Hair loss: Coping with body image issues beyond scalp cooling devices


Abstract

Introduction. Hair plays a significant role in personal and cultural identity, and hair loss, particularly chemotherapy-induced alopecia (CIA), can severely impact a patient's quality of life. Approximately 65% of cancer patients experience hair loss due to chemotherapy, with many considering it a distressing side effect. Women with breast cancer are especially affected, with 91.9% experiencing CIA. This condition can lower self-esteem, increase depression, and lead to social stigma. Coping strategies vary, with some patients adopting active approaches, such as wearing wigs or embracing hair loss, while others rely on passive strategies. Scalp cooling has shown promise in preventing CIA and improving overall well-being.

Materials and Methods. The study recruited 109 adult breast cancer patients undergoing chemotherapy. Participants were assessed using the ECOG Performance Status (ECOG PS) scale, the Dean scale, the 12-item Short Form Health Survey (SF-12), the Hospital Anxiety and Depression Scale (HADS), the Brief COPE scale, and the Body Image Scale (BIS). Socio-demographic data were also collected. Ethical approval was obtained.

Results. Scalp cooling devices were used by 61 out of the 93 enrolled patients. Results indicated that scalp cooling reduced the severity of hair loss, with 55.91% of patients retaining more than 50% of their hair. No significant differences in coping strategies or emotional distress were observed between subjects using cooling caps and those who did not. No significant correlation was found between hair loss and body image; however, greater body image concerns were associated with increased anxiety and avoidant coping. Problem-focused coping was positively associated with better mental health-related quality of life (HRQoL).

Discussion. Patients experiencing more pronounced changes in their physical appearance are likely to face greater challenges in coping with their new situation. However, CIA and the use of scalp cooling devices are not directly linked to body image. Coping strategies play a critical role in promoting psychological well-being in breast cancer patients. Notably, problem-focused coping was associated with better mental HRQoL, whereas avoidant coping was linked to poorer mental health outcomes.

Conclusions. Future research should explore the psychological variables and coping mechanisms involved in effective emotional regulation during cancer treatment, which could aid in the development of interventions for body image disturbances.

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