Sharing advice on how to
care for your hair DURING AND AFTER
COLD CAPPING.

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Regrowth. The one little word that everyone scalp cooling wants to be able to shout from the roof tops! It is a small thing but so wonderfully important and the most fantastic sign of moving onwards.

But, as with all things scalp cooling, there are no hard and fast rules about regrowth. It can happen at different times and in different ways for each patient. So, this is a regrowth 101 – all the things you need to know so that you can breathe a sigh of relief and let the little tufties row!

When will I start to see regrowth?

This can be very dependent on the drug you are receiving as well as the number of rounds of chemo you will have. If you are on weekly taxol, and have 12 rounds, you may well see regrowth before you finish your chemo. This can happen with other regimens too, particularly those that have many cycles and those where we see really good retention.
For those on harsher regimens, really you would be looking at anywhere between 8 and 12 weeks after your final chemo treatment, though this can take longer for some and less for others.
It’s one of those ‘how long is a piece of string’ questions, where the answer is different for everyone. The great news though is that we now have clinical data to confirm the anecdotal evidence that we have had for many years, that scalp cooling encourages faster, healthier and stronger regrowth than would occur without scalp cooling. So even if you have retained less hair than you would have ideally liked, you are looking after your future hair regrowth by scalp cooling.

 

I’m still shedding, I can’t possibly have regrowth

Not the case! It is completely normal and common to see regrowth occuring while shedding is happening at the same time. Shedding can continue for a quite a while after you complete your chemo but this absolutely does not mean that you won’t see regrowth too.
If you think about your normal hair cycle, we all lose around 100 hairs a day anyway, and this does not prevent our hair from getting longer.

 

What can I do to encourage regrowth?

This is a tricky one. The best thing you can do to encourage hair growth is to have a healthy balanced diet, drink lots of water, get lots of sleep and try to avoid stress. So much easier said than done!

There are a few things that you can try to encourage hair growth, but it is important that you consult your doctor before using anything topical or a supplement.

Biotin is a supplement that can encourage hair growth. Please consult your doctor first, as many will advise that you do not take biotin during chemo. Also, be aware that it can take upwards of 6 months of taking biotin daily before you will begin to benefit from it, so it isn’t a quick fix.

Minoxidil is an active ingredient that can be found in some products such as Regaine, which in some cases can help with regrowth. It is really important that you only use this product after chemotherapy and scalp cooling has been concluded as it increases blood flow to the scalp, the opposite of what you want for scalp cooling to work effectively. Again, similar to biotin, it can take many months to take effect.

Other regrowth products are a bit of a murky area. Unless they contain clinically proven active ingredients, then in all honesty they probably won’t make any difference, and certainly not while you are scalp cooling. In fact, many products will increase blood flow to the scalp and therefore may be detrimental rather than helpful during scalp cooling. Many growth products are also targeted at or designed for very different types of hair loss. There really is nothing that is going to stop your hair from shedding and encourage it to start growing during scalp cooling other than patience and time.
Sadly regrowth products can be a waste of money.

 

Regrowth seems to be taking forever. I feel really anxious about it.

Try not to worry too much. Easier said than done, but as the old saying goes, a watched pot never boils. Many patients say that they looked and looked for regrowth, then all of a sudden it just appeared. Your hair will grow back! It can sometimes be hard to see if you have had consistent thinning, but it will appear.

Will my hair grow back a different colour or texture?

This is a difficult one to say. The somewhat notorious chemo curls and changes in colour are caused by damage occurring to the hair follicle as a result of the chemotherapy drugs. Scalp cooling protects the follicles by reducing blood flow to the scalp, therefore less chemotherapy drugs reach the follicles. This means that you are less likely to see these changes as you will have sustained less damage to the follicles. There are however no guarantees.
Some patients see a big difference, other no difference at all. A change in hair texture from straight to wavy or curly, or the other way around is a result of the hair follicles changing shape. A straight hair grows from a round hair follicle, wavy or curly hair from a follicle that is more oval or elliptical in shape.  It is also important to remember that if you have naturally wavy or curly hair that new growth can appear much curlier, or in a different curl pattern when it is new and short. As it grows longer and gets heavier, you may well find it begins to fit the curl pattern you are used to.
Some patients see a lot more grey hair or notice grey hairs for the first time. This may not be permanent, your hair may become pigmented again, or it may stay grey. Also remember this may be the first time you haven’t dyed your hair for a very long time, so it may be that you had greys even before you started chemo that you hadn’t noticed previously, they are now just more visible having not coloured them for a while.

 

I was treated with docetaxel and I am aware of the risk of persistent alopecia. I am very worried because I haven’t seen any regrowth yet. Could I have persistent alopecia?

Persistent alopecia is divided in to grade 1 and grade 2. Grade 1 is defined as ‘weakening of the hair or partial alopecia, not leading to the use of a wig after 18 months from the end of adjuvant chemotherapy’ and grade 2 is defined as ‘complete alopecia that requires a wig after 18 months from the end of adjuvant chemotherapy’.
We have clinical data to show that ‘scalp cooling is effective at preventing persistent alopecia on docetaxel chemotherapy regimens’. You can see the information in our Clinical Efficacy Brochure which you can download here.
Scalp cooling does prevent persistent alopecia as a result of docetaxel. By scalp cooling you have done everything to protect your hair follicles. Regrowth will come, it can just take a little while to grow in, sometimes a couple of months. You’ll be there before you know it.

 

My hair is growing but its super pale, soft and almost fluffy!

This is nothing to worry about. These are called vellus hairs and are similar to the hairs that grow on your arms or face. This is just your follicles firing back up again and it is most likely that ‘normal’ hair will begin to show again really soon. Your hair follicles have been through a lot and it’s just starting the growing process gently.
Embrace the tufties! You’ve worked hard for those!!

 

My hair is re growing nicely, can I return to my normal hair care regimen?

There is no reason not to return to your normal routine once shedding has returned to normal. One thing to keep in mind is that your hair may now be in a different condition that it was when you started chemo. It may be that you’ve gone from having normal hair to now having dry hair. Chemo has such a drying effect, so you may want to keep this in mind when selecting your products. It may be that the products you used previously aren’t appropriate anymore. Moisturising and hydrating products are always a good idea and will help to look after your retained hair and also nurture your new growing hair.

 

I’ve got bizarre bits of regrowth that stick up all over my head. Any ideas how to style them?

Regrowth can have its own challenges, particularly as it gets going. There may be times when you feel like you’ve got two hair styles at the same time, and that the regrowth has a mind of its own! Maybe speak to your hairdresser. It may be time to think about a look that can help to manage the growing out stages, or they may be able to give you some tips on how to style the new hair more effectively. Try to think positively about your new growth, it’s a lovely problem to have!

 

Hopefully the above will help you to understand regrowth and what to expect. When you reach the end of chemo and scalp cooling, in terms of your hair the hard work is over. With a little time, you will see that strong, fast and healthy regrowth.

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