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The normal scalp contains approximately 100,000 hairs. They are constantly growing, with old hairs falling out and being replaced by new ones. Some cancer treatments will cause some people to lose some or all of their hair (alopecia). For example, with chemotherapy, drugs travel throughout the body to kill cancer cells, and some of these drugs damage hair follicles, causing the hair to fall out.
Hair loss is highly variable. Some people experience it and others do not, even when they are taking the same drugs. While some drugs can cause hair loss on the scalp and elsewhere on the body, others can cause only the loss of head hair. If hair loss does occur, it usually begins within 2 weeks of starting chemotherapy and gets worse 1 to 2 months after the start of therapy. It may come out in clumps that appear on the pillow in the morning or while shampooing or brushing your hair. Hair re-growth often begins even before therapy is completed.
Like chemotherapy, radiation therapy to the head often causes scalp hair loss. Unlike hair lost because of chemotherapy, however, hair lost as a result of radiation therapy to the head may not grow back naturally.
It is normal for someone undergoing cancer treatment to feel distressed about hair loss. But it can help to understand why it happens, to know that hair will probably grow back, and to take some steps to minimize the problem.
What to Do
- Choose a wig or toupee before treatment begins or at the very start of treatment, before hair loss begins, so that hair color and texture can be matched
- Get a prescription for the wig from the doctor, because the cost is often covered by insurance
- Obtain a list of wig shops in your area from the doctor, nurse, or the Yellow Pages
- If you have long hair, consider getting a stylish short cut and then having a beautiful wig made from your own hair
- Try on different wigs until you find one that you really like
- Consider buying 2 wigs, 1 for everyday wear and 1 for special occasions
- Before you need to wear the wig, be gentle when brushing and shampooing your own hair
- Wear a hat or scarf outdoors in cold weather to prevent loss of body heat
- Avoid too much brushing or pulling of hair, and avoid heating it with a hair dryer, electric rollers, or curling iron to help reduce hair loss and damage
- Use a sunscreen, sunblock, or hat to protect your scalp from the sun
- Choose turbans or scarves as alternatives to wigs
Do Not
- Wait to go shopping for a wig; try to have it ready when you need it
- Forget your hair will grow back and that a good wig looks very natural
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