Chemotherapy

Many patients are surprised to find that their hair looks different when it grows back after chemotherapy. Hair that was once straight may come back curly, a phenomenon sometimes called “chemo curls.” Changes in hair texture or even color are common after treatment, but they’re usually temporary.

We talked to breast medical oncologist Adaeze Iheme, M.D., to understand why this happens and what you can expect during hair regrowth after chemotherapy.

How chemotherapy affects hair growth

Chemotherapy works by targeting cells that divide rapidly. While this approach is effective at killing cancer cells, it also affects healthy cells, including those in the hair follicles. 

Damage to the follicles can temporarily disrupt your hair’s normal growth process, leading to changes in texture or color.

“Chemo can linger in the hair follicles and alter the way hair grows,” says Iheme. “That’s why patients sometimes notice their hair coming back curlier, finer or even in a different color.”

Hair growth depends on a process called hair shaft synthesis. When chemotherapy disrupts this process, it can cause new hair to grow differently than before. Texture changes are one of the most common side effects, but you might also notice that your hair feels thinner, more fragile or grows in uneven patches at first.

As chemotherapy leaves your body and the hair follicles recover, in most cases, hair should eventually return to its original texture and color.

Chemotherapy may cause your hair color to change 

Along with texture, patients sometimes experience changes in hair color after chemotherapy. If you once had brunette hair, for instance, you may notice reddish or lighter hues when your hair regrows.

The exact reasons for these color changes are not fully understood. Iheme says that genetics, age and gender may all influence how hair grows back. “We don't know the full biology behind it, but we do know that changes in hair color are possible after chemotherapy,” she says.

Fortunately, like texture changes, hair color changes are usually temporary. As your body heals, you may find that your hair gradually returns to its pre-treatment color.

Interestingly, while scalp hair may change color or texture, other body hair — such as eyebrows and eyelashes — typically regrows with little to no noticeable change.

Sometimes, patients ask me about IV vitamin therapy after reading testimonials online from people who claim it has helped them feel better, or that it can ease the side effects of cancer treatments, such as nausea caused by chemotherapy.  

But is there any evidence to support these claims? And, is IV vitamin therapy safe? 

Here, I’ll answer some of the most frequently asked questions I hear about IV vitamin therapy. 

What is IV vitamin therapy?

IV vitamin therapy is when you receive a fluid solution containing certain vitamins intravenously, or through a vein, rather than by taking them by mouth in pill form as a dietary supplement or getting them from the foods you eat. 

What is the goal of IV vitamin therapy?

That depends on who you ask, and which IV vitamins you’re talking about. People are drawn to IV vitamin therapy for different reasons.  

The one I’m usually asked about is vitamin C. Some patients have heard that IV vitamin C therapy may improve their quality of life during cancer treatment. Others hope that IV vitamin C therapy may give them a chance to live longer after diagnosis or reduce their chances of a cancer recurrence.  

So, does IV vitamin therapy actually work?

IV vitamin therapies have been investigated for a long time. But at this point, most doctors in the field of cancer medicine have not seen enough convincing, high-quality evidence to broadly recommend the use of IV vitamin therapies alongside conventional cancer treatments.  

There is very strong evidence, though, showing that a whole-food, plant-based diet and regular exercise can help you feel better, live longer, reduce your overall cancer risk and risk of recurrence. So, we encourage our patients to make lifestyle changes to improve and protect their health first. We’d rather you get your vitamins through the foods you eat than through an infusion. 

Leukopenia is the scientific term for having a low white blood cell count. It’s considered a more general term than neutropenia, which is specific to only one type of white blood cell (the neutrophil).  

The Greek prefix “leuko-” means white, while the suffix “-penia”  means “too few.” So, it encompasses all types of white blood cells, including neutrophils, lymphocytes, monocytes, eosinophils and basophils.

Read on to learn why you might have leukopenia, what its symptoms are and how it’s treated.  

What’s the most common reason for a low white blood cell count? 

The causes of leukopenia fall into two main categories. 

1. Your body doesn’t make enough of them. 
2. Some external force, such as an infection, is destroying them. 

Some people’s bodies naturally don’t make white blood cells, like the late David Vetter, who was known as the “Bubble Boy” in the 1970s. But immunodeficiencies like his tend to show up very early.

When older people develop low white blood cell counts, it’s usually because of something else, such as leukemia. Naturally occurring reasons for leukopenia are far less common.

Among our patients at UT MD Anderson, though, cancer treatment — especially chemotherapy — is the most likely reason. Neutropenia is a well-known side effect of chemotherapy.

So, leukopenia doesn’t just mean my body is fighting off an infection?

No. Not unless you’ve been fighting it off for a very long time. 

Are there any other possible causes of leukopenia?

Yes. A genetic variation called benign ethnic neutropenia has been identified in some Black, Middle Eastern and Asian populations who have lower numbers of neutrophils than people of primarily European descent. They aren’t sickly, and they don’t get more infections than anyone else. Their neutrophil counts are just naturally lower than those of others. It’s also sometimes known as Duffy-null associated neutrophil count (DANC).

Much like sickle cells, benign ethnic neutropenia appears to be a natural variation that developed in areas where malaria is prevalent. Sickle cells die more quickly if they’re infected with malaria. But because people with benign ethnic neutropenia also lack a certain receptor on the surface of their red blood cells, malaria can’t even get into them. It gives them natural immunity.  

What are the symptoms of leukopenia?  

Frequent infections, whose symptoms include fever, chills and sweating. That’s why instructions about what to watch out for are some of the most important things we give our patients. That’s also why it’s so important to see your doctor quickly if you develop a fever during cancer treatment. 

When you’re receiving cancer treatments, your body can’t always fight off infection in the same way it normally would. That’s why you may need antivirals or antibiotics.  

How is leukopenia treated? 

Growth factors like filgrastim are available that can stimulate the bone marrow to produce more white blood cells. But we determine whether you need one based on what’s causing it and how often you’re getting sick. Someone who’s getting frequent infections would be treated differently than someone who only gets an occasional cold. 

What’s considered a dangerously low white blood cell count?  

The normal white blood cell range is between 4,000 and 11,000 cells per microliter (mcL). But if you’re not getting sick all the time, even a very low count isn’t necessarily cause for alarm. A “dangerously low” blood count is more about symptoms than numbers. 

Joanne Becker, M.D., is a transfusion specialist in Laboratory Medicine. 

Request an appointment at UT MD Anderson online or call 1-877-632-6789.

Platinum-based chemotherapy drugs — including cisplatin, carboplatin and oxaliplatin — are well-known for causing nerve damage in the hands and feet. This can lead to a side effect called peripheral neuropathy. Patients who experience it often report abnormal sensations of tingling, burning or numbness.

But patients who receive the drug oxaliplatin may also experience something extra: an extreme sensitivity to cold.

Known as cold dysesthesia, this form of neuropathy is unique to oxaliplatin. It can make drinking ice-cold beverages extremely unpleasant and exposure to chilly temperatures very uncomfortable — whether they’re due to air conditioning or just the weather. For some patients, the sensation can be so strong that it’s actually painful.

So, how soon does this cold sensitivity start after receiving oxaliplatin? How long can you expect it to last? And, is there anything you can do to manage it? Read on to find out. 

When does the cold sensitivity from oxaliplatin start?

The sensitivity to cold can come on very quickly after a chemotherapy infusion. Still, some patients don’t notice it for several days. It can even surprise them, especially when it comes to cold food and drinks. That’s why I warn patients before they start any oxaliplatin-based chemotherapy regimen.  

How long does the cold sensitivity last?

That depends on the length of your treatment. The first couple of times you receive oxaliplatin, you might only have cold sensitivity for a day or two. But the longer you’re on it, the longer your symptoms can last. A few months into chemotherapy, your cold sensitivity may linger for several days, or even weeks, after an infusion. 

The good news is that cold sensitivity usually goes away once you’ve finished chemotherapy. And, it’s not dangerous, just unusual. The abnormal cold sensation of dysesthesia can be mild or bothersome. But in and of itself, it’s just a side effect; it doesn’t mean something bad is happening.