Cancer treatments and hair loss

Cancer treatments can affect the stages your hair goes through as it grows. Some people find the condition and growth of their hair changes. Others find their hair falls out completely. Your doctor or nurse can tell you if your treatment is likely to affect your hair.

Different treatments will affect your hair differently:

  • Chemotherapy can cause your hair to fall out or thin. This may happen within 2 to 3 weeks of starting treatment. Hair usually grows back after your treatment finishes. 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.
  • Radiotherapy can cause your hair to fall out, but only in the area being treated. Hair does not always grow back after radiotherapy.
  • Other cancer treatments, such as hormonal therapy or targeted (biological) therapy, can cause changes to your hair.

Hair loss can be upsetting. You can talk things over with one of our cancer support specialists on 0808 808 00 00.

Cancer treatments and hair growth

Our hair grows from tiny dents in the skin called follicles. Each hair grows, rests and then falls out. When we are healthy, about 90% of our hair is at the growing stage of this cycle.

Skin structure
Skin structure

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How do cancer treatments affect hair growth?

Cancer treatments can affect the normal stages your hair goes through when it grows:

  • 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 you may not lose all your hair. But your hair can become thinner or more likely to break (brittle).

The treatment side effect I was least looking forward to was hair loss. But I thought, “Maybe this is a chance to have a different hair style”.

Lurline


Chemotherapy

Chemotherapy uses anti-cancer (cytotoxic) drugs to destroy cancer cells. The drugs work by attacking the cancer cells and disrupting their growth. Chemotherapy can also affect the normal cells in the body, including the cells of the hair follicles.

Cancer cells and hair follicle cells both divide quickly. Chemotherapy treatment affects the normal hair growth cycle and causes hair loss. This is called chemotherapy-induced alopecia (CIA). However, unlike cancer cells, the hair 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 is not always true. Many chemotherapy drugs can cause hair loss. But some chemotherapy treatments never cause hair loss. If you don’t lose your hair, this does not mean that the chemotherapy is not working.

Hair loss can vary from mild shedding that is hardly noticeable, to complete hair loss. The amount of hair that falls out depends on:

New chemotherapy treatments are being tested all the time. So it is not always possible to tell whether someone will lose their hair.

For some people, a process called <scalp cooling > can reduce or prevent hair loss.

Some chemotherapy drugs make other body hair fall out, such as:

  • eyebrows and eyelashes
  • nose hair
  • beards and moustaches
  • chest hair
  • leg, arm and underarm hair
  • pubic hair.

This is almost always temporary. We have some practical tips to help you cope with this hair loss.

Before you start chemotherapy, your doctor or chemotherapy nurse will talk to you about side effects and how likely hair loss is.

During chemotherapy

If your hair is going to fall out from chemotherapy, it usually starts 2 to 3 weeks after your first session. Sometimes it can start within a few days, but this is rare. The first thing you may notice is hair on your pillow in the morning. You may also see more hair coming out when you brush, comb or wash it.

Some people only lose some of their hair. The remaining hair will look thinner. For other people, hair may keep falling out over several weeks, leading to total hair loss. Sometimes the hair comes out very quickly over one or two days, which can be very upsetting. You may find that your scalp feels tender. 

Your hair loss may continue throughout your treatment and for a few weeks afterwards. Sometimes your hair may start to grow back between treatments and then fall out again.

Some people do not lose their hair, but their hair becomes dry and weak and breaks easily. If this happens to your hair, be careful with your usual hair care routine to help reduce damage. 

We have more information about caring for your skin and hair during treatment.

Will my hair grow back after chemotherapy?

Hair loss from chemotherapy is almost always temporary, so your hair should start to grow back. However, very rarely hair loss can be permanent. When your hair grows back, the new hair can be different to what it was like before treatment. It may:

  • be curlier, straighter, finer, fluffier or a different colour
  • grow back unevenly at different speeds.

Facial hair, such as beards and moustaches, may also grow back patchy or a different colour. It may take a while for facial hair to return to what it was like before treatment.

You will probably have a full head of hair 3 to 6 months after treatment ends. After around 12 months, you should have a good idea of how thick your hair will be.

Very rarely, after high doses of chemotherapy, not all hair grows back. Very occasionally, some follicles will not make a new replacement hair. This can make your hair permanently thinner.

If you are concerned about your hair growth after treatment, speak to your doctor or nurse.

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

Watch our hair loss video playlist

In these videos, people with experience of cancer and hair loss share their stories. You can also watch tutorials on wigs, headwear and eye make up.

Watch our hair loss video playlist

In these videos, people with experience of cancer and hair loss share their stories. You can also watch tutorials on wigs, headwear and eye make up.


Radiotherapy

Radiotherapy treats cancer by using high-energy rays that destroy the cancer cells, while doing as little harm as possible to normal cells. There are different types of radiotherapy. External beam radiotherapy is given from outside the body. Internal radiotherapy is given using a radioactive material that is placed inside the body.

Radiotherapy will only cause hair loss in the part of the body that is being treated. Hair loss can happen where the radiation beam leaves the body (for example, on the back of the neck), as well as where it enters the body. Ask your cancer specialist or radiographer to show you exactly where your hair may fall out.

The hair loss will also depend on the strength of the dose and the number of treatments you have.

  • If you have external radiotherapy to your head, you will probably lose some hair from your scalp. This will be in the areas where the radiotherapy beam goes into and out of your scalp.
  • If you are having treatment for breast cancer, and the radiotherapy includes your armpit, the hair under your arm is likely to fall out.
  • If you have a beard and have radiotherapy to your head or neck, you may lose your beard.

Hair usually begins to fall out after 2 to 3 weeks. It takes about a week for the hair in the treatment area to fall out completely.

Will my hair grow back after radiotherapy?

Hair re-growth after radiotherapy will depend on lots of things, including the:

  • type and dose of treatment
  • number of treatments given
  • area of your body affected.

Your radiographer can usually tell you before the treatment if your hair is likely to grow back.

If you have been told your hair will grow back, this can start once your skin has healed after treatment. Usually, your hair will start to grow back 3 to 6 months after finishing your treatment. But it may take longer if the treatment dose has been high. The hair that grows back may be thinner, patchy or a different colour.

Sometimes the hair loss is permanent. This can be especially upsetting if it affects the hair on your head. Remember, you can talk things over with one of our cancer support specialists on 0808 808 00 00.

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, hair transplants are specialised treatments that are not 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.

Before I started radiotherapy, I dyed my hair green as a good send-off! My hair is not as thick as it used to be, so I shave it off now.

Vivek


Other treatments

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.

Hormonal and targeted (biological) therapies

Some people notice that their hair becomes thinner while taking a hormonal therapy or targeted (biological) therapy. This is usually mild and the hair grows back at the end of treatment. If you have a beard, you may notice that you have less beard growth.

You may also notice that the hair on your head and body is finer, curlier or more brittle. Each therapy has different possible side effects. Ask your doctor if your hair is likely to change.

Any hair loss from hormonal or targeted therapies nearly always grows back once you have finished treatment. Your doctor can advise you about the type of drug you are taking.


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.

For all types of cancer treatment

  • Does the treatment that I’m having usually 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 my hair 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 hairpiece?
  • Can you recommend any local headwear suppliers or support groups?

If you are 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 are having radiotherapy

  • Can you tell me the size and location of the treatment area?
  • Can you tell me how much hair I will lose in this area?

You can also ask your doctor for a diagram of the body, so they can show you where your hair may fall out.

Back to Hair loss

Scalp cooling

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.

When your hair grows back

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