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Hair Loss and Chemotherapy

The side effects of chemotherapy (chemo) depend on the type of chemo and the amount given. Being ready for and managing side effects can help you cope with them.

What causes hair loss?

Many chemo medicines kill fast-growing cells. This means that they affect healthy cells that grow fast, as well as cancer cells. Because cells in hair follicles are fast growing, many chemo medicines cause hair loss, or alopecia. People can lose hair anywhere on the body—the head, eyebrows, eyelashes, and facial and pubic hair. Loss usually occurs 2 to 3 weeks into treatment, depending on the medicines used. Once it starts to fall out, hair may just get thinner, or it may fall out altogether.

Just as each person is different, so is their reaction to treatment. Side effects may be severe or mild. Or you might not have any. Talk with your cancer care team about the treatment you are getting and if it will cause hair loss.

How to manage the hair loss

People often choose to wear wigs, scarves, or hats while or after losing their hair. If this is what you'd like to do, pick them out ahead of time and start wearing them before your hair is completely gone. Check with your insurance company to see if they cover the cost of a wig. You may need your healthcare provider to write a prescription. Other ways to manage your hair during treatment include:

  • Wash it less often.

  • Use a gentle moisturizing shampoo.

  • Don't use coloring products, perms, or other products with strong chemicals.

  • Don't use brush rollers, curling irons, or blow dryers on hot settings.

  • Consider cutting your hair short before you start treatment.

Cold caps

You might want to talk with your treatment team about using a cold cap during your chemo infusions. These devices can be rented or bought online. The cold makes the blood vessels in your scalp tighten up. As a result, less blood carrying the chemo medicine goes through the vessels. That might help prevent damage to your hair follicles and reduce hair loss. Ask your healthcare team about the risks and benefits of cold caps. Also check with your insurance company to see if cooling systems may be covered.

Will my hair return?

Yes, in almost all cases hair grows back. The color or texture may be different at first. But it usually starts to grow about 6 weeks after you've completed chemo. As your hair grows back, try to limit shampoos to twice a week. Also don't use chemical products like perms or straighteners until the hair has regrown. Permanent or semipermanent hair coloring should not be used for at least 3 months after treatment ends. 

Online Medical Reviewer: Jessica Gotwals RN BSN MPH
Online Medical Reviewer: Sabrina Felson MD
Online Medical Reviewer: Todd Gersten MD
Date Last Reviewed: 2/1/2023
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