Hair Loss (Alopecia) From Radiation Treatment

Abramson Cancer Center of the University of Pennsylvania
Last Modified: September 18, 2013

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Does all radiation therapy cause hair loss?

Radiation therapy will generally cause hair loss to the body part that is being treated. For example, if your arm were treated with radiation, you may lose any hair on your arm, but the hair on your head would not be affected. The degree of hair loss will depend on several factors, including the size of the area being treated and the total dose of radiation being given. Hair loss is greatest within the treatment field, but may also occur in the area where the radiation beam exits the body.

Chemotherapy drugs also can cause hair loss. If you are also receiving chemotherapy, you should discuss whether or not the medications you are receiving may cause hair loss. When hair loss is caused by chemotherapy, it will include all the hair on your body (head, eyebrows, body hair, etc.). Learn more about hair loss caused by chemotherapy.

Why does radiation therapy cause hair loss?

Radiation therapy not only destroys cancerous cells, but may also affect healthy cells in your body. The healthy cells that are most at risk for being damaged by radiation therapy are those that tend to grow at a fast rate, including hair cells. Thinning of hair and, in some cases, complete hair loss may result.

Is the hair loss permanent?

Hair loss caused by radiation therapy may be temporary or permanent. At lower doses, hair loss is often temporary, but at higher doses, hair loss can be permanent. Your physician or nurse can discuss whether the anticipated hair loss is expected to be temporary or permanent, based on the planned dose of radiation. Each patient's situation is unique, however, and it is not possible to guarantee regrowth of hair even at lower doses of radiation therapy. Hair loss caused by chemotherapy is typically temporary.

When regrowth occurs, there may be changes in texture and color. It is common for hair to grow back curlier than it was; however, a change of color is less common.

What can I do if hair loss is expected with my radiation therapy treatment?

Each person responds differently when learning that they may experience hair loss. There is no right or wrong response. What's important is to do what you feel comfortable with, to do what is right for you. If you expect to lose the hair on your head during your cancer treatments, the following tips may be helpful:

  • If your hair is long, cutting it shorter may help decrease the impact of your hair loss when it occurs.
  • Some people find it easier to deal with hair loss by shaving their heads before hair loss occurs.
  • Be sure to protect your head with a hat to prevent sun exposure on sunny days- and not just in the summer months! This is especially important for men who are less likely to wear a wig or turban/scarf.
  • Use a soft-bristle brush and a gentle, pH-balanced shampoo.
  • Don't use hair dryers, hot rollers, or curling irons because they may damage your hair and make hair loss more severe.
  • Don't bleach or color your hair, and don't get a permanent. All of these make your hair brittle and may cause your hair to fall out faster.
  • Sleep on a satin pillowcase to decrease friction.

Should I get a wig?

  • Not everyone is comfortable wearing a wig; do what is comfortable for you.
  • If you plan to purchase a wig, make an appointment with a wig stylist before the hair loss is expected so that the color, style and texture of your hair can be matched to a wig. If hair loss begins before your appointment with the wig stylist, save some pieces of your hair and take them with you.
  • Types of wigs:
    • Natural hair: More expensive and requires more care
    • Synthetic: Less expensive and easier to care for.
    • Some insurance companies provide coverage for the purchase of wigs. Check with your insurance company regarding coverage and limits.
    • Keep in mind that the cost of wigs, scarves, false eyelashes, etc. are tax-deductible medical expenses.
    • Consider scarves, turbans and hats, which can be cooler and require less care than a wig.

Learn more about wig selection and care and caring for your hair, skin and nails during cancer treatment.