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Hair Loss
Alopecia is the term for abnormal hair loss on the head and elsewhere on the body, such as eyelashes, eyebrows, hair in the armpit and pubic area, and hair on arms and legs. Hair on the head often falls out in clumps during shampooing or brushing, or even during sleep.
Alopecia occurs most commonly among people receiving chemotherapy and/or radiation therapy. Chemotherapy drugs can cause loss of hair on the head, while radiation causes hair loss only in the area being treated. Not every person treated for cancer will lose his or her hair, even when they take the same drug or have the same treatment.
Chemotherapy and radiation work by killing rapidly dividing cells, such as cancer cells. Because cells in the hair follicles also divide rapidly, they may be damaged by these treatments.
Hair loss from chemotherapy usually begins within 10-14 days after the start of treatment and gets worse within 1 to 2 months. In some instances, depending on the chemotherapy drugs, hair loss may begin with a sensation of the scalp itching, and within a few hours hair begins to fall out. Hair loss typically continues throughout treatment. Hair usually begins to grow back 4-6 weeks after the end of treatment. In general, hair grows back at a rate of about one-quarter inch per month.
It takes longer for hair to be lost during radiation therapy. Hair loss in the area being treated usually begins 2-3 weeks after the first treatment. All hair in that area falls out within about 1 week and may begin to regrow 3-6 months after treatment has ended. However, the hair loss may be permanent.
There are no effective ways to prevent the loss of hair during cancer treatment. Being gentle with your hair may help make your hair loss more gradual and improve the regrowth of your hair.
The best way to manage alopecia is to think about what will make you feel most comfortable with your appearance. Most people with cancer have found that it is easier to make that decision before treatment starts. Many women choose to wear a wig, but some women find wigs to be irritating or itchy. If you decide to get a wig, consider several factors.
Wearing a scarf, hat, or other type of head covering is also a choice. Your scalp may be tender from treatment (especially radiation therapy to the head), and a head covering can protect your scalp against cold and sunlight. If you do not wear a head covering, make sure to use sunscreen on your scalp when you will be outside.
Some people choose to cut their hair short so that hair loss will not be as traumatic when it falls out. Others shave their head completely before treatment begins. How you handle hair loss is a personal decision and the right choice is the one that makes you feel most comfortable.
Being Gentle To Your Hair
- Use a soft-bristle brush and/or a wide-toothed comb
- Wash hair with a gentle, pH-balanced shampoo (avoid shampoos with strong detergents, chemicals, or frangrances)
- Do not use hair dryers, hot rollers, or curling irons
- Do not bleach or color your hair or get a permanent
- Avoid hair sytles that pull on the hair, such as braids or ponytails
- Sleep on a satin pillow case or put a hair net on to decrease friction
Tips on Wigs
- Buy the wig before treatment begins or at the beginning of treatment — you can better match your hair color and texture
- Try on several different wigs to find one that you really like
- Consider buying two wigs, one for everyday use and one for special occasions
- If you can’t afford a custom wig, buy a standard (less expensive) wig and have it professionally styled
- Ask if the wig can be adjusted — your wig size can shrink as you lose hair
- Get a prescription from your doctor for the wig because it is often covered by health insurance (Prescription must state “skull prosthesis for hair loss caused by cancer treatment”)
- Contact your local branch of the American Cancer Society to learn about free wigs that have been donated by patients after they have completed treatment
Talk to your doctor about the possibility of hair loss when discussing treatment options. Although it is challenging to cope with hair loss, this condition is temporary and is not life-threatening so there are no situations in which you need to contact your doctor immediately.
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