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Chemotherapy, radiation and certain drug treatments may cause hair loss (alopecia) or a change in the texture or color of your hair.

  • If you have chemotherapy and other drug treatments, hair loss can happen on your scalp, face, arms, legs, underarm and pubic area. 
  • If you have radiation treatment, hair loss is only on the part of the body that is being treated.

The extent of hair loss depends on the specific treatment and your individual response to it. 

Intense scalp tenderness for a day or two often signals hair loss.(The tenderness will go away when hair starts to fall out.)  Hair does not generally fall out all at once. It generally sheds over several days or weeks or longer, coming out in handfuls or patches when you wash or comb your hair. Sometimes hair comes out just from touching it. For some people, hair loss happens in less than one day.

Your doctor can tell you if your treatment is likely to cause hair loss.

Before the start of treatment which may have hair loss as a side effect,, it is advisable to do the following:

  • Decide how you want to handle hair loss if it happens. Hair replacement alternatives include wigs, going bald, hats and caps, scarves and turbans. You can switch back and forth among the various alternatives. 
    • Shaving your head before chemotherapy-induced hair loss begins reduces the mess from falling hair. It also can act as a measure of control, which can help with coping.   
    • If you are going to use a wig, purchase one while you still have hair so you can make a match.  Free wigs are available if cost is an issue.
  • Learn proven tips for caring for your hair during treatment. For instance, you can hold on to as much hair as possible for as long as possible by wearing something like a hairnet or soft night cap to sleep, keeping your hands away from  your hair, and not washing it.
  • If you have lhair that isat least 10 inches long, consider cutting it and donating the hair to a group such as Locks of Love offsite link which makes wigs for children for free or on a discounted basis.


  • Free or low cost wigs are available.
  • For tax purposes, wigs are "Medical Expenses" if your doctor writes a prescription for "Hair Prosthesis" or "Hair prosthesis required because of hair loss caused by cancer treatment."

Some people feel more in control of the situation by cutting off all hair when hair first starts to fall out. This alternative saves the possibility of clogging drains and hair on the pillow when you wake up.

If you lose all your hair:

  • Remember that hair will almost always grow back after treatment ends, although it may be a different texture or even color.
  • Keep your scalp moisturized and protected from the sun.
  • If you have a garden, collect your hair and leave strands in bushes and trees. Birds will use it to make soft nests.

Hair loss may be one of the first outwardly obvious physical signs of a health condition. Women often have a more difficult time dealing with hair loss than men since they are not usually used to seeing themselves or other women without hair. Share emotions with family and friends, and possibly a support group and/or cancer buddy - it does help.

If the fear of potential hair loss is keeping you from undergoing chemotherapy, consider scalp cooling devices which are currently only available outside the United States. Cold caps lower the blood flow in the scalp which decreases the amount of chemotherapy drugs which reach the hair follicles on your head. The concept behind the caps is that the less drug that reaches your hair, the less likely the hair is to fall out. Cold caps are only suitable for certain drugs and certain types of cancer. There is no guarantee that cold caps will prevent hair thinning or loss for everyone. Since the device is not FDA approved, proceed only with extreme caution. To learn more, see: offsite link

For additional information see:

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Causes of Hair Loss: Chemotherapy and Radiation


The loss of hair occurs because the drugs affects the hair follicles. Hair follicles go through a cycle starting with a cycle of growth and ending with older hair falling out -- at which point a new cycle of hair growth starts again. Approximately 90% of hair is in the growth phase ("Anagen") at any point in time. Chemotherapy speeds up the process -- thus accelerating hair loss.

Some chemotherapy drugs cause no hair loss or only a very small amount of loss.

Hair loss may begin one to three weeks after the start of your treatment. Hair loss on the scalp can happen gradually or suddenly (in clumps or all at once.) Hair loss can occur on all parts of the body, not just your head. Facial hair such as eyebrows and eyelashes, arm and leg hair, underarm hair, and pubic hair may also be affected.

Typically your hair will start to grow back with the completion of your chemotherapy, although it may take six to 12 months to return completely. You may find that your hair has changed texture. For example, it may now be brittle or hair once curly may now be straight. Dark hair may become lighter.

Changes to your hair due to chemotherapy are usually only temporary.

Radiation Therapy

Radiation therapy only affects the area being treated. For example, if you are receiving radiation treatment to your back, you will not lose hair on your head.

If you are receiving radiation treatment to the head or scalp you may experience permanent hair loss depending on the amount of radiation received and the type of radiation treatment used.

Questions To Ask About Hair Loss Before Starting Chemotherapy or Radiation

You may be better prepared for possible changes if you know what to expect.

Consider asking the following questions:

  • Is it likely that I will have hair loss?
  • Are there alternative treatments that will not include hair loss?
  • When will my hair loss begin?
  • How much hair loss should be expected?
  • Is there anything that I can do to prevent or delay my hair loss?
  • When should my hair start to return?

Hair Replacement Alternatives: Wigs, The Bald Look, Hats/caps and Scarves

There is no right or wrong method of dealing with hair loss due to treatment. The only key is what works for you. Alternatives include: wigs,bald is beautiful, hats and caps, scarves and turbans - each of which are discussed below..


Wigs can be made both of human and synthetic hair. (For much more about wigs, including how to choose a wig, how to care for a wig, how to pay for a wig, and how to get a free wig, click here.)

Bald is beautiful 

In some circles the bald or shaved look has become fashionable over the last few years.

  • For women, bald could be considered a "bald chic look." 
  • For men, it could be "the Mr. Clean" or "Yul Brynner" look.
  • The choice is yours. If you feel comfortable with the idea, go for it! 

Hats and caps 

Many people choose to wear caps or hats during their treatment. Baseball and stocking caps, western hats, fedoras, and French berets are all popular choices for men. Women of course have a wide array of hat styles to choose from. 

Consider individualizing or dressing up your hats with accessories such as scarves, brooches or fabric flowers. 

An oncologist friend mentioned a male patient who purchased several beanies with propellers. "His hats became quite the conversation pieces. They seemed to help him get through his treatments by allowing him to express his "tongue-in-cheek" sense of humor." 

When selecting hats and caps it is recommended that you choose those made from natural fabrics such as cotton, linen, or canvas. Natural fabrics are less irritating to your scalp and allow it to breathe. 

Scarves and turbans 

Many women and a few men opt for scarves and turbans to cover their heads. Scarves and turbans can be inexpensive and comfortable. They can also provide a break from wearing a wig. If you have night sweats, consider sleeping in a scarf or turban made from an absorbent fabric. 

You can make a turban yourself by wrapping a scarf. You can make it more permanent if you have a sewing machine or you're handy with a needle.  There are a great variety of ways to make a turban so you can readily find one to suit your personality and taste. To learn how to turn a scarf into a turban that works for you, search in your favorite search engine on the words: how to twist a scarf into a turban. 

Be certain that your scarf or turban does not fit too tightly. A fit that is too tight can irritate a sensitive scalp. 

According to CancerToday magazine:

  • Cotton or rayon scarves stay on a bald head. Silk ones don't, but can be used as a second layer. 
  • You can buy inexpensive fabric and make your own. The general recommendation is one yard of fabric.
  • You can look for ways to tie scarves online, especially in videos on YouTube. offsite link


Free and low-cost hats, scarves and head wraps are available from heavenlyhat offsite offsite link. Also see Headcovers Unlimited offsite link. A sports cap that protects against UV rays is available at offsite link

If You Decide To Go For The Bald Look

You may feel more in control if you go for the bald look rather than wait to see if your hair will fall out, or how much of it will. Shaving your head also avoids dealing with the mess from falling hair, or waking up to hair on your pillow.

Men: A study in 2012 showed that men with shaved heads are perceived by other people as more manly and dominant than other men, with greater potential as leaders.

If you decide to go for the bald look, consider making an event or ceremony of it. For example:

  • Ask a family member or friend to help. Make a toast to good health. Take a keepsake photo.
  • Get a batch of women together. Spread a blanket or sheet under you. Create a ceremony that fits who you are as well as thoughts and beliefs you want to reinforce.

Start by using a sharp scissors to cut your hair close to your scalp. Then use an electric razor on the scalp to help prevent nicks which could get infected.

Once your hair is gone, read Survivorship A to Z information about how to care for your scalp if you lose your hair.

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How To Care For Your Hair During Radiation And Chemotherapy

The following tips for caring for your hair and scalp during chemotherapy and radiation therapy are based on recommendations from the National Cancer Institute:


  • When you wash your hair
    • It is generally recommended that you do not shampoo more frequently than 3 times a week.
    • Use mild shampoos. Baby shampoo works very well
    • Use a conditioner to combat dry and brittle hair.
    • Pat your hair dry instead of rubbing it 
  • Sun protection
    • Use hair care products containing sunscreen.
    • If you have significant hair loss, use a sunscreen or sun block on your scalp, or cover your head for protection.
  • Styling
    • Use a soft hairbrush and a wide tooth comb.
    • Use gels, mousses and sprays with light or medium holding power. Stronger preparations are harder to shampoo out.
  • If your hair becomes tangled:
    • Don't pull.
    • Hold the tangle, then gently comb through the tangled hair.
  • Consider having your hair cut short. A shorter style will make your hair appear thicker and fuller. Also, in the event of hair loss, the appearance may be less dramatic.
  • Sleep
    • Consider sleeping on a satin or silk pillowcase.
    • To prevent hair on your pillow, consider catching hair loss at night by wearing a hairnet, mesh cap or other head covering, or put a towel over your pillow. 
  • If you swim in a pool: 
    • Before swimming, protect against chlorine damage by thoroughly wetting your hair with water. The water plumps the hair, minimizing chlorine absorption and its drying and brittle effect. 
    • For additional protection, after wetting your hair, apply a conditioner or silicone-based styling gel. When done, cover your hair with a swim cap. 
  • In cold harsh weather, wear a hat or scarf around your head to keep your scalp from drying out.
  • A scalp massage may make your scalp feel better. 


  • Don't use 
    • A hair dryer. If you do use a hair dryer for a special occasion, keep it on the lowest / coolest setting.
    • Rse rollers. If you feel you must on occasion use rollers, be sure they are soft (foam). Do not sleep in them or use electric or other heated rollers.
    • Hot curling irons.
  • Don't hold your hair with:
    • Hair barrettes or clips.
    • Rubber bands or other hair bands. They will cause breakage.
  • Don't use products that may be harsh on your hair. For example:
    • Don't dye your hair, get a perm, or use hair straigheners.
    • Don't use gels, mousse, oil, grease or pomade. 
    • Avoid hair care products that contain bleach, ammonia, peroxide, lacquer or alcohol.

What To Do If Eyebrows Thin

The American Cancer Society recommends trying a clear or colored brow gel designed to help smooth, control and fill the brow line. 

A brow pencil also works for minor gaps. Drawing in the whole thing can be too obvious - especially on men.

An alernative is to try wearing eyeglasses with heavy frames to cover the area. No prescription is required for frames.

How To Care For Your Skin If You Lose All Your Hair

Once your hair is gone, your scalp and othe rparts of your body are vulnerable.


  • Protect your scalp. 
    • When you go outdoors, protect your scalp by using sunscreen or a facial moisturizer with a sun-protection factor of at least 30, especially on sunny days. 
    • Apply a moisturizer often. Apply moisturizers after bathing while your skin is damp. Reapply throughout the day if necessary.The moisturizer doesn't have to be expensive. Studies show that price is not necessarily the determining factor. According to Consumer Reports, a moisturizer should contain: 
      • Glycerin  
      • Fatty acids  
      • Ceramide OR  
      • Cholesterol 
  • Stay warm. Your hair helps keep you warm, so you may feel colder without it. You can stay warmer by wearing a hat, turban, scarf or wig.
  • Try not to be in places where the temperature is very cold or very hot. This means steaying away from the direct sun, sun lamps and very cold air.

Eyebrow and Eyelashes

Your eyebrows and eyelashes help protect your eyes from dirt in the air.

Wear protective eye coverings. For instance, eyeglasses or goggles.

Nostril Hairs

Nostril hairs help to keep dust and microorganisms from your lungs. A dab of petroleum jelly such as Vaseline can help prevent infection and dripping.

Eyebrows and Eyelashes

Makeup can conceal the loss of eyebrows. Contact the American Cancer Society offsite link (Tel.: 800.395.LOOK) and ask about the "Look Good, Feel Better" program. The program is for women, but men can get tips as well.

Fake eyelashes are available in pharmacies.

How To Cope With The Emotions Of Hair Loss

Hair loss can be the hardest part of cancer treatment to accept. It is a very visible, constant reminder of the disease.

Sometimes there is little time to adjust to the change since many patients lose their hair in a matter of days.

It is advisable to share your emotions with family and friends. They are part of your health care team and want to help.

Support groups can also be helpful - even if you just create your own one-on-one group with another person who is going through the same thing, or has gone through it. We call another person with a similar cancer a "cancer buddy."

For information about support groups, self-help groups and buddies, see "To Learn More."

To Learn More

How To Care For Your Hair As It Starts To Grow Back In

As your hair starts to grow back, your scalp may feel extra tender, dry or itchy.

When you wash your hair:

  • Use a moisturizing shampoo. It doesn't have to be expenive.
  • If you use conditioner, use a moisturizing one. 
  • Gentle creams or lotions may also help.

Hair treatments:

  • According to the American Cancer Society, most doctors do not recommend using hair dyes until after hair returns to normal and the skin has healed. This may be as long as six months after the end of treatment. (Semipermanent hair colorings that gradually wash away after 4 - 6 shampooings are less damaging than permanent hair-coloring products.
  • According to The American Hair Loss Council, wait until your hair is at least 3 inches long before having it chemically curled or permed.A mild body wave produces the best rseults, with the hair wrapped loosely around the largest size curler possible. Tight curls can damage the recovering hair shafts, causing them to break.
  • Drastic color changes may result in increased hair breakage.

Hair cuts

Consider getting a layered hair cut.