Evaluation of trichodynia (hair pain) during chemotherapy or tamoxifen treatment in breast cancer patients

Introduction In women receiving antineoplastic therapy, hair loss is often accompanied by distressing hair or scalp sensations, such as hair pain (trichodynia) and pruritus. A scientific approach to objectively evaluate the course and characteristics of these unpleasant sensations is of great importance for the establishment of treatment strategies. Methods An observational cohort study was conducted in 34 female breast cancer patients, postoperatively undergoing chemotherapy (group C, n = 17) or endocrine therapy with tamoxifen (group T, n = 17). For 28 weeks after therapy initiation, patients experiencing hair pain and/or scalp pruritus were required to complete a specially developed diary, based on a modification of pain questionnaires. Sensations were journalized in terms of time of onset, duration, intensity on a numeric rating scale, dependence on touching the scalp or hair and character of the sensation, chosen from given descriptors or using own words. Results In group C, all patients who completed the questionnaire experienced hair and scalp sensations: 87% both trichodynia and pruritus, 13% trichodynia only. Reported intensities ranged between 1 and 10. In group T, 31% of participants reported hair and scalp sensations: 12% both trichodynia and pruritus, 12% pruritus only, 7% trichodynia only. Intensities were rated between 1 and 5. No sensations were reported after week 11 in either group. Conclusions Hair and scalp sensations in group C were significantly more common, lasted longer, and were of greater intensity and more differentiated qualities than in group T. The occurrence of trichodynia in chemotherapy patients corresponded with the onset and duration of hair loss, thus suggesting a possible correlation.