Hair loss

Cancer treatments and hair loss

Some cancer treatments can cause hair loss. Your doctor will be able to talk to you about your situation. Some people find the condition and growth of their hair changes. Others find their hair falls out completely. 

Different treatments will affect your hair differently:

  • chemotherapy can cause your hair to fall out. It will usually happen within 2–3 weeks of starting treatment. Some chemotherapy drugs can make other hair from your body fall out, such as facial hair and pubic hair. Not all chemotherapy drugs make your hair fall out. Hair usually grows back after your treatment finishes
  • radiotherapy can cause your hair to fall out, but only in the area being treated. If you are having radiotherapy to your head, you will probably lose hair from your scalp. Hair does not always grow back after radiotherapy. Your doctor will talk to you about this
  • other cancer treatments, such as hormonal therapy or targeted (biological) therapy, can cause changes to your hair

It can help to know more about how treatment could affect your hair. Your doctor or nurse will be able to answer any questions.

Preventing hair loss

Scalp cooling can reduce hair loss caused by chemotherapy. It works by reducing the amount of chemotherapy drugs reaching the hair follicles. Scalp cooling doesn’t work with all chemotherapy drugs and it’s not always possible to know how effective the treatment will be.

You will need to keep your head cold before, during and after treatment. There are two methods of scalp cooling:

  • cold cap - a special cap filled with cold gel
  • refrigerated cooling system - this pumps liquid coolant through a cap

You might feel cold during your treatment, but the chemotherapy staff will try to make you as comfortable as possible. Your hospital may not have the facilities for scalp cooling. Your doctor or nurse can tell you if it’s available and whether it’s suitable for you.

If you don’t lose all your hair, but it thins or becomes dry or brittle, it’s important to treat your hair carefully. This can help to reduce hair loss.

Tips to help you care for your hair and skin during and after treatment

It’s important to look after your hair and skin during and after cancer treatment.

To look after your hair:

  • wash it at least once every two days
  • use gentle hair products
  • check with your radiotherapy team if you can use products on the affected area
  • only use conditioner on the middle and ends of long hair
  • blot wet hair with a towel and use a wide toothed comb.
  • wear a soft cap or turban at night
  • eat a balanced diet
  • avoid using hairdryers, straighteners or hot rollers
  • avoid colouring, perming or relaxing
  • try not to tie your hair in a tight band
  • if you lose your hair, it’s important to look after the skin on your head and in other places where you had hair

To look after your skin:

Avoid using deodorants, soaps, perfumes and lotions if you’re having radiotherapy. Check which products you can use with your radiotherapy team.

  • shampoo your scalp every day
  • use an unperfumed moisturiser
  • use pillows made from natural fibres
  • protect your head from the sun and from the cold

Tips to help you prepare for losing your hair

If it’s likely you will lose your hair during cancer treatment, there are ways you can prepare:

  • eat a well-balanced diet before treatment starts to help your body cope better
  • talk to friends and family about losing your hair
  • buy a hat or other headwear to protect your head
  • talk to other people who have hair loss to share tips on how to cope
  • if you decide to wear a wig, buy one before treatment starts. It will be easier to match it to your colour and style, and you can get used to wearing it
  • buy products to help you cope with losing your eyebrows and eyelashes
  • you could also consider cutting your hair short:
    • you may find it easier to cut it in stages
    • don’t use a blade to shave your head
    • it’s best to cut clean dry hair
    • you could ask a salon that specialises in styling people affected by cancer to cut your hair

What are my options?

There are many ways to cover up hair loss. Hats, scarves and turbans are popular options for men and women.

  • hats - there are many styles to choose from
  • scarves - versatile with many colour and fabric options. Lightweight materials such as cotton are best 
  • turbans - easy to wear and widely available
  • wigs - you can continue with a familiar style or try something new

Some hats, headbands or bandanas have optional fringe or hair attachments. If you still have some hair, changing your hairstyle can help cover up hair loss. Specialist hairdressers like mynewhair can offer advice. 

In certain situations surgery to replace hair (hair transplant) might be an option if your hair loss is permanent. This treatment is not available through the NHS. 

You may not want to wear anything on your head. Accessories, clothing and make up can express your style and draw attention away from the hair loss.

After treatment

As your hair grows back after treatment, you may find that it has changed.

Hair usually grows back after chemotherapy. It may be curlier, finer or a different colour. You might find that it grows unevenly or in patches. These changes are rarely permanent.

Hair re-growth after radiotherapy depends on the type and number of treatments you had, and the area of the body that was affected. If your hair grows back, it usually starts 3–6 months after treatment. It may be patchy, thinner or a different colour.

Sometimes hair loss can be permanent. If you have hair loss on your head, you may want to wear a wig, hairpiece or another type of headwear.

As your hair grows back:

  • use shampoos and products if they do not irritate your scalp
  • when your hair is long enough to style, you may decide not to cover your head
  • choose a hairdresser who understands your situation. If your hair is finer, you could ask them about using hair extensions
  • you may be able to colour or perm your hair. Seek professional advice before doing this

MacMillan have more information on hair loss.