Everything You Ever Wanted To Know About Chemotherapy Induced Hair Loss…But Were Afraid To Ask
I recently had the pleasure of chatting with Lisa Caddy, Consultant Trichologist (hair and scalp expert) of Philip Kingsley, a trichological hair care brand with hair and scalp clinics in both London and New York City.
We first met at the NYC clinic back in February, and just this week we had a GREAT Instagram Live and talked about EVERYTHING that you ever wanted to know about chemotherapy and hair loss….but were afraid to ask.
Just in case you missed it, here’s a recap of our conversation. Lisa, thanks so much for speaking with us!
Q: What are steps that one can take to prepare their hair and scalp for hair loss due to chemotherapy, prior to treatment starting?
A: Chemotherapy induced hair loss can may be inevitable for many and unfortunately can’t really be prevented. However, its good to make sure your scalp is healthy prior to treatment which means dealing with any dandruff or problematic scalps. If you do suffer from dandruff or other flaking scalp condition then try our Philip Kingsley Flaky Itchy Scalp Shampoo to improve your scalp and ensure you have a healthier scalp environment. Maximizing your diet can give your hair a boost before treatment which means it has the optimal chance of recovery. Its important to eat a protein rich diet, include complex carbohydrates and if you’re a woman who is menstruating, iron is also a key mineral. Iron is plentiful in red meat and so if you’re not on a plant based diet its good to include this twice weekly.
Q: How is diet/nutrition/hydration connected to hair and scalp hair?
A: We know how important it is to keep our body hydrated in order to benefit our facial skin, the same goes for the scalp. Making sure we drink enough water can hydrate our scalp too and help to prevent it from drying out. Our hair cells are the second fastest dividing cells in the body and hairs nutritional requirements are quite unique. The hair is never prioritized when it comes to food which means it’s at the ‘back of the queue’ and is considered a ‘non-essential’ tissue. Therefore maximizing our diet, eating ‘smarter’ which means choosing foods with the most nutritional value is key. For example, if you want a snack between meals (which is recommended) then you’re better choosing a handful of almonds than a bag of chips! Meal skipping is also a ‘no no’ for those concerned with their hair. You should also make sure you eat adequate calories and have a very inclusive diet to ensure you get the most value from your meals.
Q: How soon after your hair grows back can you begin to color it?
A: Once the hair is around 3 inches long (which might take about 6 months) you can begin to consider coloring your hair again. It is important; however, that your scalp is comfortable. Make sure that there is no soreness, itching or discomfort and it feels healthy. Its important to discuss with your hairdresser that you have had chemotherapy to ensure that extra care is taken. The hair may be much finer than before treatment, so this may mean it is weaker and needs more careful handling. A patch test is always recommended as the scalp may have become more sensitive.
Q: Is there anything you can do to make your hair go back to normal faster post-chemotherapy? For example, if your hair becomes coarse and curly.
A: Hair usually regrows normally in time for most people who have undergone chemotherapy. You can’t speed up hair growth, but you can make sure things are in place for when hair is ready to grow. Making sure your iron levels are good is so important as if you are deficient in iron (or even just have levels a little on the low side) this can really hinder your hair regrowth. Also vitamin B12, Vitamin D and zinc are vital for hair cell renewal and so either have a blood test to make sure you’re not deficient or take a good hair supplement. Our Philip Kingsley Tricho Complex was formulated by us as Trichologists and contains all the vitamin and minerals in all the right quantities that hair relies on. It’s very common for hair to be a different texture post-chemo. It may come back curly when it used to be straight. It’s thought that the chemo drug changes the hair follicle temporarily. This should return to normal within around 12 months.
Q: What should you avoid doing to your hair/scalp when you’re undergoing chemotherapy?
A: Chemical processes, such as coloring or perming, should never be undertaken during treatment. It is not recommended to massage oils into the scalp, even if it feels dry as this can cause a contact dermatitis or irritation at the least. If you have lost a significant amount if your hair then your scalp will be more exposed. Its important to cover your scalp when you’re outside in sunlight to prevent sunburn and skin damage.
Q: How can you maintain good scalp health for optimal regrowth?
A: First of all, the scalp is the bedrock of hair growth therefore a clean and healthy scalp = a healthier head of hair. Frequent shampooing, even if you have lost all or most of your hair is still important. Daily shampooing is good as this cleanses away dead skin cells, bacteria, sweat and pollution which provides a healthier scalp environment. Just make sure you use something gentle and mild.
Q: Which PK products are best to use on your scalp when you have no hair, and how often should you use them?
A: Philip Kingsley’s No Scent No Colour Gentle Shampoo (and conditioner if you have not lost all your hair) is gentle for delicate scalps. It is free from color, fragrance, sulfates and parabens. You don’t need a complicated routine, just gentle formulas which are kind to the skin.
Q: Which PK products are best to use once your hair starts to grow back?
A: Hair almost always regrows following chemotherapy, so you don’t need to use anything special to make sure this happens. However, if you feel you want to do something to optimize this growth you can. Keep your routine simple and when your scalp is comfortable, treatment is finished and hair is starting to regrow, you can use our Stimulating Weekly Scalp Mask, which optimizes scalp health. If your scalp is itchy or flaky, then the Philip Kingsley Flaky Itchy Scalp Toner is extremely soothing and cooling.
Q: How do you know if you need to see a trichologist, and what is the best way to find one in your area?
A: If your hair is not returning to normal, if it’s brittle and breaking or your scalp remains uncomfortable, then it’s wise to seek out a Trichologist. I’ve provided a link here to the International Association of Trichologists where you can locate someone qualified and registered near to you.
Q: How do you determine what kind of hair loss you have?
A: There are many hair loss conditions and numerous causes and so it can be difficult to self diagnose. The 2 most common hair loss conditions I see as a Trichologist are Pattern Hair Loss (male and female) sometimes called ‘hair thinning’, its Trichological name is Androgenetic Alopecia. This is a genetic condition where the hair follicles to the top area of the scalp become miniaturized and produce finer and shorter hairs over time. This results in the scalp becoming more visible in this area and often the parting appearing wider. This is a progressive condition which needs treatment to slow it down.
The other very common hair loss condition is excessive hair shedding, otherwise known as Telogen effluvium. This is when you are seeing an abnormal amount of hair fall when you shampoo or handle your hair. This is a temporary condition and can be caused by several factors. Thyroid dysfunction and nutritional status are the most common causes but also sickness, a fever and even Covid-19 can trigger it too. Blood tests are often advised to check the thyroid and also for iron levels and other common nutritional levels such as vitamin B12, zinc and vitamin D. once the cause is identified and corrected the hair shedding should stabilize and regrow.
Wow! Thank you Lisa for all of your expertise and insights! I hope we meet again soon!