Caring for Your Hair During Chemotherapy

Chemotherapy treatment can be physically and emotionally challenging, and the side effects can be the same. One of the side effects of chemotherapy can be hair loss.

Hair loss is one of the most dreaded side effects of chemotherapy, which works by targeting the fastest-growing cells in your body. Among the most rapid-growing cells are hair follicles, which divide every 23 to 72 hours.

Hair loss is one of the most common side effects of cancer treatment and one of the most devastating ones. While it can be challenging, it is typically temporary, and hair grows back.

Read on to learn more about hair loss from chemotherapy and how to manage hair loss.

Chemotherapy and Hair Loss

Chemotherapy-induced hair loss (also called anagen effluvium) is diffuse hair loss due to exposure to a toxic drug in the hair matrix. While some people with cancer experience a visible thinning of hair, including the eyebrows and eyelashes, others will have total hair loss.

The severity of hair loss depends on the type and dose of chemotherapy and how often it is administered. Higher doses of chemotherapy are associated with more severe loss.

Chemotherapy drugs that usually cause hair loss can include:

• Cytoxan (cyclophosphamide)
• Cerubidine (daunorubicin)
• Taxotere (docetaxel) 
• Adriamycin (doxorubicin)
• Epirubicin
• Etoposide (VP-16)
• Idamycin (idarubicin)
• Ifex (ifosfamide)
• Camptosar (irinotecan)
• Ixempra (ixabepilone)
• Mustargen (mechlorethamine)
• Taxol (paclitaxel)
• Abraxane (albumin-bound paclitaxel)
• Velban (vinblastine)
• Oncovin (vincristine)
  

Preventing and Managing Hair Loss

While there is no right or wrong way to care for the scalp, there are many helpful suggestions.

Look Into Cold Cap Therapy

Some people use this therapy, which is widely used in Europe, to preserve their hair. It freezes the scalp, reducing the effects of chemotherapy on scalp hair and slowing hair loss. While many women report great results, this method can be expensive.

Be Gentle With Your Hair

Being gentle with your hair reduces psychological distress and minimizes breakage and loss from too much brushing, pulling, or styling of the hair.

You can shampoo and frequently condition if you prefer, but washing the hair once or twice per week is generally enough. Use a wide-toothed comb when brushing. Wearing a hair net at night can prevent your hair from falling out in clumps on your pillowcase and having to clean it up in the morning.

Choose Mild Haircare Products

Many shampoos have fragrances and harsh chemicals that only serve to dry out already-irritated skin. Conditioners, by contrast, can sometimes be overly oily or contain emollients, humectants you don't need.

The first rule of thumb is to simplify when it comes to hair cleansing. If your hair is thinning, use a mild shampoo that is gentler on the scalp. Healthcare providers often recommend a baby shampoo with the proper pH balance for dry, inflamed skin.

Consider a New Hairstyle

If your hair has not entirely fallen out, you may want to consider a new, low-maintenance hairstyle. A pixie cut, for example, requires little hair product and allows you to style in whatever direction needed to conceal thinning patches.

Some people shave their heads to reassert their power over their bodies during cancer treatment and avoid seeing their hair fall out—and this is also something to consider.

Skip Coloring or Perming

Healthcare providers almost universally advise against coloring or perming during chemotherapy. Even if you don't experience a lot of hair loss, chemotherapy can still damage the hair shaft and cause a dry, itchy, flaky scalp. Adding harsh chemicals can sometimes accelerate the thinning of your hair.

If coloring your hair is important, opt for temporary/semi-permanent hair coloring that doesn't contain peroxide or paraphenylenediamine (PPD). On the other hand, if you want to lighten your hair, it is probably best to wait until you've finished chemo, as these hair products almost universally contain peroxide and bleach.

Pick Out a Wig

These days, there are countless styles and colors to choose from. You can even cut and color your wig to match your natural color and style. If you choose to wear a wig, get a cap liner to help eliminate some of the itchiness.

Insurance plans will often cover the expense of wigs for people undergoing cancer treatment if they are prescribed as a "cranial prosthesis." There are even organizations that provide them for free. You can order from the American Cancer Society's not-for-profit website and catalog, tlc (Tender Loving Care). You can also ask your cancer team and others living with cancer for recommendations or look online for local wig shops.

Wear a Headscarf

If you're uncomfortable wearing a wig, wear a headscarf to provide sun protection, keep your scalp warm, and feel more comfortable. When outdoors with nothing protecting your scalp, use UV sunscreen with an SPF of at least 30.

Summary

During chemotherapy, you may experience hair loss. This can depend on the dosage of the drug used, the specific drugs used, and the combination of treatments.

While hair loss is typically temporary, it may cause emotional distress. You can do things to help deal with hair loss, including wearing a wig or headscarf, changing your hairstyle, and being gentle with your hair.

A Word From Verywell

Whether you're simply noticing more hair in your brush or clumps are falling out in the shower, hair loss can be emotionally devastating, and support from loved ones is crucial.

While you are battling cancer, the most important thing is to stay emotionally and mentally strong for the fight. Your hair will very likely grow back, and above all, it does not define you. Your strength through adversity does.