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How to Manage Cancer-Related Hair Loss

How to Manage Cancer-Related Hair Loss

Reviewed by Jasper Clinical Board

Last updated 5/24/21


Hair loss is a fact of chemotherapy for about 65% of people receiving treatment. It happens because chemotherapy drugs attack rapidly growing cells in the body like cancer cells—and also hair cells. The good news is that the vast majority of people do regrow their hair after treatment ends (typically at a rate of about 1 inch of hair in two months). And while sometimes you might notice a different color or texture as your hair begins to grow, it will most often return to exactly what you remember. 
In addition to losing hair on your scalp, you may lose hair on the rest of your body, too, including eyebrows, eyelashes, arm and leg hair, etc. If you’re receiving external radiation, you won’t lose hair everywhere, but you will probably lose your hair on and around the part of the body being treated (so if you’re getting radiation on your head, you can expect hair loss on your scalp). 
Losing your hair can be incredibly challenging to cope with, especially if your hair has been an integral part of your style and your sense of who you are. It can be difficult, with some drugs, to predict who will lose their hair and who won’t (though some medication protocols are more likely than others to cause hair loss). 
Hair loss can start a couple weeks into treatment (two-to-four is typical), or it can take until your second chemo cycle. Some people will lose all their hair, while others will just experience thinning. Unpredictability is the theme here, but in the meantime, you have options: you can preemptively shave your head and embrace your new look as-is, you can get into hats, headwraps, turbans and other fun accessories, and you can explore the world of wigs. If you anticipate hair loss (your doc may be able to help predict this), shopping for a wig or head covering before you’re in the thick of treatment is a good idea, so that you have something to wear when you’re peak exhausted.

Your scalp care routine

No matter what your chemo style is (and you don’t have to choose just one), your first order of business is keeping your scalp in good condition. If you’re holding on to hair that has thinned, use a super gentle brush (never a comb). Depending on how much hair you’ve lost, shaving your head may be more comfortable than facing day after day of clumps in the shower. 
Between chemo and the sun, your scalp is delicate, and will need some regular TLC.  You can continue to shampoo (especially if your hair loss isn’t total), but it’s a good idea to use a product like those made for babies, and to skip a few days between washes, no matter how much hair you do or don’t have. Immediately after showering or bathing, pat your head dry (don’t rub—towel friction is intense on fragile skin). If your head is bald, apply a rich moisturizer like coconut, argan, or emu oil, give your skin some time to absorb the oil, then apply a 50 SPF or higher sunscreen made for sensitive skin to your entire scalp.

Should you consider cold caps or other preventive treatment?

"Cold caps" are hats that are filled with cold gel to keep your scalp cool during treatment. This can help you lose less hair. Scalp cooling reduces blood flow to your hair follicles which, in turn, can decrease the amount of chemotherapy drugs that get to them. Some clinics have scalp cooling systems for this purpose, while others provide or let you bring refrigerated caps that need to be changed every 30 minutes. Not all providers use or endorse scalp cooling and it may also not be appropriate for cancers that are close to your head, so be sure to discuss this option with yours. Some doctors might also recommend applying minoxidil (Rogaine) to your scalp before treatment, though more research is needed to evaluate effectiveness.

The wide world of head coverings

Hats, wraps, turbans, caps, scarves, beanies—you have tons of options for head coverings, and yes, this can be a style moment. Head coverings work particularly well during the fuzzy transitional phases when your hair is falling out, and then, later, growing back in (yay!). The two major considerations in choosing a head covering are comfort and style (ideally in that order). 
Soft, cozy woven hats and wraps will be your best bet, comfort wise, and transition easily from indoors to outdoors. Specialty retailers cater specifically to people in treatment, but you can also find great options on Etsy and at mainstream retailers. If you’re a hat person, you’re limited only by your style: go basic with a well-loved baseball cap, or consider one of the following: the 90s-era headscarf and fitted hat combo, a silk headwrap under a fedora, a cozy beanie in luxe cashmere. Hats that have seams or that aren’t super soft on the inside will wear best with a thin soft layer to protect you, like a seamless scarf or a hat liner.

What about wigs?

The idea of wearing a wig can be hard to swallow. Aren’t they hot and itchy? Won’t they look fake? Won’t it just be a hassle? The answer is...maybe. If you’re at all wig-curious, it’s worth trying a few on—high-end wigs are far more luxurious than what you might be imagining. That said, you do not need a wig unless you want a wig. The choice to go uncovered or to opt for head coverings can be incredibly liberating. If you do want a wig, the best way to get one is at a dedicated wig shop where you can be professionally fitted. (Some shops will even send a consultant to your home.) If online is a better option for you, the American Cancer Society’s TLC Catalog has great options in a wide array of styles. You’ll also want to get some wig liners, a basic wig stand, and a specialty wig brush (your regular hairbrush will snag wig hair), all of which can be purchased along with your wig.

Whoa, these are expensive!

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Many health insurance policies will reimburse you for the not-insubstantial cost of a wig if your doctor writes you a prescription for a “cranial prosthesis” (aka a wig). It’s a good idea to call and verify coverage before paying upfront—and be sure to keep all your receipts. If affording a wig is an issue, check out these resources that can help you find a high quality wig at a lower price point (eBeauty also provides free wigs for those in need). 
 
Hair loss can be surprisingly emotional, even devastating, for some people, especially at a time that is already so challenging. Others find embracing a new look empowering—there is no better time to look for silver linings and start a collection of giant earrings. But if you’re struggling, know that you are not alone. Online support groups (or peer support groups such as Imerman Angels of 4th Angel) can be helpful for the emotional side of things, and for beauty support and advice specific to cancer recovery, Look Good Feel Better is an amazing resource.

The content on this website is intended to provide the best possible information for you, but should not be considered—or used as a substitute for—medical advice. If you have questions about your diagnosis or treatment, please contact your health care provider(s). For questions or comments about this content, please email us at support@jasperhealth.com.