Hair Loss/Alopecia - OncoLink Nurse Notes

Gale Snyder-Port RN, MSN, OCN, CNA, Janice Gibson, RN, MSN, OCN and Kathleen Spurrier, RNC, OCN
Last Modified: April 13, 2009

General questions about hair loss due to cancer treatment.

Gale Snyder-Port RN, MSN, OCN, CNA, Janice Gibson, RN, MSN, OCN and Kathleen Spurrier, RNC, OCN of the Abramson Cancer Center of the University of Pennsylvania respond:

A common side effect of chemotherapy is hair loss. This "Helpful Facts" sheet answer questions about hair loss and offers alternatives for coping with this condition. Looking for information on Radiation therapy and hair loss?

Why does chemotherapy cause hair loss?
Chemotherapy attacks cells in our body that are rapidly growing, such as cancer cells. Some normal cells that also grow rapidly, like hair cells, are also affected.

Does all chemotherapy cause hair loss?

  • Many chemotherapy drugs have no affect on your hair. Others cause mild hair thinning or complete hair loss. Your doctor or nurse can tell you if hair loss is expected with your treatment.
  • Scalp hair is the most frequently affected, but loss of eyelashes, eyebrows, facial hair, pubic hair and body hair can also occur.
  • The degree of hair loss will depend on several factors, including the chemotherapy drug(s) and dose received, how it is given and other treatments.

When will the hair loss occur?
Hair loss usually begins 2 weeks after your first treatment. Some people notice achiness or tingling of the scalp as the hair loss begins. If complete hair loss is expected, the hair may come out in large amounts and is usually completed within 3-7days.

Is the hair loss permanent?
Hair loss caused by chemotherapy is usually temporary. Your hair will start to regrow after your treatment is completed. Some people experience a small amount of regrowth during treatment. Most people experience significant hair re-growth 3-5 months after treatment is completed. It is common for hair to grow back curlier and a slightly different color.

Can I apply ice packs to my scalp to decrease hair loss?
No. It generally does not work. It may actually decrease the ability of the chemotherapy to kill cancer cells in this area.

How should I care for my hair while receiving chemotherapy?
  • Even if your chemotherapy treatment is not expected to cause significant hair changes, some precautions are still recommended. If hair thinning is expected, these precautions may decrease damage to your hair:
    • Use a soft bristle brush and a gentle, pH balanced shampoo
    • Avoid using hair dryers, hot rollers or curling irons too much
    • Avoid bleaching or coloring your hair
    • Avoid permanent waves
    • Avoid braiding or placing hair in a pony tail
    • Sleep on a satin pillowcase to decrease friction.
    • Wear a hat when in the sun
  • If your hair is long, cutting it shorter may help decrease the impact of your hair loss when it occurs.

Should I get a wig?

  • Each person responds differently when learning that they may experience partial or total hair loss. There is no right or wrong response. Do what's 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 Requires more care
    • Synthetic: Less expensive
  • Some insurance companies provide coverage for the purchase of wigs

Consider scarves, turbans and hats to conceal hair loss.
They are cooler, can be more comfortable and overall require less care than wigs. There are many attractive, stylish, and creative head covers available.

Why am I so upset about my hair loss?
It is normal to be upset about hair loss from cancer treatment. It may effect how you feel about yourself. It is also a visible reminder of your cancer. Share your feelings with your doctor, nurse, family and friends. There are many educational and supportive programs available.

The The Abramson Cancer Center of the University of Pennsylvania's Boutique on 14 Penn Tower, has a range of choices in wigs, hats and scarves, as well as breast prostheses and other specialty items. If you would like to schedule an appointment to be fitted for a wig, or to talk to our Boutique Manager, please call 215-662-7900, or stop in the Boutique - our hours are 9 am - 5 pm Monday through Friday.


Oncology Skin Care
by The 4Wholeness Team
February 18, 2016