Topic: Information and Recommendations about Chemo-related Hair Loss
Some facts about hair growth:
On an average,there are 100,000 hairs on the scalp and of which 100-150 are lost normally daily in the cycle.
Hair grows at a rate of 0.35mm per day.
Approximately 85-90% of hair follicles are in the active growth phase at any time.
there are 3 grades of hair loss.
Grade1=less than 25% of hair;obvious to patients but not to others.
Grade2=25-50% loss; obvious thinning but enough to lead to the use of a wig.
Grade 3=>50% loss and a wig may be needed.
Randomized controlled trials suggest significantly less hair loss with scalp hypothermia but it may not be as effective in patients with liver dysfunction.
Among the drugs used to treat CC, ,epirubicin,paclitaxel,irinotecan are those most likely to cause complete hair loss.;5FU,gemcitabine ,mitomycin are less common and Carpoplatin,Cisplatin and Capecitabine are the least common to cause hair loss. EGFR inhibitors like erlotinib(Tarceva) ,sorafenib(Nexavar) and sunitinib (up to 50% of patients) and MoAb like cetuximab(Erbitux) may cause hair thinning and most of them are reversible except in some cases after treatment of gefitinib(Iressa).
In short,high dose of chemo, and combination chemotherapy reigmens are more likely to result in hair loss than are single agents , by oral administration and low -dose therapy and weekly administration.
Because the chemotherapy-associated hair loss is transient and reversible after cessation of the treatment; counseling and psychological support before and during therapy should be considered first over the use of devices such as scalp hypothermia and scalp tourniquet because of case reports of cutaneous metastases and therefore preclude the recommendation for there use.
No pharmacologic interventions is available to treat chemo-related hair loss effectively at this point.--From uptodate.com literature review version. 18.2.