Many people having chemotherapy worry about hair loss (alopecia). Whether or not you lose your hair will depend on the drugs you are prescribed. Some people lose all their hair quickly and others lose it after several treatments, while others may lose only a little hair or none at all. Although losing head hair is most common, you may find your eyebrows and eyelashes fall out, and you may lose hair from your underarms, legs, chest and pubic region.
When hair loss does occur, it usually starts 2–3 weeks after the first treatment. Before and while your hair is falling out, your scalp may feel hot, itchy, tender or tingly. Some people find that the skin on their head is extra sensitive, and they may develop pimples on their scalp.
After chemotherapy ends, it takes 4–12 months to grow back a full head of hair. When your hair first grows back, it may be a different colour or curly (even if you have always had straight hair). In time, your hair usually returns to its original condition.
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Many people find losing their hair difficult. Your hair may help form part of your sense of self – its loss can affect your self-confidence and make you feel sad or vulnerable. For many people, it’s a public sign of the cancer diagnosis. Talking to your treatment team may help.
Some people may be able to reduce or prevent hair loss by using a “cold cap”. This works by temporarily reducing the blood flow and the amount of chemotherapy drug that reaches the scalp. A cap is worn on the head and attached via a hose to a cooling unit, which fills the cap with cold liquid. It is worn while the chemotherapy is delivered.
The cold cap can only be used with certain drugs and types of cancer, and doesn’t always prevent hair loss. Check with your doctor or nurse whether a cold cap would be an option for you and whether it is available at your treatment centre.
- Keep your hair and scalp very clean. Use a mild shampoo like baby shampoo. If you want to use lotion on your head, use sorbolene. Check with your nurse before using any other hair or skin care
- Comb or brush your hair gently using a large comb or a hairbrush with soft bristles.
- Explain to family and friends, especially children, that the chemotherapy may make your hair fall out.
- Cut your hair, especially if it is long, before it falls out. Some people say this gives them a sense of control.
- Wear a light cotton turban or beanie to bed if you are cold at night.
- Use a cotton, polyester or satin pillowcase, as nylon can irritate your scalp.
- Talk to your hairdresser about making your hair look as good as possible even if it is thin or patchy. If you want to dye your hair during or for about six months after chemotherapy, it is best to use vegetable- based, non-chemical dyes.
- If your eyelashes fall out, wear sunglasses outside to protect your eyes from dust and sun.
- Wear a wig, hat, turban or scarf, or go bare-headed – whatever feels best to you. If you prefer to leave your head bare, protect it against sunburn and the cold.
- Consider choosing a wig before chemotherapy starts. Call Cancer Council 13 11 20 for assistance in finding a wig library or shop.
- Consider registering for a Look Good Feel Better workshop, where you can try on wigs and other head wear and learn new make-up techniques. Call 1800 650 960 or visit lgfb.org.au.
- For more on this, see Hair Loss, or call 13 11 20.
Dr Prunella Blinman, Medical Oncologist, Concord Cancer Centre, Concord Repatriation General Hospital, and Clinical Senior Lecturer, Sydney Medical School, The University of Sydney, NSW; Gillian Blanchard, Oncology Nurse Practitioner, Calvary Mater Newcastle, and Conjoint Lecturer, School of Nursing and Midwifery, The University of Newcastle, NSW; Julie Bolton, Consumer; Keely Gordon-King, Psychologist, Cancer Council Queensland, QLD; John Jameson, Consumer; Dr Zarnie Lwin, Medical Oncologist, Royal Brisbane and Women’s Hospital, and Senior Lecturer, School of Medicine, The University of Queensland, QLD; Caitriona Nienaber, 13 11 20 Consultant, Cancer Council WA; Dr Felicia Roncolato, Medical Oncology Staff Specialist, Macarthur Cancer Therapy Centre, NSW. We also thank the health professionals, consumers and editorial teams who have worked on previous editions of this title.
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