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.

Hair loss due to cancer treatment

Our hair grows from indentations in the skin called follicles. There are over 100,000 hairs on the average head and they each have a continual growing, resting and falling cycle. When we are healthy, about 90% of our hair is in the growing phase.

Cancer treatments can affect your hair’s normal phases of hair growth. Some treatments may make your hair fall out completely. This may be from your head and other parts of your body. This is usually temporary. Other treatments can cause permanent hair loss in specific areas of your body. Sometimes, complete hair loss may not happen, but your hair can become thinner and more brittle.


Chemotherapy

emptyemptyChemotherapy uses anti-cancer drugs to destroy cancer cells. The drugs work by attacking the cancer cells and disrupting their growth. Unfortunately, they can also affect the normal cells in the body, including the cells of the hair follicles. This disrupts the natural hair growth cycle and causes hair loss, known as chemotherapy induced alopecia (CIA). Unlike cancer cells, however, the normal cells quickly recover. This means that if you lose your hair due to chemotherapy, it will almost always grow back when your treatment is over.

Many people assume that they will lose their hair if they have chemotherapy. This isn’t always true. Many chemotherapy drugs can cause hair loss. But some chemotherapy treatments never cause hair loss. The hair loss may vary from mild shedding that is hardly noticeable, to complete hair loss.

The amount of hair that falls out depends on the drug or combination of drugs used, the doses given and the way your body reacts to the drug. New chemotherapy treatments are being trialled all the time so it is not always possible to predict whether someone will lose their hair.

Some chemotherapy drugs make other body hair fall out, such as eyebrows, eyelashes, nasal hair, beard, moustache, chest, underarm, leg and pubic hair. Again, this is almost always temporary. We have some practical tips to help you cope with this hair loss.

A process called scalp cooling can prevent hair loss in some people. Before you start chemotherapy, your doctor or chemotherapy nurse will discuss with you how likely hair loss is and other side effects. We have some questions below that you may want to ask your healthcare team.

Will my hair grow back after chemotherapy?

Whether you have partial or complete hair loss, your hair will nearly always grow back in full. Very rarely, after high doses of chemotherapy, not all of the hair grows back. Very occasionally, some follicles will not make a new replacement hair. This can make your hair permanently thinner – but this is rare.

Your hair may even begin to grow back before you finish your treatment. We have more information on caring for your hair as it grows back.

My hair started falling out after my first chemo. It’s not been too bad, I have lots of pretty scarves and I know it will grow back.

Sha, discussing chemotherapy side effects


Radiotherapy

There are a number of types of radiotherapy. External radiotherapy treats cancer by using high-energy rays that destroy the cancer cells, while doing as little harm as possible to normal cells. This only causes hair loss in the area being treated. For example, if you have external radiotherapy to your head, you’ll probably lose some hair from your scalp in the area where the radiotherapy beam goes into and out of your scalp. If you’re having treatment for breast cancer, and the radiotherapy includes your armpit, the hair under your arm is likely to fall out.

Whether you will have hair loss depends on a number of things, including the dose and number of treatments. You can ask the radiotherapy staff how likely you are to have hair loss and to show you exactly where your hair will fall out.

Will my hair grow back after external radiotherapy?

Hair loss following external radiotherapy is sometimes permanent. Other people find the hair that grows back is patchy. Your doctor or radiographer will discuss the possibility of permanent hair loss and other side effects with you before you start your treatment.

If you have hair loss on your head, you may want to wear a hairpiece, wig or some other type of headwear. It may also be possible to have a hair transplant. However, this is a specialised treatment that isn’t available on the NHS. If you are considering a hair transplant, contact the Institute of Trichologists for a list of qualified surgeons. This option is not suitable for everyone. 

We have more information about what your options are.


Surgery

If you are having surgery in an area of the body that has hair, such as an operation for a brain tumour, an area of the head will be shaved. This is usually a small area of hair and it will grow back after the operation.


Other cancer treatments


Questions to ask your healthcare team

Not all cancer treatments affect hair in the same way. It can help to know what changes to expect and how to prepare yourself. Here are some questions you may like to ask your doctor or nurse:

  • Is it likely the treatment I’m having will cause hair loss?
  • Will I have complete hair loss, patchy hair loss or thinning?
  • How long after starting my treatment is hair loss likely to happen? How quickly will it fall out?
  • Will I lose hair from other parts of my body? For example, my eyelashes, eyebrows, facial hair or pubic hair?
  • Is there anything I can do to prevent hair loss?
  • Will my hair grow back after the treatment has finished?
  • How long after treatment can I expect my hair to grow back?
  • Can I get financial help to buy a wig or hair piece? Can you recommend headwear suppliers or support groups?

If you’re having chemotherapy

  • Is scalp cooling an option for me to help prevent hair loss?
  • How likely is it that scalp cooling will work?

If you’re having radiotherapy

  • Can you tell me the size and location of the treatment area and the expected hair loss? You can also ask for a diagram.

Back to Hair loss

Preventing hair loss

Scalp cooling may help to reduce hair loss from the head caused by some chemotherapy drugs. Treating thinning hair carefully can also prevent further hair loss.

After treatment

Your hair may grow back after treatment but it might have changed. It’s important to care for your new hair.