Hair loss is a common side effect of chemotherapy because it attacks rapidly growing cells in the body not just cancer cells. Hair loss can be traumatic and compromise self-esteem and quality of life in people with cancer. Breast cancer is the most common cancer in women worldwide and its treatment often involves adjuvant chemotherapy (chemo following surgery).

Chemotherapy-induced hair loss is rated by women with breast cancer as one of the most distressing side effects of treatment.  A number of countries have trialed the use of scalp cooling for hair loss in people undergoing chemotherapy.

Scalp cooling is thought to potentially help by constricting blood vessels to the scalp and therefore reducing delivery of chemo to the scalp, drug uptake by cells, and follicular metabolic rate. While scalp cooling is available in Europe, use has been limited in other parts of the world.

Researchers investigated the association between scalp cooling and hair loss in women with breast cancer who are undergoing chemotherapy.

Scalp cooling was delivered through a cap device. Participants were women aged 18 years or older with stage I or II breast cancer, who were undergoing chemotherapy. A silicone cap was fitted on patients’ heads and scalp cooling commenced half an hour prior to each chemotherapy session. The outcomes assessed were hair loss four weeks after the last dose of chemotherapy and self-reported quality of life.

The results showed a significant reduction in hair loss in the women receiving scalp cooling compared to those who weren’t. Furthermore, fewer patients in the group receiving scalp cooling reported feeling less physically attractive.

Implications

Scalp cooling may be an effective method to reduce the degree of hair loss experienced by women undergoing chemotherapy. The scalp cooling system appeared to be tolerable by women in this study and there were few adverse events associated with it.

Hair loss can be traumatic for cancer patients and translate to increased rates of depression, and reduced self-esteem and quality of life.

Scalp cooling systems are not approved for common use in many countries approval from regulating bodies is required prior to its widespread implementation. Nevertheless, the results from this study suggest there may be hope for fighting the effects of chemotherapy-induced hair loss in future.

Last Reviewed: 20/12/2019

© Norman Swan Medical Communications.



References

Rugo, H et al. (2017). Association Between Use of a Scalp Cooling Device and Alopecia After Chemotherapy for Breast Cancer. JAMA. 317(6): 606-614. doi: 10.1001/jama.2016.21038.

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