Chemotherapy and hair loss: What to expect during treatment

Your doctor can tell you whether your particular chemotherapy treatment is likely to cause hair loss. This allows you to plan ahead for head coverings or treatments to reduce hair loss.

By Mayo Clinic Staff

You might not think about how important your hair is until you face losing it. And if you have cancer and are about to undergo chemotherapy, the chance of hair loss is very real. Both men and women report hair loss as one of the side effects they fear most after being diagnosed with cancer.

For many, hair loss is a symbol to the world that you have cancer. If you aren't comfortable sharing this information with others, you may fear this side effect more than other chemotherapy complications. Talking to your cancer care team about your concerns and preparing for the possibility of hair loss may help you cope with this difficult side effect of treatment.

Why does it occur?

Chemotherapy drugs are powerful medications that attack rapidly growing cancer cells. Unfortunately, these drugs also attack other rapidly growing cells in your body — including those in your hair roots.

Chemotherapy may cause hair loss all over your body — not just on your scalp. Sometimes your eyelash, eyebrow, armpit, pubic and other body hair also falls out. Some chemotherapy drugs are more likely than others to cause hair loss, and different doses can cause anything from a mere thinning to complete baldness.

Talk to your doctor or nurse about the medication you'll be taking. They can tell you what to expect.

Fortunately, most of the time hair loss from chemotherapy is temporary. You can expect to regrow your hair three to six months after your treatment ends, though your hair may temporarily be a different shade or texture.

What should you expect?

Hair usually begins falling out two to four weeks after you start treatment.

It could fall out very quickly in clumps or gradually. You'll likely notice accumulations of loose hair on your pillow, in your hairbrush or comb, or in your sink or shower drain. Your scalp may feel tender.

Your hair loss will continue throughout your treatment and up to a few weeks afterward. Whether your hair thins or you become completely bald will depend on your treatment.

People with cancer report hair loss as a distressing side effect of treatment. Each time you catch a glimpse of yourself in a mirror, your changed appearance is a reminder of your illness and everything you've experienced since your diagnosis.

When will your hair grow back?

It may take several weeks after treatment for your hair to recover and begin growing again.

When your hair starts to grow back, it will probably be slightly different from the hair you lost. But the difference is usually temporary.

Your new hair might have a different texture or color. It might be curlier than it was before, or it could be gray until the cells that control the pigment in your hair begin functioning again.

Can hair loss be prevented?

No treatment exists that can guarantee your hair won't fall out during or after chemotherapy. Several treatments have been investigated as possible ways to prevent hair loss, but none has been absolutely effective, including:

  • Scalp cooling caps (scalp hypothermia). During your chemotherapy infusions, a closely fitted cap that's cooled by chilled liquid can be placed on your head to slow blood flow to your scalp. This way, chemotherapy drugs are less likely to have an effect on your hair.

    Studies of scalp cooling caps and other forms of scalp hypothermia have found they work somewhat in the majority of people who have tried them. However, the procedure also results in a very small risk of cancer recurring in your scalp, as this area doesn't receive the same dose of chemotherapy as the rest of your body. People undergoing scalp hypothermia report feeling uncomfortably cold and having headaches.

  • Minoxidil (Rogaine). Applying minoxidil — a drug approved for hair loss — to your scalp before and during chemotherapy isn't likely to prevent your hair loss, although some research shows it may speed up your hair regrowth. More research is needed to understand whether minoxidil is effective in regrowing hair after cancer treatment.

How to make the best of it

Your hair loss generally can't be prevented or controlled, but it can be managed. Take the following steps throughout your treatment to minimize the frustration and anxiety associated with hair loss.

Before treatment

  • Be gentle to your hair. Get in the habit of being kind to your hair. Don't bleach, color or perm your hair — this can weaken it. Air-dry your hair as much as possible and avoid heating devices such as curling irons and hot rollers. Strengthening your hair now might make it more likely to stay in your head a little longer during treatment.
  • Consider cutting your hair. Short hair tends to look fuller than long hair. So as your hair falls out, it won't be as noticeable if you have short hair. Also, if you have long hair, going short might help you make a better transition to total hair loss.
  • Plan for a head covering. Now is the time to start thinking about wigs, scarves or other head coverings. Whether you choose to wear a head covering to conceal your hair loss is up to you. But it's easier to plan for it now rather than later. Ask your doctor to write a prescription for a wig, the cost of which may be covered by your health insurance.

During treatment

  • Baby your remaining hair. Continue your gentle hair strategies throughout your chemotherapy treatment. Use a soft brush. Wash your hair only as often as necessary. Consider using a gentle shampoo.
  • Consider shaving your head. Some people report that their scalps feel itchy, sensitive and irritated during their treatments and while their hair is falling out. Shaving your head can reduce the irritation and save the embarrassment of shedding.
  • Protect your scalp. If your head is going to be exposed to the sun or to cold air, protect it with sunscreen or a head covering. Your scalp may be sensitive as you go through treatment, so extreme cold or sunshine can easily irritate it. Having no hair or having less hair can make you feel cold, so a head covering may make you more comfortable.

After treatment

  • Continue gentle hair care. Your new hair growth will be especially fragile and vulnerable to the damage caused by styling products and heating devices. Hold off on coloring or bleaching your new hair until it grows stronger. Processing could damage your new hair and irritate your sensitive scalp.
  • Be patient. It's likely that your hair will come back slowly and that it might not look normal right away. But growth takes time, and it also takes time to repair the damage caused by your cancer treatment.

Covering your head

Covering your head as your hair falls out is a purely personal decision. For many people, hair is associated with personal identity and health, so they choose to maintain that look by wearing a wig. Others choose hats and scarves. Still others choose not to cover their heads at all.

Ask your doctor or a hospital social worker about resources in your area to help you find the best head covering for you.

Look Good Feel Better is a free program that provides hair and beauty makeovers and tips to women with cancer. These classes are offered throughout the United States and in several other countries. Many classes are offered through local chapters of the American Cancer Society.

Look Good Feel Better also offers classes and a website for teens with cancer, as well as a website and a guide with information for men with cancer.

Radiation therapy also can cause hair loss

Radiation therapy also attacks quickly growing cells in your body, but unlike chemotherapy, it affects only the specific area where treatment is concentrated. If you have radiation to your head, you'll likely lose the hair on your head.

Your hair usually begins growing back after your treatments end. But whether it grows back to its original thickness and fullness depends on your treatment. Different types of radiation and different doses will have different effects on your hair. Higher doses of radiation can cause permanent hair loss. Talk to your doctor about what dose you'll be receiving so that you'll know what to expect.

Radiation therapy also affects your skin. The treatment area is likely to be red and may look sunburned or tanned. If your radiation treatment is to your head, it's a good idea to cover your head with a protective hat or scarf because your skin will be sensitive to cold and sunlight. Wigs and other hairpieces might irritate your scalp.

Feb. 26, 2022 See more In-depth

See also

  1. Acute lymphocytic leukemia
  2. Acute myelogenous leukemia
  3. Adjuvant therapy for cancer
  4. Anal cancer
  5. Atypical cells: Are they cancer?
  6. Beating Ovarian Cancer
  7. Biopsy procedures
  8. Bladder cancer
  9. Infographic: Bladder Cancer
  10. Video: Bladder cancer stages
  11. Bladder cancer treatment options
  12. Infographic: Blood Cancer Awareness
  13. Bone cancer
  14. Bone metastasis
  15. Brain tumor
  16. Breast cancer
  17. Breast cancer chemoprevention
  18. Breast Cancer Education Tool
  19. Common questions about breast cancer treatment
  20. Breast cancer radiation: Can it cause dry skin?
  21. Infographic: Breast Cancer Risk
  22. Breast cancer staging
  23. Breast cancer types
  24. Infographic: Breast Reconstruction Options
  25. Dr. Wallace Video
  26. CA 125 test: A screening test for ovarian cancer?
  27. Cancer
  28. Cancer blood tests
  29. Myths about cancer causes
  30. Infographic: Cancer Clinical Trials Offer Many Benefits
  31. Cancer diagnosis: 11 tips for coping
  32. Cancer diagnosis? Advice for dealing with what comes next
  33. Cancer-related fatigue
  34. Cancer pain: Relief is possible
  35. Cancer risk: What the numbers mean
  36. Cancer surgery
  37. Cancer survival rate
  38. Cancer survivors: Care for your body after treatment
  39. Cancer survivors: Late effects of cancer treatment
  40. Cancer survivors: Managing your emotions after cancer treatment
  41. Cancer survivors: Reconnecting with loved ones after treatment
  42. Cancer treatment decisions: 5 steps to help you decide
  43. Cancer treatment for men: Possible sexual side effects
  44. Cancer treatment for women: Possible sexual side effects
  45. Cancer treatment myths
  46. Cancer Vaccine Research
  47. Carcinoid syndrome
  48. Castleman disease
  49. Cervical cancer
  50. Cervical dysplasia: Is it cancer?
  51. Chemo Targets
  52. Chemotherapy
  53. Chemotherapy and sex: Is sexual activity OK during treatment?
  54. Chemotherapy nausea and vomiting: Prevention is best defense
  55. Chemotherapy side effects: A cause of heart disease?
  56. Cholangiocarcinoma (bile duct cancer)
  57. Choroid plexus carcinoma
  58. Chronic lymphocytic leukemia
  59. Chronic myelogenous leukemia
  60. Collecting Pennies Through the Pain
  61. Colon cancer
  62. Colon Cancer Family Registry
  63. Colon cancer screening: At what age can you stop?
  64. Colon cancer screening
  65. Curcumin: Can it slow cancer growth?
  66. Cutaneous T-cell lymphoma
  67. Cancer-related diarrhea
  68. Dragon Boats and Breast Cancer
  69. Eating during cancer treatment: Tips to make food tastier
  70. Embryonal tumors
  71. Endometrial cancer
  72. Ependymoma
  73. Esophageal cancer
  74. Infographic: Esophageal Cancer
  75. Ewing sarcoma
  76. Fertility preservation
  77. Frequent sex: Does it protect against prostate cancer?
  78. Gallbladder cancer
  79. Gene expression profiling for breast cancer: What is it?
  80. Genetic Testing for Breast Cancer
  81. Genetic testing for breast cancer: Psychological and social impact
  82. Get ready for possible side effects of chemotherapy
  83. GI Stents
  84. Ginger for nausea: Does it work?
  85. Glowing Cancer Surgery
  86. Hairy cell leukemia
  87. Have brown or Black skin? Use sunscreen
  88. Head and Neck Cancer Transoral Surgery
  89. Head and neck cancers
  90. Heart cancer: Is there such a thing?
  91. High-dose vitamin C: Can it kill cancer cells?
  92. Hodgkin's lymphoma (Hodgkin's disease)
  93. Hodgkin's vs. non-Hodgkin's lymphoma: What's the difference?
  94. Infographic: HPV Related Oral Cancers
  95. Inflammatory breast cancer
  96. Infographic: Innovative Rectal Cancer Treatments
  97. Invasive lobular carcinoma
  98. Leukemia
  99. Liver cancer
  100. Infographic: Liver Cancer
  101. What is liver cancer? An expert explains
  102. Liver cancer FAQs
  103. Infographic: Liver Transplant Bile Duct Cancer
  104. Living with Brain Tumors
  105. Long Term Brain Cancer Survivor
  106. Low blood counts
  107. Lung cancer
  108. Infographic: Lung Cancer
  109. Lung nodules: Can they be cancerous?
  110. Magic mouthwash
  111. Male breast cancer
  112. What is breast cancer? An expert explains
  113. Measles Virus as a Cancer Fighter
  114. Melanoma
  115. Merkel cell carcinoma
  116. Mesothelioma
  117. Monoclonal antibody drugs
  118. Mort Crim and Cancer
  119. Mouth cancer
  120. What is mouth cancer? A Mayo Clinic expert explains
  121. Mouth cancer FAQs
  122. Mouth sores caused by cancer treatment: How to cope
  123. Multiple myeloma
  124. Infographic: Multiple Myeloma
  125. Myelofibrosis
  126. Myelofibrosis
  127. Nasopharyngeal carcinoma
  128. Neuroblastoma
  129. Neuroendocrine tumors
  130. Neurofibromatosis
  131. New immunotherapy approved for metastatic bladder cancer
  132. No appetite? How to get nutrition during cancer treatment
  133. Non-Hodgkin's lymphoma
  134. Osteosarcoma
  135. Living with an ostomy
  136. Ovarian cancer
  137. Ovarian cancer: Still possible after hysterectomy?
  138. Paget's disease of the breast
  139. Pancreatic cancer
  140. Infographic: Pancreatic Cancer: Minimally Invasive Surgery
  141. Pancreatic Cancer Survivor
  142. Infographic: Pancreatic Cancers-Whipple
  143. Pap test: Can it detect ovarian cancer?
  144. Paulas story A team approach to battling breast cancer
  145. Peripheral nerve tumors
  146. Pet therapy
  147. Pheochromocytoma
  148. Photodynamic therapy: An effective treatment for lung cancer?
  149. Pineoblastoma
  150. Pink Sisters
  151. Pomegranate juice: A cure for prostate cancer?
  152. Prostate cancer
  153. Prostate cancer: Does PSA level affect prognosis?
  154. Prostate cancer brachytherapy: Can I pass radiation to others?
  155. Infographic: Prostate Cancer: Choline c-11
  156. Prostate cancer metastasis: Where does prostate cancer spread?
  157. Prostate cancer prevention
  158. Prostate cancer treatment: Does initial treatment preclude others later?
  159. Infographic: Proton Beam Brain Tumor
  160. Punk Guitarist Survives Brain Tumor
  161. Rectal cancer
  162. Recurrent breast cancer
  163. Retinoblastoma
  164. Robotic bladder surgery
  165. Salivary gland tumors
  166. Infographic: Scalp Cooling Therapy for Cancer
  167. Scientists propose a breast cancer drug for some bladder cancer patients
  168. Scrotal masses
  169. Self-Image During Cancer
  170. Skin cancer
  171. Infographic: Skin Cancer
  172. Skin Cancer Reconstruction
  173. Melanoma pictures to help identify skin cancer
  174. Radiation simulation
  175. Small cell, large cell cancer: What this means
  176. Soft tissue sarcoma
  177. Spinal cord tumor
  178. Spray tanning? Hold your breath
  179. Stomach cancer
  180. Infographic: Stomach Cancer
  181. Summer sun: Know the danger zone
  182. Super Survivor Conquers Cancer
  183. Testicular cancer
  184. Testicular microlithiasis
  185. Thalidomide: Research advances in cancer and other conditions
  186. The Long Race Beating Cancer
  187. Throat cancer
  188. Thyroid cancer
  189. Tumor vs. cyst: What's the difference?
  190. Vaginal cancer
  191. Vasectomy: Does it increase my risk of prostate cancer?
  192. Vertebral tumor
  193. Melanoma — Early stage and advanced melanoma
  194. How cancer spreads
  195. PICC line placement
  196. Skin cancer — How skin cancer develops
  197. Vulvar cancer
  198. Weight Loss After Breast Cancer
  199. When cancer returns: How to cope with cancer recurrence
  200. Wilms' tumor
  201. Your secret weapon during cancer treatment? Exercise!
  202. Zollinger-Ellison syndrome