All Cancer treatments – Overview hair loss and hair changes

All Cancer treatments – Overview hair loss and hair changes

Why do some cancer treatments cause hair loss or changes to hair and scalp?

Often people say that they associate all cancer treatments with the visual imagine of hair loss on the head. However, not all cancer treatments result in hair loss or changes to hair but some do.

In terms of hair loss and hair changes some treatments for cancer may cause hair from your head and other parts of your body to fall out or change.

All treatments – brief overview

• All cancer treatments – in-depth
• Overview per treatment type of hair loss and hair changes
• Chemotherapy – overview
• Radiotherapy – overview
• Hormonal and targeted (biological) therapies – overview
• Surgery – overview

All treatments – brief overview

Hair loss and thinning:

• Mild hair thinning
• Hair thinning leading to reduced total mass of hair or patchy hair loss
• An isolated area of hair to fall out (e.g. external beam radiotherapy to head)
• Fall out completely
• Hair may be shaved prior to surgery

Hair and scalp changes:

• Hair may change in appearance and texture e.g. become brittle
• Skin on scalp may change e.g. become dry
• In some rare cases accelerated hair growth e.g. facial hair
• New hair growth occurs after treatment in some but not all cases
• There may be no changes experienced to hair or scalp

With over 200 types of cancer and many different treatments, understanding how your particular type of treatment may affect your normal hair growth cycle is a really good start to taking control of options to deal with hair loss should it happen to you.

Treatments for cancer and side effects are changing all the time. Your cancer nurse will be able to sign post you to the most up-to-date information about your specific regime.

In this section we will look at a more in-depth overview of how different treatments may cause hair loss or hair changes. We will then go into more specific details in relation to each treatment type.

All cancer treatments – in-depth

Cancer treatments may cause changes or disruptions to your normal hair growth cycle. In terms of hair loss and hair changes some treatments for cancer may cause hair from your head and other parts of your body to change in the following ways:

Some cancer treatments may cause all of your hair to fall out completely – this is usually temporary, meaning that in most cases the hair is expected to grow back e.g. after chemotherapy treatment. Hair loss may be from your scalp, head and other areas of the body.

Some treatments cause hair thinning, meaning that not all of your hair falls out but there may be mild thinning and hardly notable or a reduction in the general mass of hair or patchy hair loss. E.g. some chemotherapy treatments and some hormonal and targeted (biological) therapies.

In some cases treatments can result in long-term and permanent hair loss in specific areas e.g. radiotherapy to the scalp or in rare cases of unexpected lack of hair growth following chemotherapy.

In rare cases some treatments may cause indirect hair loss, thinning or changes. This is where the direct treatment is not expected to cause hair loss or hair changes however another side effect, such as anaemia may cause hair to thin.

In rare cases some treatments may not cause changes to your hair but may cause changes to the skin on your scalp – resulting in the need for you to adapt your regular hair care regime.

There may be no changes to your hair at all.

The only known way to reduce hair loss is called ‘Scalp cooling’. Scalp cooling is only compatible with certain cancer types and specific chemotherapy drugs. Scalp cooling does not work for other treatments for cancer.

In the sections that follow you can scan through your particular treatment type or read more in-depth information about all treatments. We will then signpost you to further information and guidance.

Overview per treatment type of hair loss and hair changes

Chemotherapy – a glace at hair loss and hair changes
Radiotherapy – overview
Hormonal and targeted (biological) therapies – overview
Surgery – a glace at hair loss and hair changes

Chemotherapy – a glace at hair loss and hair changes

In relation to possible hair loss and what to expect, it is important to check your specific type of chemotherapy drug. It’s also good to know that we are here to support you – help is at hand. From ideas to cover up if you wish, to ways to care for your scalp and new hair growth or with help to look for long terms solutions.

Any hair loss experienced usually grows back once treatment is complete.

We are here to support you with guidance and ideas.

Chemotherapy – overview

Hair loss/changes to hair
Not all chemotherapy treatments cause hair loss
Areas of possible hair loss – chemotherapy treatments may cause total hair loss from the scalp and other parts of the body such as:

Scalp hair
Eyelashes & brows
Facial hair including beards and moustaches
Nose hair
Underarm hair
Chest hair
Leg hair
Pubic hair
And other areas of the body

Chemotherapy treatments may cause hair thinning. The amount of hair may be very mild and not noticeable or may be more resulting in a reduced total mass of hair or visible patchy hair loss.

Fragile hair – chemotherapy treatments may cause changes in hair e.g. hair becomes more fragile (brittle)

Scalp changes – some people notice changes to their skin such as the skin on their scalp may become drier.

No changes – chemotherapy may not cause any changes to hair. However you may not be able to continue with regular hair care activities such as permanent hair colouring during treatment

Rare accelerated growth – in rare cases some chemotherapy treatments may cause accelerated hair growth.

Hair loss prevention/reduction

Scalp cooling – The only known way to reduce hair loss is called ‘Scalp cooling’. Scalp cooling is only compatible with certain cancer types and specific chemotherapy drugs.

Scalp cooling or a cold cap is one of those things that, until you are faced with the possibility of losing your hair, you probably may not have heard much about. It’s a method of cooling the scalp, which can be used with some forms of chemotherapy (not with other treatments) to try and help reduce hair loss. Once you understand the basics you can explore if scalp cooling might be available and suitable for you. Read more about scalp cooling.

Hair Growth

Usually hair grows back once treatment is complete. Most people find that their hair grows back after chemotherapy treatment is complete. It may take a while and the hair texture and colour may be different than before.

Rare cases hair growth may be problematic – in some rare cases hair may not grow back as expected resulting in long term or permanent hair thinning/loss

Support and further guidance

We have created a dedicated section called Chemotherapy guide.

In this section we have put together topics that will offer you a broad overview about chemotherapy induced hair loss and new hair growth. We hope this will support you before, during and after chemotherapy.

Additionally, your nurse or doctor can further advise you about the type of drug you are taking.

Radiotherapy – a glance at hair loss and hair changes

Radiotherapy will only cause hair loss in the part of the body being treated. Hair loss can happen where the radiation beam enters and leaves the body. This means that hair loss will be isolated to areas where the external radiotherapy beam enters and leaves the head area.

In relation to radiotherapy to the head area it is good to ask your cancer nurse specialist or radiographer if hair loss is likely. If the answer is yes you can ask them to show you exactly where your hair is likely to fall out.

Whether or not the hair grows back is on a case-by-case basis. In some cases hair does not grow back resulting in long term/permanent hair loss. We are here to support you with guidance and ideas if this is the case.

Radiotherapy – overview

Hair loss/changes to hair
There are different types of radiotherapy treatment. In this section we deal with external beam radiotherapy – specifically to the scalp area.

Radiotherapy will only cause hair loss in the part of the body being treated. If you are having treatment for breast cancer and radiotherapy includes your armpit you may loose some under arm hair. But you will not loose hair on your head (scalp).

Head area – if you have external beam radiotherapy to the top of your head you will probably loose some hairs on your scalp. The amount of hair lost will depend upon the size of the area being treated.

Depending on your hairstyle and treatment area the amount of hair loss may be very little and not noticeable or may be more, resulting in a visible patch of hair loss or in some cases the entire scalp.

If you are being treated in the neck area and have facial hair e.g. a beard, you may find that you loose hairs from your beard.

Hair loss prevention/reduction

There are no known ways of preventing hair loss due to external beam radiotherapy. Scalp cooling; a method to reduce/prevent hair loss during chemotherapy treatment does not work with radiotherapy treatment.

Ask your cancer nurse specialist or radiographer to show you exactly where your hair is likely to fall out. Take a look at our helpful list of questions for your medical team in our Radiotherapy guide.

Hair Growth

When it comes to planning new hair growth following hair loss due to external beam radiotherapy, it is a very individual process. This is because unlike chemotherapy treatment, external beam radiotherapy to the scalp area will be very specific to you in terms of the area affected and the amount of hair loss.

New hair growth on the scalp:

The hair may grow back again but some people can be left with an area of permanent baldness or thinner hair on the treatment area.

In some cases hair does not grow back resulting in long term/permanent hair loss. Take a look at Radiotherapy – wigs and options for ideas

In cases where the hair does grow back – the new hair can be very slow to grow at first. After three to six months new hair often starts to grow through, although it can take longer and be up to six to twelve months.

Your cancer nurse specialist or radiographer will tell you more about your treatment and what to expect in terms of possible hair loss and how to best care for your scalp.

Over the last three years hair replacement systems have become much more readily available and can be an excellent option to cover patchy areas of hair loss, which can often be the case with radiotherapy to the scalp area.

Support and further guidance

We have created a dedicated section called Radiotherapy guide.

In this section we have put together topics that will offer you information and ideas for external beam radiotherapy to the scalp/head and neck area.

We hope this will support you.

Hormonal and targeted (biological) therapies – a glance at hair loss and hair changes

In relation to hormonal and targeted (biological therapies) and possible hair loss/hair thinning or hair changes, it’s important to check side effects of your specific regime. Your nurse or doctor can give you specific information.

Any hair loss tends to be described as ‘mild thinning’ and does not commonly result in vast hair thinning or total hair loss. Unlike some commonly known chemotherapy treatments, the vast majority of hormonal and targeted (biological) therapies don’t cause total hair loss.

The hair normally grows back after treatment but can sometimes remain thinner.

Some therapies may cause hair changes such as hair to become curlier, more brittle or a change in texture. Some people notice changes to their skin such as the skin on their scalp may become drier.

We are here to support you with guidance and ideas.

Hormonal and targeted (biological) therapies – overview

There may be no change to hair or scalp
Some therapies may cause hair changes such as hair to become curlier, more brittle or a change in texture.

Scalp changes – Some people notice changes to their skin such as the skin on their scalp may become drier.

Mild hair thinning – it is important to note the difference between mild hair thinning and other types of hair thinning hair loss. Unlike some commonly known chemotherapy treatments, the vast majority of hormonal and targeted (biological) therapies don’t cause total hair loss or mass hair thinning. You may see ‘mild hair thinning’ noted as a side effect.

The term ‘mild hair thinning’ – tends to describe hair falling out a bit more then usual. Depending on your hairstyle this may result in very mild hair thinning that is hardly noticeable or a reduction of the total mass of hair or maybe an area that might be more viably thinner.

Men may find that facial hair e.g. beard may be sparser then normal.

New hair growth:

Hair is expected to return to normal – if hair has thinned it is expected that the hair will return to a normal hair growth cycle once treatment is complete.

It may take a while and the hair texture and colour may be different than before.

Support and further guidance

If you need ideas and help for hair thinning take a look in our sections Wig guide and Scarves, hats & head wear. We have also created a dedicated section all about New hair growth.

We hope this will support you.

Additionally, your nurse or doctor can further advise you about the type of drug you are taking.

Surgery – a glance at hair loss and hair changes

If you are having surgery in an area of the body that has hair, this area will usually be shaved prior to the operation. In most cases hair will grow back quite quickly after the operation. See below for in-depth points.

Surgery – overview

Shaving prior to surgery – your nurse will do this for you or may advise you of an area to shave yourself. If this is the case your nurse will provide you with shaving products and specific instructions.

The hair will usually grow back after the operation unless there is an area of scaring alopecia. This is where a scar can cause areas of long term or permanent hair loss.

Ask your medical team – your surgeon, nurse or doctor can further advise you about what to expect.

Surgery to the head area – if you are having surgery to the head area, such as an operation for a brain tumour, an area of the scalp or the entire scalp may be shaved in preparation for surgery.

New hair growth is specific to your case – whilst hair should generally grow back after most surgery, when it comes to surgery on the head area new hair growth will depend on the type of surgery and any possible resulting scar that could cause areas of long term or permanent hair loss.

Additionally, any treatment that may follow e.g. radiotherapy to the scalp area may all affect possible new hair growth.

Your surgeon, nurse or doctor can further advise you about what to expect.

Support and further guidance

If you need ideas and help take a look in our sections Wig guide and Scarves, hats & headwear. We have also created a dedicated section all about New hair growth.

We hope this will support you.

Additionally your nurse or doctor can further advise you in relation to your surgery.