The Chemotherapy Drugs That Cause Hair Loss

The Most and Least Likely Chemo Drugs to Cause Hair Loss

Woman receiving chemotherapy
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Chemotherapy is a systemic treatment that your doctor may prescribe to fight your breast cancer. Some, but not all, chemo drugs cause unwanted side effects like hair loss, as they fight your cancer.

Let's learn about hair loss from chemotherapy, and which drugs are most likely to cause this side effect. 

Hair Loss From Chemotherapy

You may experience hair loss as one side effect of chemotherapy. Whether or not you develop hair loss and the degree of your hair loss depends on a number of factors including:

  • dose of chemotherapy
  • how often the chemotherapy is given
  • the route of administration

The good news is that chemotherapy-induced hair loss is almost always reversible.

Usually a person will notice hair loss during weeks one to three of chemotherapy. This continues for about one to two months after starting chemotherapy. Hair re-growth then begins typically within three to six months after chemotherapy is over. When the hair starts growing back, some people may develop chemo curls, with a gradual returning of their natural hair.

Which Chemotherapy Drugs Cause Hair Loss?

There are a number of chemotherapy agents used in breast cancer — many of them used in combination. For instance, chemotherapy regimens that contain Cytoxan (cyclophosphamide) and a taxane therapy, like Taxol (paclitaxel) or Taxotere (docetaxel) are usually associated with hair loss. 

Here is a list of chemotherapy drugs — not exclusive to breast cancer — that are most and least likely to cause hair loss.

 

Chemotherapy Drugs Most Likely to Cause Hair Loss

  • Adriamycin (doxorubicin)
  • Cytoxan (cyclophosphamide)
  • Daunorubicin
  • Taxotere (docetaxel), Taxol (paclitaxel)
  • Ellence (epirubicin)
  • etoposide
  • ifosfamide 
  • irinotecan 
  • topotecan
  • Navelbine (vinorelbine)

​Chemotherapy Drugs That Sometimes Cause Hair Loss

  • Amsacrine
  • Bleomycin
  • Busulphan
  • Cytarabine
  • 5-FU (5-fluorouracil, Fluorouracil, Adrucil)
  • Gemzar (gemcitabine)
  • Lomustine
  • Melphalan
  • Thiotepa
  • Vinblastine
  • Vincristine

​Chemotherapy Drugs That Rarely Cause Hair Loss

  • Paraplatin (carboplatin)
  • Xeloda (capecitabine)
  • Carmustine
  • Platinol (cisplatin)
  • Fludarabine
  • Methotrexate (Amethopterin, Mexate, Folex)
  • Mitomycin C
  • Mitroxantrone
  • Procarbazine
  • Raltritexate
  • 6-Mercaptopurine
  • Streptozotocin

What Should I Do?

Speak with your oncologist about what to expect in terms of hair loss from your chemotherapy. If you decide you would like to wear a wig or hairpiece, it's a good idea to shop prior to undergoing chemotherapy so you can match your natural color.

The American Cancer Society suggests buying a wig or hairpiece from a speciality shop for patients with cancer. Alternatively, you can purchase one through their "tic" or Tender Loving Care catalog at www.tlcdirect.org or call 1-800-850-9445.

Sources:

American Cancer Society. A Guide to Chemotherapy: Hair loss from chemo. Retrieved October 26th 2015. 

Kanti V. Analysis of quantitative changes in hair growth during treatment with chemotherapy or tamoxifen in patients with breast cancer: a cohort study. Br J Dermatol. 2014 Mar;170(3):643-50.

Tallon B, Blanchard E, & Goldberg LJ. Permanenet chemotherapy-induced alopecia: case report and review of the literature. J Am Acad Dermatol. 2010 Aug;63(2):333-6.

Trüeb RM. Chemotherapy-induced hair loss. Skin Therapy Lett. 2010 Jul-Aug 15(7):5-7.

Trüeb RM. Chemotherapy-induced alopecia. Semin Cutan Med Surg. 2009 Mar;28(1):11-4.

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