A diagnosis of lymphoma, a cancer affecting the lymphatic system, can bring many concerns, including changes to hair. The relationship between lymphoma and hair loss is often misunderstood; understanding the actual causes of hair changes during treatment is important. This information can help individuals prepare and cope with potential alterations to their appearance.
Lymphoma and Hair Loss
Lymphoma itself does not directly cause hair loss. The disease primarily affects the lymph nodes, spleen, thymus, and bone marrow. Hair loss is rarely a direct result of the disease’s presence.
However, certain rare types of lymphoma, such as cutaneous lymphoma, can lead to hair loss. This occurs when cancer cells infiltrate and damage hair follicles in the affected skin areas. For instance, folliculotropic mycosis fungoides (FMF), a variant of cutaneous lymphoma, can cause patchy hair loss as aberrant T-cells disrupt hair growth.
Treatment-Induced Hair Loss
The primary cause of hair loss in individuals with lymphoma is the treatment used to combat the disease. Cancer treatments target rapidly dividing cells, which include not only cancerous cells but also healthy, fast-growing cells like those found in hair follicles. This widespread impact leads to hair shedding.
Chemotherapy is a common treatment that often results in hair loss. Drugs such as doxorubicin, cyclophosphamide, daunorubicin, and etoposide are known to cause hair loss because they interfere with the DNA of rapidly dividing cells, halting the hair growth cycle. The extent of hair loss varies depending on the specific chemotherapy drugs used, their dosage, the administration method (e.g., intravenous versus oral), and the frequency of treatment cycles. Hair loss becomes noticeable within two to three weeks after starting chemotherapy and can affect hair on the scalp, eyebrows, eyelashes, and other body hair.
Radiation therapy can also induce hair loss, but this effect is localized to the area being treated. If radiation is directed at the head or neck, hair loss in those specific regions is likely. Unlike chemotherapy-induced hair loss, which is often temporary, hair loss from higher doses of radiation therapy can sometimes be permanent in the treated area.
Targeted therapies and immunotherapy are less likely to cause significant hair loss compared to chemotherapy. For example, fewer than 15% of individuals on targeted therapy and less than 2% on immunotherapy experience hair loss. Some targeted drugs, like those affecting the epidermal growth factor receptor (EGFR), can still lead to hair changes because EGFR is involved in normal hair growth. Stem cell transplants, which often involve high-dose chemotherapy beforehand, can also lead to hair loss due to the intensive conditioning regimen.
Coping with Hair Changes
Experiencing hair loss due to lymphoma treatment can be emotionally challenging, but it is important to remember that for most individuals, this change is temporary. Hair begins to regrow within three to six months after chemotherapy concludes, though it may initially have a different texture or color. For hair loss from radiation, regrowth can take two to six months, but it can be permanent with higher doses.
Preparing for hair changes can help individuals manage the emotional impact. Some choose to cut their hair short before treatment begins, or even shave their heads, to gain a sense of control and ease the transition. Exploring options like wigs, scarves, hats, or turbans before hair loss allows for better matching to natural hair color and style, or provides comfortable head coverings. Gentle hair care practices, such as using mild shampoos and avoiding harsh styling products, are recommended for the scalp and any remaining hair. Seeking support from healthcare providers, support groups, or mental health professionals can also provide valuable strategies for coping with appearance changes.