Hair loss can be very distressing for both men and women when receiving treatment for multiple myeloma. The loss of hair can trigger feelings of anxiety, depression and cause low self-esteem. 

Many of the medications and therapies used in the treatment of multiple myeloma do not cause a complete loss of hair, but may cause a change in the hair texture or volume. Nonetheless, when undergoing an autologous stem cell transplant (ASCT), hair loss is inevitable. 

Hair loss is one of the many side effects of an ASCT caused by receiving a high dose of intravenous chemotherapy called melphalan. Some patients also get a high dose of cyclophosphamide (Cytoxan) before transplant, which also causes hair loss.

Hair loss typically occurs two weeks after receiving melphalan infusion. Some patients experience total hair loss all over the body and not just the scalp: hair on the arms and legs, in the armpits, and in the pubic area is not spared. For many, the eyelashes and eyebrows will thin out but may not be lost completely. The same applies to beards and mustaches. For many, not shaving facial hair or the hair on your legs for several months is an added benefit, along with lessening the need to wash and condition the hair frequently. 

There are several things that you can do to prepare for the loss of your hair to ease the stress associated with chemotherapy-induced hair loss.

Preparing for Hair Loss

Knowing in advance that hair loss will occur, you can proactively prepare. Hair loss can be such an emotional process. You may find that talking with a counselor, a close friend, or a family member may provide comfort.

You may also find cutting your hair short to be helpful. Shorter hair tends to have a fuller look than long hair. As your hair falls out, it will not be as noticeable if you have short hair. Also, if you have long hair, going short might help you better transition to total hair loss.

Some patients will have hair shaving parties with family members to shave the hair off before it falls out. Shaving your head can reduce the irritation and save the embarrassment of shedding.

Other patients decide to donate their hair to Locks of Love. Locks of Love is an organization that accepts donated hair to make wigs and hair pieces for financially disadvantaged children suffering from long-term medical hair loss. 

The decision to go bald, to wear a wig or head covering to conceal your hair loss is a personal one. Should you decide that a wig is right for you, it is a good idea to plan to find the wig before losing your hair. In doing so, you have a better chance of finding one that matches the color and texture of your hair.

Your doctor can prescribe a wig, also called a cranial prosthesis. Your health insurance may cover the cost. If you find that insurance will not cover the cost of a wig, there are several organizations that you can partner with to receive a wig or head covering free of charge.

Many see this as a good time to try a different hairstyle or color they normally would not wear. Have some fun along the journey!

Protecting Your Scalp

Your scalp may be sensitive because of the treatment. This can lead to it being easily irritated when exposed to extreme cold or sunshine. If your head is going to be exposed to the sun or to cold air, protect it with sunscreen or a head covering. A head covering may make you more comfortable, especially when you have no hair or have less hair, which can make you feel cold.

Can Hair Loss Be Prevented?

Cold caps are seen by many to be a solution to hair loss that results from high-dose chemotherapy. The caps work by making the tissue cold, restricting blood vessels, and limiting the amount of chemotherapy that is administered to the hair follicle. Although cold caps have been shown to work for many solid tumor cancers, there is still ongoing research on how well they work in multiple myeloma. Current research shows that when myeloma patients use cold caps to prevent hair loss, the caps could reduce the effectiveness of the therapy being used.

Currently, there is no FDA approval for the use of cold caps in myeloma. Cold cap therapy can be very expensive and, in most cases, is not covered by insurance. You are encouraged to partner with your doctor to determine if cold caps are right for you.

Hair Regrowth Care

The good news is that hair loss is temporary. It may take several weeks to months after treatment for your hair to recover and begin growing again.

When your hair grows back, it may have a different texture, thickness, or even color.

You can massage your scalp gently to remove dry skin and flakes to help with regrowth.

Permanent or semi-permanent hair color should be avoided for at least three months after treatment ends.

Avoid curling or straightening your hair with chemical products such as permanent wave solutions until it all grows back. You may need to wait up to a year before you can chemically curl or straighten your hair. Before trying chemical products again, test a small patch of hair to see how it reacts.

For resources on wigs, head coverings, and cold caps, click here: 

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