Alopecia (hair loss)
When will alopecia occur?
The clinical term describing hair loss is alopecia. Hair loss usually occurs two to three weeks after the beginning of chemotherapy or radiation therapy. The rate at which people lose hair varies, as each person responds differently to treatment. Several days before hair loss occurs, your scalp may become very itchy and sensitive.
How much hair is lost?
Chemotherapy may affect all body hair. Since scalp hair is generally in an active growth phase, it is affected by chemotherapy more often than other body hair. Alopecia is usually temporary among patients receiving chemotherapy. The degree of hair loss is dependent on the drug and dosage used.
Radiation therapy affects hair in the area being irradiated. With radiation therapy, hair loss may or may not be permanent. The amount of hair loss can range from thinning to complete baldness. The quantity of hair loss as a result of radiation therapy is dose and site-dependent.
Why does hair fall out?
Cancer cells divide and grow rapidly. Hair is also made up of fast-growing cells. Radiation therapy and chemotherapy are designed to destroy any cells that multiply quickly, and cannot differentiate between cancer cells and hair cells. This causes the hair to fall out at the root.
Who can help me with hair loss?
Before hair loss occurs, see a professional who can assist you in selecting a wig that closely matches your hair style and color and who will show you other hair alternatives. Early consultation can ease your mind before you begin your treatment. Have a friend or family member present to offer support and a second opinion.
When does hair grow back?
- Normally, hair does not grow back until you have completed chemotherapy. Some people do experience hair growth before the therapy is completed.
- Radiation therapy may retard hair growth. Regrowth does not usually begin until several months after the radiation treatment is completed.
- It may take six months to one year for hair to regrow to its prior length; hair generally grows about a quarter of an inch every four weeks once you have completed treatment.
- If you want to have your hair chemically curled, it is best to use a mild body wave. In order to prevent damage to the recovering hair shaft, wrap your hair loosely on the largest curling rod for a short amount of time.
- If you want to color your new hair, a safer, gentler way to do so is by using a semi-permanent color. Do not bleach hair to lighten.
What hair alternatives are available?
There are a number of natural-looking hair replacements that will stay in place, are easy to care for, comfortable to wear, and reasonably priced.
- Wraps should be cotton, polyester, or rayon, not silk.
- Hair prostheses (wigs) create a more natural look.
- Hair prostheses can be made from synthetic hair, human hair, or a combination of the two.
- Any hair prosthesis should be fitted and shaped to suit each individual.
- Combinations of hats, head wraps, or scarves are available in many styles.
What special care does a hair prosthesis require?
- A hair prosthesis should be washed only when needed, or after about 20 wearings if made from synthetic hair. Less care is better. Human hairpieces usually need to be cared for every day.
- Soak the prosthesis in a mild, gentle shampoo for a few minutes using cool water and rinse thoroughly.
- Pat with a towel to remove excess moisture and shake the prosthesis vigorously. Hang it over a tall object (hairspray can, bottle) or spread it on a towel to dry if you don't have a wig stand.
- Do not brush synthetic wigs while wet.
- Style after wig is thoroughly dry. Do not use a curling iron or hair dryer on synthetics or blends.
- Always use a vent brush for straight styles or a pick for curly styles.
- Avoid using standard hair brushes because they can create excessive tension, over-stretching the hair and damaging it.
- Think "reverse" when brushing your wig. Start from the ends and work gradually toward the root area of the wig. When using a wire pick, also work the curls from ends to root area.
- Do not wear your hair prosthesis near extreme heat (cooking, baking, or when using a barbecue grill).
Will the hair prosthesis be comfortable?
If fitted properly and securely, your wig will be comfortable. We recommend wearing a cotton skull cap under the wig to reduce itching. Wigs can be resized to fit your head.
Tips for securing wig:
- adjust tabs, pull in to tighten, let out to loosen
- hairpiece double-sided tape placed in base of wig cap at forehead and on both ear tabs
- using hairpins, place through nylon cap and wig on both sides and back of head
- roll on adhesive can be placed directly on scalp and washed off with water
What should I know about hair and scalp care during therapy?
- Use a mild shampoo and conditioner weekly.
- Pat dry gently with a towel, do not rub.
- Comb hair very gently.
- Avoid electrical hair appliances; let hair dry naturally.
- Consult your doctor before having any chemical processing done on your hair.
- Always protect your uncovered scalp with sunscreen when outdoors.
- Wear a night cap for sleep if you find you are losing body heat with an unprotected scalp.
- You might find that sleeping on a satin pillowcase reduces friction.
Will my insurance cover my hair prosthesis?
While every insurance plan is different and there is no guarantee of coverage in all cases, these guidelines may assist you in obtaining insurance reimbursement.
- Get a prescription from your doctor.
- Prescription should read "Cranial/Hair Prosthesis for medical purposes. Alopecia secondary to chemotherapy or radiation therapy."
- Obtain a receipt from your salon, specialty shop, or hospital center for fulfillment of the above prescription.
- Submit to insurance, prepare for denial of the claim.
- Resubmit if denied, include a picture of yourself without hair and request a review by medical review board. Send new claim to claim supervisor.
- Educate your insurance company. Explain that the prosthesis is needed as a medical necessity and is not cosmetic.
- Have your doctor write a letter on your behalf.
- Some specialty shops and hospital centers will do the insurance billing for you.
- Keep a copy of all correspondence, document telephone conversations (with dates and person spoken to) in writing. Most policies do not spell out exclusions under prosthetics; check your policy carefully.
- Massachusetts law provides for coverage of a hair prosthesis up to $350 per calendar year for anyone with Massachusetts health insurance undergoing cancer treatment.
Do I need to make an appointment before coming into Friends' Place?
Making an appointment for a compression garment, wig, breast prosthesis, or bra fitting is helpful to us so we can give you our full attention and reduce your wait time. By scheduling ahead, we can verify the necessary prescription and insurance information, which will minimize your wait when you come in for your consultation. You can be confident that we will make every effort to accommodate your needs.
To schedule an appointment, please call 617-632-2211.
If we are able to accommodate walk-ins, we will be more than happy to help you.