Hair loss During chemotherapy and radiotherapy Information for patients Weston Park Hospital
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Cancer treatments such as chemotherapy and radiotherapy can cause total hair loss or thinning. If you lose your hair due to cancer treatment there are many ways of dealing with this. This leaflet gives you information to help you cope, practically and emotionally, with possible hair loss during your treatment. Why does hair loss occur during cancer treatment? Chemotherapy Chemotherapy works by attacking cancer cells and stopping them from growing. Unfortunately it also affects normal cells in the body. Some chemotherapy drugs can temporarily affect the hair follicles which causes hair loss, also known as alopecia. Normal cells can recover from this damage so if you lose hair due to chemotherapy it will almost always grow back after treatment. Not all chemotherapy drugs affect hair growth; some cause complete hair loss, some cause hair thinning while others have no effect on hair growth. In many cases hair loss is only from the head, but some drugs cause hair loss in other parts of the body. This includes eyebrows, eyelashes, facial hair, chest, underarm, leg and pubic hair. Before you start your chemotherapy your doctor or nurse will discuss with you whether you will lose any hair due to your treatment. If you are going to have hair loss it usually happens 2-3 weeks after chemotherapy has started but very occasionally it can be sooner than this. If your treatment causes total hair loss it can fall out quickly, over 1-2 days. Your scalp may become itchy and tender and hair that is still growing may become dull and dry. page 3 of 12
Radiotherapy Radiotherapy will cause hair loss only in the area that is being treated. It will start to occur about 2 to 3 weeks after radiotherapy has started. It often grows back 3 to 4 months after the end of treatment. However, if it is a high dose of radiotherapy the hair loss could be permanent. Your doctor or therapy radiographer will discuss hair loss with you if this can happen with your treatment. Can anything be done to reduce hair loss? Some patients having chemotherapy can be offered a procedure called scalp cooling. This involves wearing a specially designed cap that is connected to a cooling system. When the cooling system is switched on it keeps the cap at a low temperature, reducing the amount of chemotherapy that reaches the hair follicles in the scalp. This provides some protection to the hair follicles and can reduce the amount of hair that falls out due to treatment. The scalp cooling cap needs to be put on about 30 minutes before chemotherapy is started. It then stays in place during all of the treatment and for a short while after it has been given. This time varies between different chemotherapy drugs. Wearing a cold cap can be uncomfortable and some patients get headaches from the cold temperature. The nurses on the chemotherapy unit will try to make scalp cooling as comfortable as possible. Scalp cooling can only be used with a few chemotherapy drugs and it is not advisable for certain types of cancer. When it is used its effects can vary and it is not always possible to know how well it will work for each person until it has been tried. Your doctor or nurse will discuss with you whether scalp cooling can be used with your chemotherapy treatment. page 4 of 12
Emotional reactions to hair loss Losing your hair because of cancer treatment can be very upsetting. For some people hair loss is one of the hardest parts of cancer treatment. It can be a visible reminder to you and other people that you have cancer and you may be worried about how other people will react to you. These feelings and worries are completely normal. Please talk to the doctors or nurses about any concerns you may have. There are also organisations that provide support and advice about hair loss: their details are at the back of this leaflet. What can I do to help me cope with hair loss? Preparing for hair loss You could think about having your hair cut short before treatment starts. If it is shorter you might feel as if you are losing less hair if it falls out. Shorter hair is also easier to manage under a wig if you decide to have one (see page 7). It can be a good idea to try to choose a wig before you lose your hair completely as it is much easier to match hair colour and style with your present head of hair. Patients who lose their eyelashes may find wearing false eyelashes helpful. Some people may not want to cut their hair for personal, cultural or religious reasons and may find alternative headwear helpful instead (see Headways page 8). page 5 of 12
Looking after your hair Even if you don t lose all or some of your hair, it may become dry and brittle during your cancer treatment. These are some things you can do to help: Only use gentle hair products and non-medicated shampoo If you are having radiotherapy to your head, ask the radiotherapy staff about suitable types of shampoo Brush or comb your hair gently, with a non-metal brush or comb with widely spaced teeth. A baby brush is soft and can be a good alternative Dry your hair naturally or use a hairdryer on the lowest setting and avoid using heated rollers, curling tongs, or straighteners Eat a well-balanced diet with plenty of fruit, vegetables and protein if your diet allows Avoid perming or colouring your hair as this can make it even more dry and brittle Looking after your skin If your hair falls out it is important to look after your skin in the places where you had hair. Here are some tips: Use a gentle unperfumed moisturiser on your scalp if it gets dry, flaky or itchy. If you are having radiotherapy always check with the radiotherapy staff before using any creams or lotions Cover your head with a hat or scarf on sunny days to prevent sunburn Use a high factor sun cream page 6 of 12
If I need a wig will I have to pay for it? Your nurse will give you a prescription which will entitle you to choose from a range of NHS wigs for around 67.75 (2015 prescription fees). If you prefer to have a non-nhs wig you will have to pay the full cost, minus the VAT, even if you are exempt from prescription charges. If you are an inpatient you are eligible for an NHS wig. There are exemptions for payment if you: are under 19 and in full time education have a war pension exemption certificate are part of the HC2 NHS low income scheme or HC3 NHS help with health costs receive income support, pension credits, income based jobseekers allowance or tax credits If you need a hairpiece because of cancer treatment, this is a tax-deductible expense and may be partially covered by private health insurance. Westfield Health Scheme, for instance, classes wigs as surgical appliances and will give an allowance. Be sure to check your policy and ask your nurse for a wig prosthesis prescription. Where do I go to get my wig? There are two local wig suppliers, Millers and Trends. Both are within walking distance of the hospital and have their own car parks. Information about other wig suppliers is available at the cancer information and support centre. You should take your prescription with you when you go to the wig supplier. Contact details Trends: 0114 276 8676, Monday - Friday (Saturday until 2pm) Millers: 0114 266 5829, Tuesday - Saturday page 7 of 12
What is the Headways service? You may not want a wig, or if you do have one you may not want to wear it all of the time. The Headways service provides stylish alternatives to wigs. They can show you hats, turbans, scarves and hairpieces. They can also show you how to tie the scarves and give you advice about suppliers, so that you can look and feel confident during and after your treatment. The headways service is based in the Patients Library on the 3rd floor of the hospital and you can pop in anytime Monday to Friday between 9.30am and 4.30pm. Will I be able to use a deodorant? If you have lost hair under your arms you should avoid using perfumed deodorants. What happens when my hair grows back? When your hair grows back it may be curlier or finer than it was before. It may also be a different colour. Gradually your hair will become thicker and long enough to be styled. We advise you not to perm or colour your hair for about 3 to 6 months after your treatment finishes always have a strand test done before colouring your hair. You need to wait until your scalp is in a healthy condition and your skin is no longer sore, scaly, flaky or irritated. page 8 of 12
Other sources of support and information Macmillan Cancer Support has produced an excellent booklet Coping with Hair Loss which is free to patients. To get a copy please call: 0808 808 0000 (freephone) www.macmillan.org.uk Local organisations Wig suppliers Millers 0114 266 5829 Trends 0114 276 8676 Cavendish Centre for Cancer Care 0114 278 4600 www.cavcare.org Weston Park Hospital support Weston Park Cancer Information and Support Centre The Cancer Support Centre is situated behind the main hospital car park. The Centre has experienced health care professionals available without an appointment, to provide reliable information and emotional support in a friendly relaxed environment. Other services are also available by appointment, which include welfare and benefits advice, legal advice on Wills and lasting power of attorney, and the Look Good Feel Better pampering workshop for ladies with a cancer diagnosis. There are free complementary therapy sessions available for radiotherapy patients and one of their carers. There is also a regular craft page 9 of 12
afternoon and coffee morning open to all! You can also access courses for patients and carers and be signposted to other appropriate services you may require. Call in to the Centre or telephone our helpline on 0114 226 5666 during our opening times, Monday to Friday, 9am 5pm. A warm welcome awaits you! Headways (Patients Library) For stylish alternatives to wigs call: 0114 226 5390 National organisations Macmillan Cancer Support 0808 808 0000 (freephone) www.macmillan.org.uk Breast Cancer Care 0808 800 6000 (freephone) www.breastcancercare.org.uk Alopecia Patients Association Offers support, practical advice and information for people who are suffering from hair loss, including help with hair loss due to chemotherapy. Lyons Court 1668 High Street Knowle West Midlands B93 OLY 01564 785 980 www.hairlineinternational.co.uk page 10 of 12
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Produced with support from Sheffield Hospitals Charity Working hard to fund improvements that make life better for patients and their families Please donate to help us do more www.sheffieldhospitalscharity.org.uk Registered Charity No 1059043 Alternative formats may be available on request. Please email: alternativeformats@sth.nhs.uk Sheffield Teaching Hospitals NHS Foundation Trust 2016 Re-use of all or any part of this document is governed by copyright and the Re-use of Public Sector Information Regulations 2005 SI 2005 No.1515. Information on re-use can be obtained from the Information Governance Department, Sheffield Teaching Hospitals. Email infogov@sth.nhs.uk PD3525-PIL1139 v4 Issue Date: March 2016. Review Date: March 2018