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How to Address Hair Loss after Breast Cancer Treatment

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Unfortunately, breast cancer is not an uncommon condition. Most Americans know someone who has been affected by this malignancy. In the United States, one in every eight women will be diagnosed with it in their lifetime. Over 220,000 women are diagnosed every year and it is the second leading cause of death. Fortunately, due to early detection, deaths from breast cancer have been decreasing, and there are more than 2.9 million breast cancer survivors in our country today.

Although being diagnosed with breast cancer can be foreboding, often many of my patients express that it is the fear of losing their hair with treatment that also concerns them. Chemotherapy treatments for breast cancer work by interfering with rapidly producing cells, which is ideal for destroying cancer cells. Unfortunately, hair is rapidly producing as well. 

Chemotherapy can lead to a condition termed anagen effluvium. All body, facial and scalp hair stops growing altogether and breaks off at the surface, resulting in the smooth, hairless appearance that can be commonly seen in these patients. Some of my patients express to me that they feel this appearance can be seen as a stigma. If it were not for their extensive hair loss, it would not be obvious that they are undergoing cancer treatments. The hair loss is an outward manifestation or sign of what is happening internally. For many women, this notion can affect them more emotionally than even the breast cancer diagnosis itself.

Thankfully, while undergoing chemotherapy, there are a plethora of options to mask the hair loss. Many women choose to purchase a wig, which tends to be covered by insurance. Others wear colorful scarves. Finally, there is now a movement to embrace the fully bald scalp.  

After the chemotherapy regimen has been completed, most women’s hair will return in full. It may not look the same as before, however. Often the texture and color may vary. I will often recommend over the counter minoxidil 5 percent foam or solution to help directly stimulate new hair growth.

It is possible that the hair may not return in full. This may be a result of some breast cancer treatments affecting hormonal influences on the hair. In these instances, I often recommend platelet rich plasma, or PRP, growth factor treatment, an autologous preparation of the patient’s own blood. There are cells around the hair bulb that are needed for normal hair cycling and growth. When those cells start to diminish from hormonal influences, the hairs start to thin. The growth factors from PRP treatment directly signal those cells to amplify, thus enhancing thicker hairs to grow.

In summary, breast cancer affects millions of women in this country. Thankfully, more are surviving than in years past. Although receiving a diagnosis of breast cancer is quite difficult, many women are even more distraught about losing their hair along with the chemotherapy treatment. Fortunately, there are many options to address this concern.

Dr. Meena Singh is a board-certified dermatologist and dermatologic surgeon. She attended Harvard Medical School, trained at the Mayo Clinic, and completed a surgical fellowship in New York City. From there, she trained in Mohs micrographic surgery. Upon completing a fellowship with the International Society for Hair Restoration Surgery under world-renowned surgeon Dr. Marc Avram, Dr. Singh trained in all areas of hair transplantation techniques including strip excision, manual/motorized/robotic follicular unit extraction as well as transplanting into scarring alopecias. Dr. Singh has performed clinical trials in laser hair stimulation and studies in hair transplantation for scarring and non-scarring forms of hair loss.

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