According to Macmillan, there are estimated to be three million people currently living with cancer in the UK, and this number is predicted to rise to over five million by 2040. Yet, BAME communities are still under-served when it comes to post-treatment support and care.
Professionals like Lorna Jones are looking to change this by spreading awareness, improving education and providing first-hand support to those with Afro-textured hair who have undergone or are preparing to undergo cancer treatment that can result in hair loss.
Here, she talks about her work as a trichologist, answers common questions about Afro hair and alopecia, and expands on the work of her organisation, C & Hair, which is backed by Macmillan Cancer Support.
For those who are new to trichology, tell us about what you do!
A trichologist is a hair loss and scalp specialist, so I carry out consultations in my clinic to see people experiencing hair loss and scalp issues. I run two clinics – one in Central London and one in Forest Hill, South East London. I also train new trichologists, who attend to carry out their clinical training as part of their studies with the International Association of Trichologists (IAT). On top of that, I run an online training course, the IAT Hair Practitioner’s Certificate Course, which covers the science of hair and the most common types of hair loss.
I’m also the national Support Group Leader for the UK CCCA Support group. CCCA is short for Central Centrifugal Cicatricial Alopecia, which is a type of central hair loss and is the commonest type of permanent hair loss in black women.
Finally, I am also a published author, and have written two books: If Only Hair Could Talk and Way Beyond the Scalp.
What are the most common types of alopecia for those with Afro hair, and why do they occur?
Traction Alopecia is by far the commonest type of non-scarring hair loss that occurs in women with Afro-textured hair. It is caused by tight hairstyles, including braids, tight ponytails, wigs and locs. If it is caught early enough, it can be reversible, however late-stage traction alopecia as a result of persistent pulling sustained over a period of time, results in permanent hair loss in that area.
CCCA is the commonest form of scarring hair loss, and is a permanent type of central hair loss which is progressive and predominantly found in black women.
How does C & Hair help cancer patients from the black community?
It is essentially a support network that has been set up to provide four services. Firstly, support groups, where individuals with lived experiences of cancer can meet others, share experiences and offer support to each other. Secondly, hair clinics that enable individuals to be seen on a one-to-one basis to discuss any hair issues they are concerned about in relation to cancer treatment, including wig advice. Also, educational webinars where we will have invited expert speakers to cover a range of useful topics. And, finally, interactive workshops where individuals can have hands-on experience of trying out a range of activities like head-wrapping, live demonstrations of hair preparation for scalp cooling and other useful tips.
For those who have undergone chemotherapy, hair loss can be a big confidence knocker. What’s the best way to prepare yourself and your hair for chemotherapy?
Support can play a very important role right through from diagnosis to post-treatment. Support can take many different forms ranging from speaking to other people who have or are going through a similar situation, to gathering useful information and being aware of options for preventing/reducing hair loss through scalp cooling, if that is offered.
In preparing for cancer treatment, we have produced a set of questions that patients can ask their oncology doctor or nurse regarding their treatment and side-effects in relation to their hair and scalp. The medical teams will be able to confirm the specific treatments and likely outcomes in terms of hair loss
Our clinics offer individuals one-to-one consultations to discuss their concerns and we can give hair styling and care advice, wig advice and options for head coverings, eyelash advice and scalp cooling preparation advice.
Wigs, turbans, headscarves or uncovered – there are plenty of ways to reclaim your confidence after chemo, but what’s the best option for maintaining hair health?
Hair care will need to be gentle, especially if the scalp is sensitive because of treatment, and hair styling should not be traumatic i.e. no tight styles, and no chemical treatments are advised, like straightening or permanently colouring hair immediately after treatment.
Are there certain chemotherapy drugs that are more likely to cause hair loss than others?
Yes, that is correct. The extent of hair loss depends on the type of the chemotherapy drug used, the amount of the drug that is administered and the length of time of treatment, so this will vary. However, the health care team will be best placed to advise on the likelihood and extent of hair loss when the treatment plan is agreed.
Some women find that their hair texture changes once their hair grows back following chemo. Why does this happen?
Not only could the texture change but the colour can also be affected and also the shape of the hair. For example, it can change from curly to straight and the other way round.
It is not completely understood why this happens. Beneath the scalp are structures called hair follicles. Hair follicles produce hair which could be straight, wavy or curly and this is determined by the shape of the follicle. It is thought that during chemotherapy, the structure of the hair follicle changes, which then changes the type of hair that grows back. The changes may be temporary or can be permanent.
Is there a possibility that you could permanently lose your hair after cancer treatment?
In the vast majority of cases following chemotherapy, hair will regrow. However, in some cases, it could become permanent, and the condition is known as persistent Chemotherapy-Induced Alopecia (pCIA) or permanent Chemotherapy-Induced Alopecia (CIA).
Radiotherapy induced alopecia (RIA) can also occur if treatment is applied to the head and neck area. This can sometimes result in permanent hair loss with higher doses. I would always suggest having this conversation with the oncology health care team, to help manage expectations.
You’re speaking at the House of Commons about Afro hair loss related to cancer – can you tell us more about what attendees can expect from the discussion?
We have a fabulous line-up of speakers and a packed agenda which will look at the work Macmillan are doing with hairdressers to raise awareness about cancer and why, following research, it is particularly important for women with Afro-textured hair. In addition, it will explore work within the community and about the importance of community partnerships from one of our sponsors, Croydon BME Forum. We will also cover a study that has researched the lived experience of some cancer survivors accessing current services and why there is a need for services to be developed to meet current need.
Attendees will learn more about options to reduce/prevent hair loss with the use of a scalp cooling cap and the preparation techniques for women with type 3 and 4 hair; the specific characteristics of Afro-textured hair and the particular hair care needs; and the effect of radiation on different skin tones.
According to Cancer Research UK, around 1,000 Brits are diagnosed with cancer per day, yet there are many who don’t know how to care for their hair post-chemo. What’s the best way to get educated on this topic?
Through the C & Hair network, there will be a range of opportunities to learn about hair care at our hair clinics, via interactive workshops and also through webinars.
