Why does chemotherapy cause hair loss?

The article was written by doctors of Internal Oncology - Radiation Oncology Center - Vinmec Times City International General Hospital.

Hair loss is a common side effect of cancer treatment. This is a real concern for many cancer patients. The image of a cancer patient masking hair loss is all too familiar. Chemotherapy drugs usually aim to kill growing cancer cells. Like a tumor, a hair follicle is a functioning structure with cells that are constantly dividing to create and grow hair.

In general, chemotherapy drugs cannot recognize healthy cells and cancer cells, so the drug effectively destroys all rapidly dividing cells, so hair is also lost along with it. the destruction of cancer cells. Some people are so distressed at the thought of hair loss that they refuse chemotherapy, but most people will see their curls grow back once treatment is over.
The degree of hair loss or hair loss caused by chemotherapy, depends on the type of cancer, the type of drug, the specific dose and treatment regimen.
Many patients experience their first hair loss within 1 to 2 weeks of starting treatment.
Areas of high friction during sleep, such as the top of the head and the sides of the ears, are often the first places to see hair loss. However, this mainly depends on the individual's hair.

Actively growing hairs will be most affected, but as the growing hair follicles can be arranged in patches or evenly distributed throughout the scalp, the sequence of hair loss cannot be predicted. What will happen to each person?
After 3 months, the hair loss will be over.
Hair grows back within 1 to 3 months after treatment ends. Up to 60 percent of patients notice a change in hair color or texture during the first wave of hair regrowth, and many have frizzy hair. However, these changes are mostly temporary and the hair will eventually return to normal.

Hair has an important function in life and communication, so hair loss is always at the top of the list of effects for many patients undergoing chemotherapy.
Some patients even refuse chemotherapy for fear of hair loss. The best treatment for hair loss is being tested. Well-known remedies such as cooling the scalp with ice packs or special caps were first introduced in the 1970s. This treatment is cooling aimed at narrowing the blood vessels leading to the hair follicles. Some studies have reported success rates of up to 50 percent with this technique, but there is clearly a need for more effective therapies.

Very little is known about the mechanism by which chemotherapy drugs cause hair loss. Most of the information comes from studies using rats.
Research has shown that programmed cell death, aka apoptosis, is most likely the cause of cell death in hair follicles, causing hair to fall out.
Researchers from the Department of Medicine at the University of Chicago, used genomic association studies to compare the genetics of breast cancer patients who experienced hair loss with those who did not.
They found several genes that may be involved in the loss of hair follicle function. One of them, CACNB4 plays an important role in cell growth and apoptosis. Another gene, BCL9, is known to play a role in hair follicle development.
Scientists are continuing their efforts to develop effective chemotherapy-induced hair loss inhibitors, hoping to reduce the burden this unwanted side effect places on cancer patients.
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Reference article: Medical news today 2019

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