Supportive Care in Cancer

, Volume 5, Issue 2, pp 139–143 | Cite as

Changes in self-concept and body image during alopecia induced cancer chemotherapy

  • K. Münstedt
  • N. Manthey
  • S. Sachsse
  • H. Vahrson
Short Communication


Alopecia as a result of cancer chemotherapy has been reported to cause changes to the self-concept and body image. In a prospective longitudinal study, self-concept and body image were analysed in 29 patients after histological confirmation of gynaecological malignancy, mainly ovarian cancer, who were assigned to receive a complete-alopecia-inducing PEC combination chemotherapy (cisplatin 50 mg/m2, epirubicin 60 mg/m2 and cyclophosphamide 500 mg/m2 in 1 day every 28 days). The analysis was performed before the commencement of treatment and repeated when alopoecia was complete and after completion of therapy when patients had already experienced regrowth of hair, using the Frankfurt self-concept scales (FSKN) and Frankfurt body concept scales (FKKS). Significant differences were observed in the various evaluation scales FSAP (general ability to solve problems), FSSW (general self-esteem), SGKB (state of health), and SKEF (physical fitness). For all scales the results worsened during chemotherapy but did not return to normal or improve when patients experienced regrowth of hair. It was found that 73.3% of the patients did not feel as self-confident as before treatment and that for 46.6% alopecia was the most traumatic side effect of chemotherapy. Since there is no chemotherapeutic regimen or any other effective treatment that can prevent alopecia, either of the following conclusions can be drawn: the observed differences may not be related exclusively to alopecia, but also associated with coping processes initiated by chemotherapy and perhaps enhanced by alopecia; or the changes persist even after the discontinuation of chemotherapy. Regrowth of hair and other adaptive processes do not normalize or improve the impaired body image and self-concept.

Key words

Alopecia Self-concept Body image Chemotherapy 


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Baxley KO, Erdmann LK, Henry EB, Roof BJ (1984) Alopecia: effect on cancer patients' body image. Cancer Nurs 7:499–503Google Scholar
  2. 2.
    Beard (1986) Social and psychological implications of alopecia areata. J Am Acad Dermatol 14:679–700Google Scholar
  3. 3.
    Coates A, Abraham S, Kaye SB, Sowerbutts T, Frewin C, Fox RM, Tattersall (1983) On the receiving end — patients perception of the sideeffects of cancer chemotherapy. Eur J Cancer Clin Oncol 19:203–208Google Scholar
  4. 4.
    Deusinger IM (1986) Die Frankfurter Selbstkonzeptskalen (FSKN). Verlag für Psychologie, GöttingenGoogle Scholar
  5. 5.
    Deusinger IM (1996) Die Frankfurter Körperkonzeptskalen (FKKS). Verlag für Psychologie, Göttingen (in preparation)Google Scholar
  6. 6.
    Diehl JM, Arbinger R (1989) Einfüh-rung in die Inferenzstatistik (Supplement). Koltz, EschbornGoogle Scholar
  7. 7.
    Freedman TG (1994) Social and cultural dimensions of hair loss in women treated for breast cancer. Cancer Nurs 17:334–341Google Scholar
  8. 8.
    Gallagher J (1992) Women's experience of hair loss associated with cancer chemotherapy: a qualitative study. UMI Dissertation ServicesGoogle Scholar
  9. 9.
    Hamburg D (1974) Coping behavior in life threatening circumstances. Psychother Psychodyn 23:13–26Google Scholar
  10. 10.
    Manchester PB (1981) The adolescente with cancer; concerns for care. Top Clin Nurs/Oncol 2:31–37Google Scholar
  11. 11.
    Moermann DE (1988) The meaning of baldness and implications for treatment. Clin Dermatol 6:89–92Google Scholar
  12. 12.
    Nerenz DR, Love RR, Leventhal H, et al (1986) Psychosocial consequences of cancer chemotherapy for elderly patients. Health Serv Res 20:960–976Google Scholar
  13. 13.
    Perlin E, Amin D (1991) Protection from chemotherapy-induced alopecia. Med Pediatr Oncol 19:129–130Google Scholar
  14. 14.
    Raquepaw JM (1990) Psychological and behavioral effects of alopecia. UMI Dissertation SevicesGoogle Scholar
  15. 15.
    Seipp CA (1993) Hair loss. In: DeVita VT, Hellman S, Rosenberg SA (eds) Cancer: principles and practice of oncology. Lippincott, Philadelphia, pp 2394–2395Google Scholar
  16. 16.
    Stroud JD (1983) Hair loss in children. Pediatr Clin North Am 30:641–657Google Scholar
  17. 17.
    Tierney A, Taylor J (1991) Chemotherapy-induced hair-loss. Nurs Stand 5:29–31Google Scholar
  18. 18.
    Tollenaar RA, Liefers GJ, Repelaer van Driel OJ, Velde CJH van de (1994) Scalp cooling has no place in the prevention of alopecia in adjuvant chemotherapy for breast cancer. Eur J Cancer [A] 30:1448–1453Google Scholar
  19. 19.
    Wagner L, Bye MG (1979) Body image and patients experiencing alopecia as a result of cancer chemotherapy. Cancer Nurs 2:365–369Google Scholar
  20. 20.
    Wolf N (1991) The beauty myth. Anchor/Doubleday, New YorkGoogle Scholar

Copyright information

© Springer-Verlag 1997

Authors and Affiliations

  • K. Münstedt
    • 1
  • N. Manthey
    • 1
  • S. Sachsse
    • 1
  • H. Vahrson
    • 1
  1. 1.Department of Gynaecological Oncology and RadiotherapyJustus Liebig UniversityGiessenGermany

Personalised recommendations