jackieb's Cancer Blog
March 14, 2010
So what feels like a zillion years ago, I asked a doctor why people’s hair falls out two weeks after their first chemo infusion. The answer I got was pretty confusing, and seemed to imply that there’s a continual turnover every 2 weeks of 100% of the hair on people’s heads, which just plain isn’t plausible, and suggested to me that I probably misunderstood his answer.
4 months later, I finally hit Wikipedia for the answer!
So time for some pop science.
The hair growth cycle has 3 relevent phases: Anagen, Catagen, and Telogen. Anagen is the growth phase, catagen is the “transitional” phase, and telogen phase is the “resting” phase.
Typically, the overwhelming majority of a person’s hair is in the “growth” phase, with a very small percentage in the transitional or “resting” phases. “Resting” is a bit of a misnomer here—a hair in “resting” phase is a hair that is ready to be shed—any hair that comes out in the hairbrush is probably in “resting” phase. The follicle is resting, the hair itself is dead.
So when I first asked my doctor about the “delay,” he told me that when you get chemo, all your hair enters the “resting” phase at once. Okay… but what does that have to do with the 2 weeks?
To get to the “resting” phase, it turns out, hair must first go through the “transitional” phase, which involves the formation of a “club hair,” a hair which is “complete” and no longer connected to the scalp. This phase of club hair formation takes—you guessed it—two weeks!
So it’s not the hair growth cycle itself that is two weeks, but rather the transitional phase from a healthy growing hair into a dead one. It’s not instant, it’s a 2 week long process. The overall cycle takes 2-7 years to complete, with only about 2% of hair ordinarily being shed at a given time.
It still doesn’t answer why hair starts to slowly grow back in throughout chemo and typically doesn’t fall out again after the first dramatic shedding, but my new, slightly more informed guess, is that the chemo-shocked hair is not dividing rapidly enough to attract the medicine and needs a few months to recover before returning to full health and becoming “attractive” to chemo again.
Interestingly, the telogen (resting) phase tends to last about 3 months, which is similar to what I’ve seen people say about the amount of time it took to see significant, healthy-looking hair regrowth.
Why does hair fall out after two weeks? The answer!, 
4 comments)
March 6, 2010
I should have known I was tempting fate posting a “comprehensive and complete” list of all the side effects I got from chemo, because no sooner did I write that list up, than another one snuck up on me.
If you’re male, then not to worry! I’m doubtful this one will affect you.
Yes, the newest side effect is menopause!
Technically it set in around midway through, but it wasn’t until about a week ago that I started getting symptoms, namely hot flashes. When these initially set in, I took them as an announcement of permanence: I had lost the russian roulette I was playing with my fertility and would never be producing any hormones again. This was upsetting, but innacurate.
Apparently if you’re young it usually comes back (eventually), even if you get Real Menopause Symptoms. It’s strange, for some reason I assumed the body would “know” the difference between chemo-induced temporary menopause and chemo-induced forever menopause and not bother with any symptoms if it was only going to be a few months. Actually, to be honest, before getting hot flashes, I didn’t think chemo-induced menopause came with any symptoms at all.
Mainly because my doctor didn’t mention themmmm. Bah, him and his crazy preoccupation with … cancer.
For now it is not the worst of side effects. Sometimes it messes with a full night’s sleep, but other times it’s good to know that if I bundle up before the morning walk, I’ll be broiling by the time I get outside in the cold. I feel a bit as though I’ve acquired a finnicky new thermostat that I can control as long as I learn the tricks.
In other news:
My breathing problems (the ones that got me diagnosed) CAME BACK for about a week and a half, which gave me a giant scare (as basically everyone I know can probably now attest) but my doctor seems to think it was mostly anxiety, and whatever real symptom was causing the anxiety was very unlikely to be cancer-related. Whew. Shiver. Two weeks or so until the final scan. Hopefully my brain can hold together until then.
...In other, other news:
My hair is finally starting to grow in on the sides! Shyly.
But wait, there's more! (side effects!), 6 comments)
Phew! Hang in there Jackie. I have anxiety related faux-symptoms too, I think.
On the bright side, at least you got to skip perimenopause :) Hopefully everything will return to normal and you can get on with your life.
In case you missed my answer to your comment, I have a cat scan week after next…at 4 weeks instead of 3…and have no idea why he waited an extra cycle to schedule it.
I know you must be loving the hair growth…I’m tried of being bald myself!
Posted on I meant to say 4 cycles instead of 3. (I hate that we can’t edit comments.) Sigh.
Hey, Jackie.
You may have more male compatriots than you imagined. My friend who is on hormone therapy for prostate cancer has hot flashes too. Glad the hair is making a return engagement. Hope your ovaries get to regroup and go back to work.
Andrea
Posted on Hey Jackie,
Welcome to the “chemo causes menopause” club, although, your oncologist is way more optomistic than mine. He said in all the years he’s done this, although they say menopause will reverse for those young enough (like me, at 44), he’s never seen it happen.
Initially, I was thinking that not having my monthly period was a pretty cool thing…that is, until I began to experience the hot flashes and insomnia. Oh holy cow…I think this may be karma for me making fun of my mother for all of these years for her hot flashes.
So…enjoy your personal summers. It’s just another indication that you’re alive!
Jill
Posted on Bob, your scan is probably soon then! Let us know how it goes. A plus to waiting longer is you’ll probably see smaller tumors on it since the meds have been working on them a longer time.
Jill, I do have a really optimistic doctor! So much so that it worries me sometimes, like he might be sugarcoating things. He didn’t seem to have the slightest doubt it would reverse (a consideration might be that I’m 23, so that’s about 30 years early for biological menopause.)
So, I’m hopeful that his predictions come to pass. But if not, I can schedule a vacation for whenever I want and not have to worry about the monthly visitor! Ahahaha.
Posted on Yes, yes, yes, Hot flashes are sooooooo annoying. I used to wake up every 10 minutes with intense heat followed by chills.
BTW, my period came back about 5-6 months after finishing chemo, back to normal.Yuyu
Posted on 
Thanks for your support - 
Ok. That is fascinating. And comforting. All through this process, we are nagged with the question “is it working” and things like your new, stubby, fuzzy-wuzzy hair NOT falling out bring that question back to the forefront.
This space is a great thing…knowing that…your hair acted like mine, puts that question back to the ‘do not go there’ box.
One thing I’m interested in that you didn’t mention is the pain. On chemo-row I’ve spoken with several people who have experienced what I did: the initial fall out hurt—not a lot, but like when you sleep on it wrong….only over my entire head.
I wonder if when hair enters the ‘resting’ phase it is sensitive to being moved (like having slept wrong)...and if the 2% there is not enough to notice—or if when you do notice it (while not undergoing chemo) maybe it isn’t that you slept on it wrong at all…maybe it is just an area that is entering rest.
Ah the things to ponder…
My question is, why is my hair coming back in like “baby Hair” and when will it feel normal again? I still can’t wear my hair down, I have to pull it back in a small pony tail with lots of gel and hairspray and I am 5 months post chemo. I just want my hair back laying softly down my shoulders again. :(
Pulled up the following answer:
When your new hair comes in, it may be different from your natural hair at first. This is due to the loss or change of pigment and may result in white, gray, or some color different than your natural hair color. As your body recovers and hair pigment rebounds, your hair may return to its original color, or a color close to your pre-chemo hair. Expect a change in hair texture as well – it may initially be kinky, curly, coarse, or even fine as baby hair. This initial chemo hair may be trimmed away as it grows out over the next six to twelve months after treatment. Give yourself time to recover – meanwhile, treat your new hair gently.
Aaaaaugh. But 6-12 months is better than forever, and you’re edging close to that timeframe now.
And Bob, I don’t know if I experienced the same thing, but it could be the dead hairs that had died but hadn’t left your head jabbing back into the nerves since they were no longer connected.
I think my hair started coming back at the end of chemo. After radiation six weeks later, I had the baby hair——very soft, white with black specs. In three months, it was gray and curly, but finally growing a little. Two months after that, I felt safe (and desperate enough) to have it colored at a salon. No problems. A year after that, my hair went exactly back to its old texture: wave, but no curl.
It all just takes time, but it will return.
Enjoy!