Dear Doctor: Is it true that chemotherapy not only makes you lose your hair, but that it can also change the color and texture of hair that grows back, and even get rid of gray?

Dear Reader: We think your question may be addressing two different types of cancer treatment -- chemotherapy and immunotherapy. And in both cases the answer is yes; each can have an effect on the regrowth of hair.

After decades of use, much is known about the side effects of chemotherapy. These powerful drugs target cells in the body that grow and divide rapidly. However, chemotherapy drugs are indiscriminate. They can't tell the difference between the rapidly dividing cancer cells and the cells that form our hair, eyebrows and eyelashes.

Many cancer patients undergoing chemotherapy experience hair loss. Depending on the type of treatment, it can range from partial, with perceptible thinning of hair on the scalp and body, to complete hair loss, including body hair, eyelashes and eyebrows. When hair begins to grow back, usually three to six months following treatment, it can indeed be different from the hair that was lost.

For some patients, hair that was previously straight before treatment may grow back slightly coarse and quite curly. We've had some of our patients refer to this as "chemo curl." Changes in color, while not common, are also possible. Once the cells that control hair growth and color recover from the effects of chemotherapy and begin to function again, many patients find that their hair reverts to the color and texture it was before treatment.

Your question about cancer therapy returning color to gray hair makes us think you're talking about recent news stories emerging from the field of immunotherapy. Unlike chemotherapy, which directly targets cancer cells, immunotherapy drugs enlist a patient's own immune system in the fight against cancer cells. It's a new and often experimental approach to treatment, and the full range of potential side effects is not yet understood.

Last year, researchers followed 52 lung cancer patients who were each taking one of a trio of immunotherapy drugs in order to monitor any side effects the treatments might produce. They were surprised to see that 14 of the patients had their hair color go from gray to shades that varied from dark brown to black. One of the 14 patients had patches of black interspersed in his gray hair.

Of these 14 patients, 13 responded well to the immunotherapy drugs. This has led researchers to suspect that the change in hair color is linked to -- or is even an indicator of -- how well the cancer drugs are working. The researchers concluded that the sample size is small enough that these changes in hair color can be random flukes, so they plan to continue to investigate.

If you're hoping that immunotherapy can be used to reverse or stave off the onset of gray hair, you'll have to be patient. At this point in time, immunotherapy drugs have very serious side effects, so their use on otherwise healthy people is still a long way off.

(Send your questions to askthedoctors@mednet.ucla.edu, or write: Ask the Doctors, c/o Media Relations, UCLA Health, 924 Westwood Blvd., Suite 350, Los Angeles, CA, 90095. Owing to the volume of mail, personal replies cannot be provided.)

Dear Doctor: My daughter, who is in her 40s, has fibromyalgia. Is there any cure for this painful condition, or any natural remedies? I hate to see her suffer.

Dear Reader: The word "suffer" perfectly sums up fibromyalgia, and my heart goes out both to your daughter and to you, who can see the condition's terrible effect on her. A chronic pain disorder initially termed "fibrositis syndrome" in the mid-19th century, fibromyalgia has been an official diagnosis only since 1990. The condition causes widespread musculoskeletal pain and fatigue, as well as sleep problems and difficulties in concentration and with memory.

In the United States, 2 to 3 percent of the population suffers from fibromyalgia, with women affected twice as often as men. Blood tests can't detect fibromyalgia, so the diagnosis is based on a person's symptoms, including the tender points identified during a physical examination. That said, people with fibromyalgia have shown abnormal biochemical responses to painful stimuli, and those responses can help guide treatment.

The first step in treating fibromyalgia is to understand the illness and what triggers a flair of symptoms. Anxiety and depression are common with fibromyalgia, and the resulting emotional stress can create a cycle of worsening pain and even lower energy levels.

Let's take a look first at non-medical interventions. Practicing good sleep hygiene is vital because poor sleep can worsen fibromyalgia pain and fatigue, and trigger the cycle mentioned above. Relaxation techniques and therapy can relieve anxiety and depression, while meditation training can ease pain. Further, reflexology and acupuncture have each shown benefits in small studies at easing a variety of symptoms.

Exercise is a crucial component of therapy. Multiple studies have shown that it decreases pain, increases flexibility and boosts energy. Note that if exercise is too vigorous or of high impact, it may cause a flair of symptoms. The key is to start slowly with low-impact exercise, such as walking, biking, swimming or water aerobics. As symptoms improve, patients can increase their level of exercise.

Although they don't cure the illness, various drugs and supplements can improve specific symptoms.

-- The antidepressants amitriptyline, duloxetine and milnacipran can be effective in several ways. Amitriptyline improves sleep, but can lead to dry mouth, constipation and grogginess the following day. Duloxetine can help ease depression or generalized anxiety and has been shown to reduce pain as well.

-- The muscle relaxant cyclobenzaprine can improve sleep and decrease fatigue. It also has been shown to reduce pain after four weeks of use, but not after eight weeks.

-- The anticonvulsants gabapentin and pregabalin can ease pain.

-- The synthetic cannabinoid Nabilone has shown some benefits in improving sleep, but none against pain.

-- Vitamin D supplementation has shown some efficacy against subjective feelings of pain.

Because fibromyalgia is a chronic condition, opiates are not recommended due to the likelihood of tolerance or addiction.

Yet, even with all these treatment options, the best hope is that people can find help controlling, if not curing, their specific symptoms.

Your daughter has one thing in her favor -- the fact that you are there for her and taking her condition seriously.

(Send your questions to askthedoctors@mednet.ucla.edu, or write: Ask the Doctors, c/o Media Relations, UCLA Health, 924 Westwood Blvd., Suite 350, Los Angeles, CA, 90095. Owing to the volume of mail, personal replies cannot be provided.)

Dear Doctor: I've been having trouble with my handwriting, not being able to control the letters. I have also had an occasional tremor in my little finger, and have an ongoing problem with a "frozen shoulder." Do you think a neurological evaluation would be appropriate?

Dear Reader: While this collection of symptoms can certainly be benign, the fact that they are occurring together gives us pause. We're happy to help you by discussing them here. However, we also urge you to make an appointment with your family doctor. He or she will have an understanding of your medical history and can make an informed decision regarding a neurological evaluation.

Let's start with the frozen shoulder. This condition, which is also called "adhesive capsulitis," usually develops gradually. The symptoms -- stiffness and pain in the shoulder joint, which results in a limited range of motion -- tend first to grow more severe, and then slowly begin to improve. The condition usually resolves by itself over the course of months or a few years. Some people categorize the arc of the condition in three distinct phases -- freezing, frozen and thawing.

Frozen shoulder can occur after surgery, or as the result of an injury like a broken bone or damaged rotator cuff. It can arise in people with diabetes, those who have suffered a stroke, people with a thyroid condition, with cardiovascular disease, and in individuals with Parkinson's disease. It's more common among women than men, and in people over the age of 40.

Treatment can include the use of over-the-counter NSAIDs for pain, as well as any mobility and range-of-motion exercises that the patient can tolerate. In severe cases, oral steroids or a steroid injection can bring relief.

When it comes to handwriting, things get a bit trickier. The onset of problems with handwriting can, as you referenced in your question, signal a neurological problem. You mention not being able to "control the letters," and we're not sure whether that's due to shakiness in your hands, or that the letters are not the size and shape you are trying to form.

Shaky handwriting can be caused by something as harmless as too much caffeine, the side effect of a medication or even lack of practice. With so many of us trading in our pens for keyboards of all sizes, handwriting suffers.

A common cause of shakiness, particularly in the hands, is something known as an "essential tremor." While not dangerous, it can become worse over time and interfere with simple tasks. Tremors are also associated with diseases like Parkinson's. However, in Parkinson's, the tremors are most prominent when the hand or limb is at rest. In an essential tremor, the shakiness worsens with movement.

Changes in handwriting have also been associated with certain types of dementia, as well as Alzheimer's disease. In Parkinson's disease, handwriting becomes progressively smaller, a condition known as micrographia.

We can tell from your letter that this cluster of symptoms worries you. Please, as we said at the start of our reply, do see your doctor. Whatever the cause turns out to be, you'll have the advantage of an early diagnosis.

(Send your questions to askthedoctors@mednet.ucla.edu, or write: Ask the Doctors, c/o Media Relations, UCLA Health, 924 Westwood Blvd., Suite 350, Los Angeles, CA, 90095. Owing to the volume of mail, personal replies cannot be provided.)