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Chemotherapy: Coping with hair loss

We often seek medical treatment to help us feel better. But some lifesaving treatments, such as chemotherapy for cancer, can have temporary side effects that make you feel worse. It can even be harder to cope with how this therapy changes the way you look.

For many people, hair loss is a difficult side effect of chemotherapy. But knowing what to expect can help.

What's happening?

Chemotherapy drugs kill cancer cells by attacking fast-growing cells. This works because cancer cells are some of the most rapidly growing cells in the body.

Unfortunately, some of our normal body cells also grow very quickly. Chemotherapy can affect these cells too. Fast-growing normal cells include the cells in hair follicles and nails.

When chemotherapy drugs damage the cells in the hair follicles, the hair may break off at the scalp or simply fall out. The effect ranges from a bit of thinning to complete hair loss.

When you stop taking the drugs, your hair follicles recover and your hair will start to grow back one to three months later.

If you're taking a chemotherapy drug that affects your hair follicles, you'll probably begin to see some hair loss within two weeks of starting treatment.

What to do

Your hair may come out a bit more slowly if you treat it gently. The American Cancer Society (ACS) and the American Hair Loss Council (AHLC) suggest these steps:

  • Use a mild shampoo to wash your hair and a soft-bristled hairbrush or comb.
  • Avoid excessive brushing or pulling of hair, which can happen while making braids or ponytails, using rollers, blow-drying, or using curling or flat irons.
  • Hold off on dyeing your hair or having a permanent curl put in.
  • Use satin pillowcases or wear a hair net at night to keep hair from coming out in clumps.
  • Ask your doctor about using a cooling cap. Cooling caps are sometimes used during chemotherapy to try to prevent hair loss from drugs given through the vein.

Remember, though, that you probably can't do anything to completely prevent hair loss.

Getting ready

Before you start chemotherapy, ask your doctor what kind of side effects to expect. If your treatment might cause hair loss, start thinking about if and how you want to cover your head. Simple options include hats, scarves and turbans.

If you want a wig, start shopping before your hair falls out so you can get one that matches your natural hair as closely as possible. Keep in mind that your wig will fit differently after your hair is gone. Check with your insurance company to see if it will help pay for a hairpiece during cancer treatment.

If your hair is long, you may want to consider a shorter haircut. This can make your hair look thicker and fuller and reduce the amount of hair you'll see coming out on your pillow or in the shower. It can also make it easier to adjust to baldness.

Shaving your head before you lose your hair is another option. Some people prefer this to watching their hair come out, according to the National Cancer Institute.

Talking to other people who have lost their hair might help too. You might find a support group by contacting your local ACS chapter.

Rules of regrowth

Complete hair growth may take six months to one year.

According to the AHLC, gentle treatment is best for new growth. They offer these tips:

  • Wash your hair twice a week with a gentle shampoo. Follow with a conditioner made for fine or limp hair.
  • Massage your scalp to remove scaling.
  • Avoid heavy styling, curling appliances and high heat from hair dryers. Your hair will be more prone to breaking and your scalp may be tender. You'll probably want to hold off on permanent waves, permanent hair coloring and bleaching too.
  • Stick with normal and light-hold styling products. High-hold products don't always wash out with mild shampoos and may build up, causing hair dullness or scalp problems.

Don't be surprised if your hair looks a little different when it grows back. It may be a different color or texture or come back curly instead of straight. These changes in your hair's character may be temporary or permanent.

Hang in there

Remember, hair loss from chemotherapy is rarely permanent. Knowledge and support can help you cope.

Reviewed 12/1/2022

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