that reach the hair follicles on the head. However, cold caps aren’t recommended for people with lymphoma because blood cancers circulate through the bloodstream and a cold cap may reduce the circulation of chemotherapy drugs that kill cancer cells.

Seeking Counseling

Some people struggle with hair loss or find that it seriously affects how they think and feel about themselves. If this is the case, ask your oncologist for a referral to a mental health professional who specializes in working with those diagnosed with lymphoma and other cancers. This can be a great way to process your lymphoma diagnosis as a whole and begin to feel better about your hair loss.

Tips to Manage Hair Loss

• Treat your hair gently: Use a hairbrush with soft bristles or a wide-tooth comb. Do not use hair dryers, irons, or products such as gels or clips that may hurt your scalp. Wash your hair with a mild shampoo.
• Protect your scalp: Use sunscreen or wear a hat when you are outside. Choose a comfortable scarf or hat that you enjoy and that keeps your head warm.
• Talk about your feelings: Many people feel angry, depressed, or embarrassed about hair loss. It can help to share these feelings with someone who understands.

Hair Regrowth

In most cases, hair loss from cancer treatment is temporary, and hair will regrow after treatment is completed.

After Chemotherapy

Hair often grows back in 2 to 3 months after treatment has ended. Your hair will be very fine when it starts to grow back. Sometimes your new hair can be curlier or straighter-or even a different color. In time, it may go back to how it was before treatment.

After Radiation Therapy

Hair often grows back in 3 to 6 months after treatment has ended. If you received a very high dose of radiation, your hair may grow back thinner or not at all on the part of your body that received radiation.

Read also: Managing Hair Loss from Chemo

tags: #hair #loss #cancer #types

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