As if being diagnosed with cancer isn't hard enough, cancer treatment and the side effects it can cause may leave you feeling physically and emotionally drained. And bodily changes, such as losing your hair, are a worry for many people.
Whether or not you lose your hair depends very much on the type of treatment you have. Some don’t cause any hair loss, while others can cause all your hair to fall out, including your eyelashes, eyebrows and body hair.
Losing your hair, particularly if you’re female, can be very emotional, and affect your confidence and the way you see yourself. In fact, for many people, hair loss is one of the most upsetting side effects of cancer treatment.
But the good news is that there’s lots of support available, as well as things you can do to help yourself get through this tough time. So keep reading to find out how different types of cancer treatment can affect your hair, and what you can do to prepare for and cope with hair loss in cancer treatment.
How different cancer treatments can affect your hair
The effect cancer treatment can have on your hair depends on the type of treatment, the dose and how long you have it for. And remember that everyone reacts differently – you may not lose any hair, get some thinning or partial hair loss, or lose all your hair.
Chemotherapy and hair loss
Chemotherapy works by targeting any rapidly dividing cells in your body – and this includes both cancerous and healthy cells. Hair follicles are home to some of the fastest-growing cells in your body, so chemotherapy also damages these cells, which can cause hair loss.
Key things you need to know about chemotherapy and hair loss:
- not all types of chemotherapy cause hair loss, but those that do commonly make you lose hair from your head
- some types also cause hair loss on your body – including eyelashes, eyebrows, arm and leg hair, and pubic hair
- hair usually starts to fall out within a few weeks of starting treatment, and if you lose lots of hair, it often happens within 1 to 2 months
- how much and how quickly hair loss happens can vary – depending on dosage, how often you have treatment and if you’re having any other treatments
- once you finish treatment, your hair will usually start to grow back – the timeline can vary, but you’ll probably regrow a full head of hair after 3 to 6 months
- your hair may grow back differently – it may be curlier, straighter, finer, fluffier or a different colour. It can also grow at different rates, so it may be patchy for a while
- it’s very rare for hair loss from chemotherapy to be permanent – very occasionally, some hair follicles won’t make new hair, so your hair will be thinner. This is usually when very high doses of particular medications have been used
Radiotherapy and hair loss
Key things you need to know about radiotherapy and hair loss:
- your hair will only fall out from the area(s) being treated
- hair usually starts to fall out 2 to 3 weeks after your first treatment session – then takes about a week to fall out completely
- you might also lose hair on the opposite side of the area treated, where the radiotherapy beam passes through your body – this is called the ‘exit site’
- how your hair is affected depends on various factors – including the dose, number of treatments and which part of your body is treated
- it can take 3 to 6 months, or occasionally longer, for your hair to start growing back – it might grow back patchy at first, or stay patchy
- it usually grows back, but radiotherapy hair loss can sometimes be permanent – this is more likely with high doses. Your doctor or radiographer can advise about if and when your hair will grow back
Hormone therapy and hair loss
Hormone therapy can be used to stop certain hormones being made in your body, which can slow down or stop the growth of some cancers. Because hormones are involved in hair health, this can sometimes lead to hair loss.
Key things you need to know about hormone therapy and hair loss:
- it doesn’t usually cause total hair loss – but some hormone therapies can cause mild to moderate hair thinning
- hair thinning won’t happen straight away – it can start between 6 months and 2 years after you begin treatment
- it will continue while you have the treatment – but the amount of hair you lose will often level out after the first year or so
- it isn’t permanent – your hair will usually start to thicken again as soon as you’ve finished treatment, but may take a few weeks to return to its original thickness
Targeted therapy and immunotherapy and hair loss
Targeted therapy uses medication that’s designed to attack cancer cells without affecting your healthy cells, while immunotherapy uses your body’s own immune system to attack cancer cells. They can affect your hair in different ways.
Key things you need to know about targeted therapy and immunotherapy and hair loss:
- not all types cause hair loss – some cause slower hair growth or hair thinning, while others can cause total hair loss
- some types can cause other hair symptoms – such as dry, brittle hair
- effects can be noticeable from a few weeks to 2 or 3 months after starting treatment
- some types can cause hair growth in unexpected areas – you may get unwanted facial hair, or your eyelashes may get very long and curly (talk to your doctor or nurse about the safest way to remove any unwanted hair)
- any hair you lose will usually start to grow back as soon as treatment ends
Surgery and hair loss
If you have surgery as part of your treatment plan, part of your body may need to be shaved before the operation. This area will usually be quite small, and your hair will grow back as normal after surgery.
Coping with hair loss due to cancer treatment
Going through cancer diagnosis and treatment can be very stressful, physically and emotionally (and stress can cause hair loss, too). But thankfully, as well as general tips for coping with hair loss, there are several things you can try to help yourself both in the lead up to and during cancer treatment.
If you’re having chemotherapy, you may be able to try scalp cooling – a process that keeps your head cool during treatment to help prevent or reduce hair loss.
There are 2 types – a cold gel cap and a refrigerated cooling system. With both types you need to wear a cap for 30 to 40 minutes before treatment, throughout the treatment and for sometime afterwards. Some people find this uncomfortable.
Scalp cooling can’t be used by everyone or with all types of chemotherapy. And while it can be effective, it only protects the hair on your head, and it doesn’t work for everyone. Your doctor can advise about whether it’s suitable for you.
Hair cutting or shaving
If you’re having chemotherapy and it’s likely that you’ll lose a lot or all of your hair, you may want to cut it short or shave it off before you start treatment.
For some people, this makes hair loss easier to deal with, as it can provide a sense of control over the situation – but it’s a very personal decision.
Looking after your hair and scalp
If you do start to lose hair, it’s important to treat your hair and scalp gently. Here’s how:
- use a baby or other mild shampoo and conditioner to wash your hair
- always rinse your hair and scalp well and it pat dry with a soft towel
- brush your hair with a soft-bristle brush or a wide-tooth comb
- don’t use heated tools, or products such as gels or clips that could hurt your scalp
- keep your head covered from the sun and apply sunscreen with a high SPF
- if your scalp is itchy, try an oil or moisturiser rather than anti-dandruff shampoo
- don’t colour, bleach or perm your hair
Wigs and head coverings
Whether you shave your head or choose to wait for your hair to fall out, you may want to try a wig to help you feel more comfortable and confident. It’s a good idea to have a wig made and fitted before or at the start of your treatment, so you can get a good colour match and have it ready for when you need it.
If a wig isn’t for you, head coverings such as scarves, turbans and hats can be an alternative.
Your nurse will be able to give you a list of places to get wigs and head coverings, or try these Cancer Research recommendations.
Losing hair from your eyelashes and eyebrows can make you look very different, but make-up can help some people feel more like themselves. There are techniques you can learn to draw on natural-looking brows and use eyeliner to create the illusion of eyelashes.
You can get advice and lessons about make-up from charities and organisations such as:
Talking to family, friends and colleagues
As well as hair loss affecting your own mental health, you may be worried about how other people will react to you losing your hair. It can be helpful to be open about what’s happening and talk about your feelings. If you have children, it’s a good idea to explain to them that your hair might fall out before you start treatment.
You may also want to talk to colleagues about your diagnosis, treatment and hair loss. Or if you want to keep it private, that’s also OK – you may want to wear a wig or make-up to conceal your hair loss.
Losing your hair can lead to snap judgments, so going out and about may feel difficult. If you’re feeling self-conscious, reach out to people you trust for support.
Remember that your family and friends won’t see you any differently, and they’ll want to support you – so tell them how you’re feeling and ask for help if you need it.
Cancer support resources
Whether you’re looking for help with wigs or you just need someone to talk to, there’s plenty of free support available from charities and organisations including:
- Cancer Support UK
- The Nightingale Cancer Support Centre
- Cancer Research UK
- Marie Curie
When to see a doctor
You should speak to your doctor if you're finding it difficult to cope with your hair loss. They’ll be able to offer advice and support that fits your individual needs.
You may also need to speak to a doctor if your hair doesn’t start to grow back after cancer treatment. Depending on the treatment you’ve had, they may want to rule out other possible causes of hair loss, such as stress, a scalp condition or another health condition.