Hair loss and hair care

Hair is important to everyone's appearance and self-image, so losing your hair can be a distressing experience.

Some patients feel anxious when they find out their treatment will affect their hair. If you feel worried, you may find that talking to the staff caring for you helps. They will be able to answer any questions you may have.

Hair loss during treatment

Many people assume that chemotherapy always causes hair loss but this isn't true. Some drugs cause none at all. However, certain drugs do cause partial or complete alopecia, which means all body hair is temporarily lost. If the drugs included in your treatment plan will result in you losing hair, the doctors and nurses treating you will explain this to you. If you have any questions, do not hesitate to ask them.

Hair loss may start within a couple of days of beginning treatment or may not occur for some weeks. You'll probably notice more hair on your brush, in the basin or shower after washing your hair or on your bed linen. Some people notice that their scalp becomes quite tender just before their hair comes out.

Body hair may also be lost, that is underarm and pubic hair, eyebrows and eyelashes. Your eyes may water more easily and be more sensitive to the sun. Wearing sunglasses will help to protect your eyes.

Scalp cooling

Scalp cooling is a method of preventing hair loss but it can only be used with certain drugs. Research has shown that scalp cooling can prevent hair loss with three drugs - doxorubicin, epirubicin and taxol. Even then success depends on the dose of drug and whether other drugs are given at the same time.

The procedure uses a cold cap to lower the temperature of the top of your head. The cold narrows the blood vessels and prevents the drug passing into the cells at your hair root and damaging them.

Your doctor will tell you if scalp cooling can be used with your chemotherapy. You can then decide whether or not to try it. A doctor or nurse will explain the procedure before you begin treatment.

Hair loss and radiotherapy

Radiotherapy causes hair loss in a different way to chemotherapy and only affects the specific area being treated. For example, if radiotherapy is given to the breast or chest, only chest and underarm hair will be lost; if your head is being treated, only head hair will come out.

Although hair loss is usually temporary, for a few people it can be permanent. It depends on the dose of radiotherapy and the length of treatment you receive. If your hair loss is likely to be permanent, this will be explained to you before treatment begins.

During treatment the skin may become red and sore and it's important not to irritate it. The staff at your radiotherapy department will give you advice about how to care for your skin in the treatment area at the beginning of your course of radiotherapy. If you feel unsure of what to do or which products to use, do not hesitate to ask the staff looking after you.

Will my hair regrow?

Your hair will usually grow back when treatment is finished. The time regrowth will take depends on your treatment. Your doctor or nurse will be able to advise you on how long it will take.

Your scalp may itch more than usual while your hair is regrowing, so wash it often with a mild moisturising shampoo. Your hair may grow back slightly differently, for example a different shade or colour, curlier than before or very straight.

Hair care during treatment

When we're unwell or below par we often notice that our hair doesn't have the same bounce or condition as usual.

Whatever treatment you're receiving, take care of your hair and treat it as gently as possible. Chemotherapy in particular may cause your hair to become dry and brittle even if you don't lose it.

Advice on hair care during treatment

  • Use a mild shampoo.
  • Limit the number of times you wash your hair to twice a week, if possible.
  • Always use a conditioner.
  • Use tepid, not hot, water.
  • Pat your hair dry using a soft towel  don't rub it.
  • Use a wide-toothed comb or a soft hairbrush, such as one for a baby.
  • Don't be afraid to brush or comb your hair daily but remember to do it gently.
  • Use ribbons to tie back hair rather than elastic which can easily damage the hair.
  • Don't plait your hair as this may damage it.
  • Don't use harsh chemicals, such as hair dyes, perms, gels and sprays.
  • Use milder, vegetable-based colouring products - your hairdresser will advise you.
  • Don't use excessive heat, for example heated rollers, hot hair dryers or hair tongs.