Hair Loss

Updated 
August 31, 2015

Of all the side effects of breast cancer treatment, hair loss can be one of the most difficult ones to deal with emotionally.

You may think it seems silly or vain to worry about your hair given everything else you are coping with. But it’s OK to feel bad that your hair may thin or fall out completely. Your hair is part of who you are, and losing it can make you feel a loss of control. Women from many cultures and backgrounds find that hair loss affects the way they view their bodies and femininity.

On the other hand, you may not feel strongly about the possible loss of your hair. You may view it as a positive sign that you are working hard to get rid of the breast cancer. Or you may miss your hair but want to experiment with hats and head scarves. There is no right or wrong way to feel.

It can help to understand why hair loss may occur during breast cancer treatment and have some tips on how to manage it.

What Are the Symptoms of Hair Loss?

Hair loss does not cause pain. But before your hair falls out, you could feel scalp tenderness or discomfort. The process may be quick or gradual. Before you start treatment, ask your doctor what to expect.

Hair loss usually doesn’t start until after a few treatments. You may lose hair in the shower or notice clumps of hair on your pillow, comb or brush. Your eyebrows, eyelashes, pubic hair and the hair on your arms, underarms and legs may also fall out.

Your hair could grow back during your chemotherapyinfo-icon treatments or within the months after. Most women have about an inch of hair grow back about a month after the last chemotherapy treatment. When your hair grows back, it could be a different color or texture than before. It may slowly go back to what it was before your treatment.

What Causes Hair Loss?

Many cancer treatments kill quickly dividing cells. Cancer cells divide rapidly, but so do some healthy cells, such as those found in hair. Hair follicles are among the most quickly growing cells in the body and are likely to be harmed by cancer treatments.

Not everyone loses hair during breast cancer treatment. If you’re having certain kinds of chemotherapy, you may be more likely to lose your hair because these medicines go after quickly dividing cells. Some chemotherapyinfo-icon medicines make all your hair fall out. Others thin or change your hair, and still others do not impact your hair at all. Whether and when hair loss happens depends on the types of chemotherapy medicines you receive. The doseinfo-icon and timing of your treatments may also be a factor.

Other cancer treatments can also have an effect on hair

Ask your providers whether the treatments you will receive could cause hair loss, and what type of hair loss you should expect. Having this information will help you prepare.

How Can I Manage Hair Loss if it Occurs?

Some women want to take charge by shaving their heads, or cutting their hair very short, before the hair falls out. You may find it empowering to do so. Or you may prefer to wait and see.

If you wish to cover your head, you may want to explore your options ahead of time. You could choose a wig that resembles your natural hair or one that gives you a new look, or you could buy caps and brightly colored scarves.

Heat escapes from the tops of our heads. Without hair, you may find yourself feeling chilly. Buy hats to protect your scalp from the sun and to keep warm. If you don’t want to cover your head, it is perfectly fine to go bald.

It would be great if there were a simple pill to prevent hair loss or a magic lotion you could rub on your scalp to keep your hair full. There isn’t such a product (though you might see some that make the claim), though research into how to minimize cancer effects, including hair loss, is ongoing.

You may have heard of a product referred to as a “Chemo Cold Cap,” which is like an ice pack for the scalp. It is believed to work by cooling the temperature of the scalp so that chemotherapyinfo-icon doesn’t get inside the hair follicles. Some hospitals are trying the caps, and early reports are promising. This approach is still being studied, and providers do not yet know the long-term impacts of the treatment. Talk with your doctors before trying this technique.

The American Cancer Society offers these tips on ways to be gentle to your hair during cancer treatment:

  • Use mild shampoo
  • Use soft-bristle hair brushes
  • Use low heat if you use a hair dryer
  • Don’t use brush rollers
  • Don’t dye or perm your hair
  • Use a satin pillowcase

If you have metastatic breast cancer, learn more about ongoing treatment and hair loss here.