Many people having chemotherapy worry about hair loss (alopecia). Whether you lose your hair will depend on the drugs prescribed.
Some people lose all their hair quickly, while others may lose only a little hair or none at all. Although losing hair from the head is most common, you may find your eyebrows and eyelashes fall out, and you may lose hair from your underarms, legs, chest and pubic area.
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What might happen?
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.
Many people find losing their hair difficult. 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 about how you feel may help.
Some people may be able to reduce scalp hair loss by wearing a “cold cap” on their head while chemotherapy is delivered. The cap is attached via a hose to a cooling unit, which fills the cap with cold liquid. This reduces the blood flow and the amount of chemotherapy drug that reaches the scalp.
The cold cap can only be used with certain drugs and types of cancer, and doesn’t always prevent hair loss. Ask your treatment centre if they offer cold caps and if they are an option for you.
Ways to manage hair loss
- 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 products.
- Comb or brush your hair gently using a wide tooth 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.
- Talk to your hairdresser about making your hair look as good as possible even if it is thin or patchy.
- 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.
- If you plan to wear a wig, choose it before treatment starts so you can match your own hair colour and style. Call Cancer Council 13 11 20 for information about wig services.
- Use a cotton, polyester or satin pillowcase, as nylon can irritate your scalp. Wear a light cotton turban or beanie to bed if you are cold.
- Avoid dyeing your hair during or for about six months after chemotherapy or consider using vegetable-based dyes.
- If your eyelashes fall out, wear sunglasses outside to protect your eyes from dust and sun.
- If your eyebrows fall out, you can buy reusable eyebrow wigs to wear until your eyebrows grow back.
- Contact Look Good Feel Better – this national program helps people manage the appearance-related effects of cancer treatment. Workshops are run for men, women and teenagers.
- For more on this, see Hair loss.
Clinical A/Prof Rosemary Harrup, Director, Cancer and Blood Services, Royal Hobart Hospital, TAS; Katie Benton, Advanced Dietitian, Cancer Care, Sunshine Coast Hospital and Queensland Health, QLD; Gillian Blanchard, Oncology Nurse Practitioner, Calvary Mater Newcastle, NSW; Stacey Burton, Consumer; Dr Fiona Day, Staff Specialist, Medical Oncology, Calvary Mater Newcastle, and Conjoint Senior Lecturer, The University of Newcastle, NSW; Andrew Greig, Consumer; Steve Higgs, 13 11 20 Consultant, Cancer Council Victoria; Prof Desmond Yip, Clinical Director, Department of Medical Oncology, The Canberra Hospital, ACT.
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