Does Chemotherapy Cause Hair Loss?

Table of ContentsView AllTable of ContentsWhy It HappensDrug CausesTimingHair RegrowthCancer TherapiesCoping

Table of ContentsView All

View All

Table of Contents

Why It Happens

Drug Causes

Timing

Hair Regrowth

Cancer Therapies

Coping

Chemotherapy often causes hair loss, but it can depend on the type of chemo drug as well as other factors. An estimated 65% of people undergoing classic chemotherapy experience hair loss, or what doctors callalopecia.

Some people may experience hair loss from all parts of the body, including eyebrows and eyelashes, while others may have minimal hair thinning. It often depends on the type of chemo drug, the dosage, and your individual susceptibility.

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Why Does Chemotherapy Cause Hair Loss?

While chemotherapy drugs can be effective in killing cancer cells, they also damage normal cells that divide rapidly. This includes:

Keratinocytesare cells in the hair follicles that help produce hairs. These keratinocytes divide faster than many malignant cancer cells, and they have a good blood supply that delivers chemotherapy agents to them efficiently. Their fast metabolism also puts them under oxidative stress, an imbalance of free radicals and antioxidants that results in cellular damage. Chemotherapy drugs can enhance that stress to the point that the cell dies.

In addition to hair loss from the scalp, chemotherapy can cause hair loss from other parts of the body, including the eyebrows and lashes, arms and legs, underarms, and pubic area.

Whether or not you develop hair loss, and the severity of hair loss, depends on a number of factors, including:

Chemo Drugs That Cause Hair Loss

Not all chemotherapy causes hair loss. Some chemotherapy drugs are known to often cause hair loss and hair thinning, while others may cause only a small amount of it.

Chemotherapy medications frequently associated with hair loss include:

The likelihood of hair loss depends on the specific drug used, the combination of drugs, and the dosage. It’s important to talk to your healthcare provider about the chemotherapy drugs you are receiving and the risk associated with them.

When Does Chemotherapy Cause Hair Loss?

Hair loss from chemotherapy can begin as early as five days to two weeks after the first cycle. However, the most noticeable hair loss typically occurs between three and six weeks after starting treatment. This timeline varies based on individual responses and the specific chemotherapy regimen used.

When Does Hair Loss Grow Back After Chemotherapy?

Chemotherapy can cause permanent hair loss and hair thinning, but in most cases, the hair loss is temporary.Ask your healthcare provider about the risk of hair loss from the drug you will receive.

Hair re-growth typically begins within three months of concluding chemotherapy. When your hair does grow back, many people find they have what’s been coined “chemo curls.” Your hair may initially grow back curlier and with a different texture. If your hair was straight prior to chemotherapy, it will likely become straight again, but this process can take up to several years.

Some women with breast cancer have developed permanent hair loss following a combination of taxanes (such as Taxol or Taxotere) and hormonal therapy, though this is rare.These are not the only treatments implicated.

There have also been a few reported cases of permanent and severe hair loss in people with breast cancer who have received treatment with the drug docetaxel.

Effect of Other Cancer Therapies

The newer targeted therapies for cancer don’t usually causetotalhair loss like chemotherapy drugs but can result in changes like thinning and dryness. Some targeted therapies may also affect the pigmentation of hair, often causing the hair to become darker.

Some of the targeted therapies that have been linked with hair changes or hair loss include:

Some of the hormonal therapies commonly used for breast cancer have been associated with thinning of the hair for some people. Unlike chemotherapy, people may use hormonal therapies for many months or even yearsbeforethey notice the changes in their hair. Hormonal therapies more often linked to hair loss include:

Immunotherapy drugsfor cancer, at least checkpoint inhibitors, do not usually cause hair loss, though oftentimes these drugs are used along with chemotherapy.

Researchers are looking at ways of harnessing the gene involved in autoimmune alopecia (hair loss such as with alopecia areata) to improve the effectiveness of chemotherapy.

How to Handle Hair Loss From Chemotherapy

There is no reliable way to completely prevent chemotherapy-related hair loss, but there are some therapies that may help reduce hair loss or help it regrow. They include:

Aside from these hair loss prevention strategies, it’s also important to:

Ways to Disguise Hair Loss if DesiredIf you choose to hide your hair loss, there are options to disguise it. Wigs, scarves, and hats offer both comfort and style during treatment. Hairpieces, such as toppers, makeup, and specialty sprays can mask thinning areas. The decision to embrace hair loss or explore these solutions is entirely personal and up to you.

Ways to Disguise Hair Loss if Desired

If you choose to hide your hair loss, there are options to disguise it. Wigs, scarves, and hats offer both comfort and style during treatment. Hairpieces, such as toppers, makeup, and specialty sprays can mask thinning areas. The decision to embrace hair loss or explore these solutions is entirely personal and up to you.

Summary

Hair loss is a fairly commonside effect of various chemotherapy drugs. The severity of hair loss depends on things like the specific drug used, whether drugs are used in combination, the dosage, and how it is given. Other types of cancer therapies can also have effects on hair.

While you may not be able to fully prevent hair loss or thinning, there are things you can do to reduce the risk and plan ahead for potential hair loss. Talk with your treatment team about the drugs you will be on and the risk of hair loss, and develop a plan to cope with it, should it happen.

15 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Rubio-Gonzalez B, Juhász M, Fortman J, Mesinkovska NA.Pathogenesis and treatment options for chemotherapy-induced alopecia: a systematic review.Int J Dermatol. 2018;57(12):1417-1424. doi:10.1111/ijd.13906National Cancer Institute.Hair Loss (alopecia) and cancer treatment.Dunnill CJ, Al-Tameemi W, Collett A, Haslam IS, Georgopoulos NT.A clinical and biological guide for understanding chemotherapy-induced alopecia and its prevention.Oncologist. 2018;23(1):84–96. doi:10.1634/theoncologist.2017-0263Memorial Sloan Kettering Cancer Center.Hair loss and your cancer treatment.Saraswat N, Chopra A, Sood A, Kamboj P, Kumar S.A descriptive study to analyze chemotherapy-induced hair loss and its psychosocial impact in adults: Our experience from a tertiary care hospital.Indian Dermatol Online J. 2019 Jul-Aug;10(4):426–430. doi:10.4103/idoj.IDOJ_471_18Breastcancer.org.Hair loss.Northwest Medicine.Quick dose: Why does your hair grow back differently after chemotherapy?.Fonia A, Cota C, Setterfield JF, Goldberg LJ, Fenton DA, Stefanato CM.Permanent alopecia in patients with breast cancer after taxane chemotherapy and adjuvant hormonal therapy: Clinicopathologic findings in a cohort of 10 patients.J Am Acad Dermatol. 2017;76(5):948-957. doi:10.1016/j.jaad.2016.12.027Martín M, de la Torre-Montero JC, López-Tarruella S, et al.Persistent major alopecia following adjuvant docetaxel for breast cancer: incidence, characteristics, and prevention with scalp cooling.Breast Cancer Res Treat. 2018 Jun;171(3):627–634. doi:10.1007/s10549-018-4855-2Mir-Bonafé JF, Saceda-Corralo D, Vañó-Galván S.Adverse hair reactions to new targeted therapies for cancer reacciones capilares de las nuevas terapies diana dirigidas contra el cáncer.ACTAS Dermo-Sifiliográficas. 2019 Apr;110(3):182-192. doi:10.1016/j.adengl.2019.02.017American Society of Clinical Oncology.Hair loss (alopecia).Wikramanayake T, Haberland N, Akhundlu A, Nieves A, Miteva M.Prevention and treatment of chemotherapy-induced alopecia: What is available and what is coming?.Curr Oncol. 2023 Apr;30(4):3609–3626. doi:10.3390/curroncol30040275Rossi A, Carro G, Fortuna MC, Pigliacelli F, D’Arino A, Carlesimo M.Prevention and treatment of chemotherapy-induced alopecia. Dermatol Pract Concept. 2020;10(3). doi:10.5826/dpc.1003a74American Cancer Society.Cold caps and scalp cooling.American Cancer Society.Coping with hair loss.Additional ReadingNIH: National Cancer Institute.Hair Loss (Alopecia) and Cancer Treatment.Watanabe T, Yagata H, Saito M, et al.A multicenter survey of temporal changes in chemotherapy-induced hair loss in breast cancer patients. PLoS One. 2019;14(1):e0208118. doi:10.1371/journal.pone.0208118West H.Chemotherapy-induced hair loss (alopecia). JAMA Oncology. 2017;3(8):1147. doi:10.1001/jamaoncol.2017.1026

15 Sources

Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Rubio-Gonzalez B, Juhász M, Fortman J, Mesinkovska NA.Pathogenesis and treatment options for chemotherapy-induced alopecia: a systematic review.Int J Dermatol. 2018;57(12):1417-1424. doi:10.1111/ijd.13906National Cancer Institute.Hair Loss (alopecia) and cancer treatment.Dunnill CJ, Al-Tameemi W, Collett A, Haslam IS, Georgopoulos NT.A clinical and biological guide for understanding chemotherapy-induced alopecia and its prevention.Oncologist. 2018;23(1):84–96. doi:10.1634/theoncologist.2017-0263Memorial Sloan Kettering Cancer Center.Hair loss and your cancer treatment.Saraswat N, Chopra A, Sood A, Kamboj P, Kumar S.A descriptive study to analyze chemotherapy-induced hair loss and its psychosocial impact in adults: Our experience from a tertiary care hospital.Indian Dermatol Online J. 2019 Jul-Aug;10(4):426–430. doi:10.4103/idoj.IDOJ_471_18Breastcancer.org.Hair loss.Northwest Medicine.Quick dose: Why does your hair grow back differently after chemotherapy?.Fonia A, Cota C, Setterfield JF, Goldberg LJ, Fenton DA, Stefanato CM.Permanent alopecia in patients with breast cancer after taxane chemotherapy and adjuvant hormonal therapy: Clinicopathologic findings in a cohort of 10 patients.J Am Acad Dermatol. 2017;76(5):948-957. doi:10.1016/j.jaad.2016.12.027Martín M, de la Torre-Montero JC, López-Tarruella S, et al.Persistent major alopecia following adjuvant docetaxel for breast cancer: incidence, characteristics, and prevention with scalp cooling.Breast Cancer Res Treat. 2018 Jun;171(3):627–634. doi:10.1007/s10549-018-4855-2Mir-Bonafé JF, Saceda-Corralo D, Vañó-Galván S.Adverse hair reactions to new targeted therapies for cancer reacciones capilares de las nuevas terapies diana dirigidas contra el cáncer.ACTAS Dermo-Sifiliográficas. 2019 Apr;110(3):182-192. doi:10.1016/j.adengl.2019.02.017American Society of Clinical Oncology.Hair loss (alopecia).Wikramanayake T, Haberland N, Akhundlu A, Nieves A, Miteva M.Prevention and treatment of chemotherapy-induced alopecia: What is available and what is coming?.Curr Oncol. 2023 Apr;30(4):3609–3626. doi:10.3390/curroncol30040275Rossi A, Carro G, Fortuna MC, Pigliacelli F, D’Arino A, Carlesimo M.Prevention and treatment of chemotherapy-induced alopecia. Dermatol Pract Concept. 2020;10(3). doi:10.5826/dpc.1003a74American Cancer Society.Cold caps and scalp cooling.American Cancer Society.Coping with hair loss.Additional ReadingNIH: National Cancer Institute.Hair Loss (Alopecia) and Cancer Treatment.Watanabe T, Yagata H, Saito M, et al.A multicenter survey of temporal changes in chemotherapy-induced hair loss in breast cancer patients. PLoS One. 2019;14(1):e0208118. doi:10.1371/journal.pone.0208118West H.Chemotherapy-induced hair loss (alopecia). JAMA Oncology. 2017;3(8):1147. doi:10.1001/jamaoncol.2017.1026

Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.

Rubio-Gonzalez B, Juhász M, Fortman J, Mesinkovska NA.Pathogenesis and treatment options for chemotherapy-induced alopecia: a systematic review.Int J Dermatol. 2018;57(12):1417-1424. doi:10.1111/ijd.13906National Cancer Institute.Hair Loss (alopecia) and cancer treatment.Dunnill CJ, Al-Tameemi W, Collett A, Haslam IS, Georgopoulos NT.A clinical and biological guide for understanding chemotherapy-induced alopecia and its prevention.Oncologist. 2018;23(1):84–96. doi:10.1634/theoncologist.2017-0263Memorial Sloan Kettering Cancer Center.Hair loss and your cancer treatment.Saraswat N, Chopra A, Sood A, Kamboj P, Kumar S.A descriptive study to analyze chemotherapy-induced hair loss and its psychosocial impact in adults: Our experience from a tertiary care hospital.Indian Dermatol Online J. 2019 Jul-Aug;10(4):426–430. doi:10.4103/idoj.IDOJ_471_18Breastcancer.org.Hair loss.Northwest Medicine.Quick dose: Why does your hair grow back differently after chemotherapy?.Fonia A, Cota C, Setterfield JF, Goldberg LJ, Fenton DA, Stefanato CM.Permanent alopecia in patients with breast cancer after taxane chemotherapy and adjuvant hormonal therapy: Clinicopathologic findings in a cohort of 10 patients.J Am Acad Dermatol. 2017;76(5):948-957. doi:10.1016/j.jaad.2016.12.027Martín M, de la Torre-Montero JC, López-Tarruella S, et al.Persistent major alopecia following adjuvant docetaxel for breast cancer: incidence, characteristics, and prevention with scalp cooling.Breast Cancer Res Treat. 2018 Jun;171(3):627–634. doi:10.1007/s10549-018-4855-2Mir-Bonafé JF, Saceda-Corralo D, Vañó-Galván S.Adverse hair reactions to new targeted therapies for cancer reacciones capilares de las nuevas terapies diana dirigidas contra el cáncer.ACTAS Dermo-Sifiliográficas. 2019 Apr;110(3):182-192. doi:10.1016/j.adengl.2019.02.017American Society of Clinical Oncology.Hair loss (alopecia).Wikramanayake T, Haberland N, Akhundlu A, Nieves A, Miteva M.Prevention and treatment of chemotherapy-induced alopecia: What is available and what is coming?.Curr Oncol. 2023 Apr;30(4):3609–3626. doi:10.3390/curroncol30040275Rossi A, Carro G, Fortuna MC, Pigliacelli F, D’Arino A, Carlesimo M.Prevention and treatment of chemotherapy-induced alopecia. Dermatol Pract Concept. 2020;10(3). doi:10.5826/dpc.1003a74American Cancer Society.Cold caps and scalp cooling.American Cancer Society.Coping with hair loss.

Rubio-Gonzalez B, Juhász M, Fortman J, Mesinkovska NA.Pathogenesis and treatment options for chemotherapy-induced alopecia: a systematic review.Int J Dermatol. 2018;57(12):1417-1424. doi:10.1111/ijd.13906

National Cancer Institute.Hair Loss (alopecia) and cancer treatment.

Dunnill CJ, Al-Tameemi W, Collett A, Haslam IS, Georgopoulos NT.A clinical and biological guide for understanding chemotherapy-induced alopecia and its prevention.Oncologist. 2018;23(1):84–96. doi:10.1634/theoncologist.2017-0263

Memorial Sloan Kettering Cancer Center.Hair loss and your cancer treatment.

Saraswat N, Chopra A, Sood A, Kamboj P, Kumar S.A descriptive study to analyze chemotherapy-induced hair loss and its psychosocial impact in adults: Our experience from a tertiary care hospital.Indian Dermatol Online J. 2019 Jul-Aug;10(4):426–430. doi:10.4103/idoj.IDOJ_471_18

Breastcancer.org.Hair loss.

Northwest Medicine.Quick dose: Why does your hair grow back differently after chemotherapy?.

Fonia A, Cota C, Setterfield JF, Goldberg LJ, Fenton DA, Stefanato CM.Permanent alopecia in patients with breast cancer after taxane chemotherapy and adjuvant hormonal therapy: Clinicopathologic findings in a cohort of 10 patients.J Am Acad Dermatol. 2017;76(5):948-957. doi:10.1016/j.jaad.2016.12.027

Martín M, de la Torre-Montero JC, López-Tarruella S, et al.Persistent major alopecia following adjuvant docetaxel for breast cancer: incidence, characteristics, and prevention with scalp cooling.Breast Cancer Res Treat. 2018 Jun;171(3):627–634. doi:10.1007/s10549-018-4855-2

Mir-Bonafé JF, Saceda-Corralo D, Vañó-Galván S.Adverse hair reactions to new targeted therapies for cancer reacciones capilares de las nuevas terapies diana dirigidas contra el cáncer.ACTAS Dermo-Sifiliográficas. 2019 Apr;110(3):182-192. doi:10.1016/j.adengl.2019.02.017

American Society of Clinical Oncology.Hair loss (alopecia).

Wikramanayake T, Haberland N, Akhundlu A, Nieves A, Miteva M.Prevention and treatment of chemotherapy-induced alopecia: What is available and what is coming?.Curr Oncol. 2023 Apr;30(4):3609–3626. doi:10.3390/curroncol30040275

Rossi A, Carro G, Fortuna MC, Pigliacelli F, D’Arino A, Carlesimo M.Prevention and treatment of chemotherapy-induced alopecia. Dermatol Pract Concept. 2020;10(3). doi:10.5826/dpc.1003a74

American Cancer Society.Cold caps and scalp cooling.

American Cancer Society.Coping with hair loss.

NIH: National Cancer Institute.Hair Loss (Alopecia) and Cancer Treatment.Watanabe T, Yagata H, Saito M, et al.A multicenter survey of temporal changes in chemotherapy-induced hair loss in breast cancer patients. PLoS One. 2019;14(1):e0208118. doi:10.1371/journal.pone.0208118West H.Chemotherapy-induced hair loss (alopecia). JAMA Oncology. 2017;3(8):1147. doi:10.1001/jamaoncol.2017.1026

NIH: National Cancer Institute.Hair Loss (Alopecia) and Cancer Treatment.

Watanabe T, Yagata H, Saito M, et al.A multicenter survey of temporal changes in chemotherapy-induced hair loss in breast cancer patients. PLoS One. 2019;14(1):e0208118. doi:10.1371/journal.pone.0208118

West H.Chemotherapy-induced hair loss (alopecia). JAMA Oncology. 2017;3(8):1147. doi:10.1001/jamaoncol.2017.1026

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