Hairloss Prevention During Chemotherapy

      Hairloss as a result of chemotherapy is the ultimate insult to injury. Having to undergo chemotherapy while simultaneously dealing with male or female pattern baldness, or worse yet hair transplant patients, with large donor scars makes the chemo induced hair loss a truly chilling prospect.

      Oncologists will typically reassure you that “you’ll get all your hair back” after chemotherapy. Unfortunately, when hair does grow back it is invariably thinner than it was before, and there are often textural changes in hair that occur as a result. This is with healthy hair. Add to this a pre-existing condition of male pattern baldness, and the prospects of full hair recovery become increasingly bleak.

      Fortunately there *are* several ways that chemo induced hair loss can be prevented, at least for the majority of chemotherapeutic agents.

      The first step is to review the chemo cocktail you or your significant other are specifically prescribed. Not all chemo therapy drugs are created equal when it comes to hair loss. It is often possible to get your oncologists to use chemo cocktails that are much less likely to cause hair loss and still have the same tumor shrinking effects.

      Here is a summary of chemo drugs and their effects on hair.

Drugs which usually do cause hairloss
Drygs which sometimes cause hairloss
Drygs which usually don't cause hairloss
Adriamycin Amsacrine Methotrexate
Daunorubicin Cytarabine Carmustine(BCNU)
Etoposide Bleomycin Mitroxantrone
Irinotecan (Campto) Busulphan Mitomycin C
Cyclophosphamide 5 Fluorouracil Carboplatin
Epirubicin Melphalan Cisplatin
Docetaxel, (Taxotere) Vincristine Procarbazine
Paclitaxel, (Taxol) Vinblastine 6-Mercaptopurine
Ifosphamide Lomustine(CCNU) Sreptozotocin
Vindesine Thiotepa Fludarabine
Vinorelbine Gemcitabine Raltitrexate (Tomudex)
Topotecan Capecitabine

      The next step is to use one or several hair loss prevention strategies that have some degree of scientific support. We’ll review the ones we know about.

Cold Cap System

Prevention of Hairloss
Preventing as much of the chemotherapy drug getting to your scalp as possible can do this. This is done using a cold cap that acts to cool the scalp and therefore restrict blood circulating in that area and reaching the follicles. The availability and types of cold cap used varies from hospital to hospital. The cap put on fifteen minutes before chemotherapy to start restricting blood flow, and kept on during and up to 1-2 hours after your chemotherapy. This does mean that your time in the unit is longer.

Not everyone can tolerate wearing the cold cap as it can feel very cold. This discomfort varies from patient to patient so it is not a failure if you can't wear it and it has no influence on the outcome of your treatment. In other clinical trials to date, less than 2% of patients who had retained their hair did not continue with the procedure.

While cold caps may be effective in preventing hair loss for some chemotherapy drugs they are not successful for all drugs. Your doctor or nurse will be able to advise you.

How it works
Studies have shown that scalp cooling is effective in preventing hair loss in patients treated with some chemotherapy drugs. Cooling the scalp to a temperature of +17 oC to achieve a subcutaneous temperature of +20 0C (68 oF) constricts the blood supply to hair follicles diminishing or abolishing their perfusion hence preventing high chemotherapy dose delivery during the initial phase of chemotherapy. Further, coldness itself reduces the availability of (chemotherapy) cytotoxic drugs to the cells of the hair follicles by directly reducing their metabolic rate. It is the combined effect of both these mechanisms, induced by cooling the scalp, that prevents or reduces hair loss (alopecia).

How effective is it?
The cold cap system works better for some drugs than others. Some clinical trials show a success rate of up to 85% with:

Docetaxel (taxotere) Epirubicin
Paclitaxel (Taxol) Cyclophospha


Nine physicians - professors at the universities who were oncologists, dermatologists, gynecologists and general internists - participated in the production of a thymus gland extract called ThymuSkin, a product they developed primarily for cancer patients who were subjected to chemotherapy.

The preceding progression shows a female with alopecia areata. Before treatment with ThymuSkin, after several weeks of treatment, after several months of treatment with ThymuSkin, then finally after a year and a half.

These physicians performed placebo controlled, double-blind studies on the effects of this product on hair loss in cancer patients. When the product was rubbed on the patient's scalp before he/she took a chemotherapeutic agent, there was no hair fallout -- hair loss was kept at a minimum.. The German GMP subsequently declared the product to be a preventative for hair fallout for chemotherapy patients.

It could be demonstrated that Thymu Skin does not only prevent hair loss in patients undergoing a chemotherapeutical treatment (more predominantly in these treated with 5-Fu than those with adriamycin) but also the degree of prevention of hair loss dependent on the age and the type of the malignant disease. This statement can be condensed by the following one: older patients with breast carcinoma undergoing a chemotherapy with 5-fluorouracil will have a significant benefit by Thymu Skin application as could be shown by no or only slight hair loss during treatment." C.O. Kohler, author of German study entitled "Alopecia during treatment with different chemotherapeutical regimen, summary section."

"Positive adjuvant effects in view to alopecia diffusa during cytostatic chemotherapy with simultaneous application of Thymu-Skin preparations occur in different degree depending on the pathological disease and resulting chemotherapy with different degree of aggressivity. This effect is most obvious in patients with cytostatic chemotherapy of breast carcinoma or malignant diseases of the colon and rectum; in patients with carcinoma of the stomach and the esophagus the effect is only slightly detectable. According to the experiences in this study the simultaneous application of Thymu-Skin preparations in patients with chemotherapy of slight and moderate aggressivity during the postoperative phase is helpful in view to the diminishing of the alopecia rate." University Professor Dr. N.P. Lupke, Chairman of the Division of Pharmacology and Toxicology University Osnabruck, Germany

Summary of Boltzmann Report 2: "The efficacy of the Thymu-Skin preparations in view to a positive adjuvant effect against alopecia inducing side effects of cytotoxic treatment is obvious. Recent data show a positive correlation between the protective effect and the aggressivity of this cytotoxic treatment: the milder chemotherapy, the better are the positive results. Additionally, the local application of the Thymu-Skin products over a complete observation period of 19 months showed no undesired side effects." Professor Dr. H. Denck and Dr. GM Wallner in Final Report Thymu-Skin trial oncology - Wien 1989

Kelly’s comment:Despite the dismissing of Thymuskin as a scam by a few cynics there does seem to be some evidence supporting their claims. Thymuskin is widely available on the internet.


Japanese Researchers Find Cure For Hair Loss During Chemotherapy
July 10, 2007 12:10 a.m. EST
Tokyo, Japan (AHN) - Japanese researchers have found a new form of antibiotic called "alopestatin" that can help cancer patients from losing hair during chemotherapy.

A team lead by Toshiyuki Sakai found that the compound was successful in reducing the hair loss by 70 percent when used on rats that were given etoposide, a chemical used to treat lung and other cancers, but can cause hair loss.

The team of researchers from the Kyoto Prefectural University of Medicine now hope to use the compound to prevent hair loss for cancer patients in future.

Nidhi Sharma - AHN News Writer
Tokyo, Japan (AHN) - Japanese researchers have found a new form of antibiotic called "alopestatin" that can help cancer patients from losing hair during chemotherapy.

A team lead by Toshiyuki Sakai found that the compound was successful in reducing the hair loss by 70 percent when used on rats that were given etoposide, a chemical used to treat lung and other cancers, but can cause hair loss

The team of researchers from the Kyoto Prefectural University of Medicine now hope to use the compound to prevent hair loss for cancer patients in future.

AFP quotes Sakai as saying: "I want people to know that few studies have been made on reducing side-effects of anti-cancer drugs."

He also added that there is a lot of research needed in this field before the drug could be applied to human beings.

However, Saki also added that due to very less research in this field yet, the chances of alopestatin to get commercialised soon, are very "low." The ongoing study was presented at an academic meeting in Japan last week.

Though doctors are not conducting any clinical trials, researchers are hoping that one possible use for humans would be to apply it to the head in the period when hair loss is most likely to occur during chemotherapy.

Hair loss (alopecia) due to chemotherapy is one of the most distressing side effects of chemo treatments. Hair loss happens because the chemotherapy affects all cells in the body, not just the cancer cells.

The lining of the mouth, stomach, and the hair follicles are especially sensitive because those cells multiply rapidly just like the cancer cells. The difference is that the normal cells will repair themselves, making these side effects temporary.

Hair loss may occur as early as the second or third week after the first cycle of chemotherapy, although it may not happen until after the second cycle of chemotherapy.

Kelly’s comment:This should be available in Japan years before you see it in the U.S. You will be able to legally import a personal use quantity,(up to 6 months) when it becomes available, as its not a “controlled” substance. If you have to undergo chemo, remember that you would be well advised to continue whatever treatment regime you are on for male or female pattern loss. In fact several compounds in our MPB treatment protocol have established cancer preventative effects and will in some cases augment the tumor shrinkage caused by chemotherapy. It would be ironic to successfully protect your hair from cytotoxic drugs only to continue to recede or thin due to purely androgenetic reasons.

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