Table of ContentsView AllTable of ContentsEffect on CellsHair Loss TimelineOther Hair Loss SymptomsPreventionHair RegrowthFrequently Asked Questions
Table of ContentsView All
View All
Table of Contents
Effect on Cells
Hair Loss Timeline
Other Hair Loss Symptoms
Prevention
Hair Regrowth
Frequently Asked Questions
Hair loss is a commonside effect of chemotherapy treatment. Since chemotherapy targets rapidly dividing cells throughout the body, it can also affect the healthy cells that produce hair on the scalp and all over the body.
Hair loss from chemotherapy usually starts in the few weeks following chemo. Many chemotherapy medications may cause hair loss, but not all of them will. Thehair regrowthbegins not long after chemotherapy treatment has ended. Knowing what to expect can help youprepare for chemotherapy.
This article will review hair loss from chemotherapy, why it happens, how to manage it, and what to expect.
Christopher Futcher / Getty Images
How Chemo Affects Cells
Cancer cells tend to divide very quickly—at a much higher rate than most of the cells in the body. They ignore the signals and mechanisms that tell normal cells to stop dividing.
Some normal cells in our bodies also rapidly divide, like hair follicle cells, the mucous membrane cells lining the digestive tract (mouth, throat, stomach, intestines), and the blood-producing cells in the bone marrow.
Chemotherapy drugs damage the genetic material (RNA and DNA) inside rapidly dividing cells that guide cell division. Because these drugs cannot tell the difference between rapidly dividing healthy and cancer cells, they also affect healthy cells.
The hair follicles have a good blood supply, which unfortunately allows chemotherapy drugs to reach them efficiently. As a result, about 65% of people who receive chemotherapy will experience hair loss. The amount of hair loss can depend on which chemotherapy agent is used and the timing, dose, and route of administration. It can also vary from person to person, and it’s hard to predict who will be affected most.
There are multiple classes of chemotherapy drugs, each of which affects a different part of the cell growth cycle or acts in a different way. Which agent is chosen depends on the type of cancer.
Alkylating Agents
Alkylating agents damage the cell DNA at all phases of the cell growth cycle. They are used to treat many types of cancer, both solid tumors, like lung or breast cancer, and blood cancers, such as leukemia and multiple myeloma.
Agents more likely to cause hair loss include Cytoxan (cyclophosphamide), Ifex (ifosfamide), and Busulfex (busulphan). The platinum metal salts, such as Paraplatin (carboplatin) and Platinol (cisplatin), are less likely to cause hair loss.
Hair Loss (Alopecia)
Antimetabolites
Antimetabolites impersonate the building blocks for RNA and DNA, keeping the genetic material from making copies of itself, so the cell can’t divide.They are used for breast, ovarian, and colon cancer, as well as leukemia.
This class of chemo drugs is less likely to cause hair loss as compared to others, but some hair thinning may occur.
Anti-Tumor Antibiotics
Anti-tumor antibiotics act on the ability of cells to make copies of DNA, inhibiting cell growth and division.They are used to treat many types of cancer.
Not all anti-tumor antibiotics will cause hair loss. Among these,Adriamycin(doxorubicin) and Idamycin (idarubicin) are more likely to cause hair loss.
Topoisomerase Inhibitors
Plant alkaloids (topoisomerase inhibitors) target specific enzymes that enable DNA strands to separate and make copies of themselves.They are used for lung, ovarian, colorectal, and pancreatic cancer, as well as some leukemias.
In this group, more hair loss is seen with VePesid (etoposide) and Camptosar (irinotecan).
Mitotic Inhibitors
Other plant alkaloids are mitotic inhibitors. They inhibit enzymes that are needed for cell reproduction. These include the taxanes (made from the bark of the Pacific yew tree) and vinca alkaloids (derived from the periwinkle plant).They are used for breast, lung, and blood cancers.
These chemotherapy agents are more likely to cause hair loss. They include paclitaxel, Taxotere (docetaxel), Ellence (epirubicin), Ixempra (Ixabepilone), and Vincasar (vincristine).
Is Radiation Contributing to My Hair Loss, Too?
Variation in Effects
Some of the newer cancer drugs are more precise in targeting cancer cells and may not result in hair loss. There are also varying degrees of hair loss, regardless of chemotherapy drug type and regimen.
Does Chemotherapy Cause Hair Loss?
Hair loss usually doesn’t happen immediately after chemotherapy. It usually starts one to two weeks after the first treatment with chemo.
Timeline for Hair LossOne to three weeks after the first treatment: Hair loss begins.One to two months after the first treatment: Hair loss becomes severe.Three to six months after treatment ends: Hair regrows.
Timeline for Hair Loss
One to three weeks after the first treatment: Hair loss begins.One to two months after the first treatment: Hair loss becomes severe.Three to six months after treatment ends: Hair regrows.
Hair may fall out in clumps or seem like it is thinning as you lose a few strands at a time from all over your scalp. Depending on the type of chemotherapy used, you could lose the hair on your head only, or also on all parts of your body, including the eyelashes andeyebrows, arm, legs, underarms, and pubic area.
Other symptoms you may experience include:
Prevention and Treatment
While hair loss may depend on the chemotherapy drug used and how the treatment is given, these choices are appropriately made to be the most effective against the type of cancer being treated.
One preventive measure is the use of scalp cooling. This can be done with ice packs, cooling caps, or scalp cooling systems used before, during, or after treatment. This causes the capillaries supplying the hair follicles to constrict, exposing them to less chemotherapy medication.
Using Rogaine (minoxidil) has not been shown to prevent hair loss, but it may reduce the severity or shorten the time it takes to regrow the hair.
Taking Care of Your Hair During Chemo
Hair Growth After Chemo
With most types of chemotherapy, the cells in the hair follicles will regenerate enough to resume hair growth. They normally go through a cycle of active growth, then rest. Chemotherapy sends more of them into the rest phase (telogen), which usually lasts for 100 days.
By about six months after treatment, you may have enough hair to be able to style it.
Still, some people do not see hair regrowth. Some types of chemotherapy (such as busulfan and cyclophosphamide) have a higher risk of permanent hair loss.
The effects of chemotherapy on the hair follicles can result in the regrown hair being a different color or texture and having different waves or curls than before. In the breast cancer treatment study, 53% said their hair became wavier or curlier, 58% reported thinner hair, 6% noted thicker hair, 38% said their hair was grayer or whiter, and 5% reported darker hair.
Caring for Your Hair After Chemo
Summary
Preventative measures for hair loss are limited. Scalp cooling may be effective but can be expensive and not work for everyone. Topical medications have also not been found to be effective in preventing hair loss from chemo.
A Word From Verywell
Hair loss is a consequence of cancer treatment that can be very distressing. There is no right or wrong way to feel about this hair loss or how you face it. It may affect some people’s self-esteem and emotional well-being, while others can view it as a symbol of their fight against the disease.
Talk to your treatment team about your risks, options, and their recommendations. You can choose to wear a wig or head covering or embrace the new look. Many have been down this same path and can offer helpful suggestions and support.
Frequently Asked QuestionsBody hair can grow back after chemo. Hair loss from chemo is often temporary, and hair will begin to regrow after the chemo causing hair loss has been discontinued. However, there is a risk that hair loss can be permanent in some people.Yes, it is possible that pubic hair may fall out because of chemotherapy. This generally happens later than when the hair on the head is lost.Yes, it is possible that facial hair may fall out because of chemotherapy. This generally happens later than when the hair on the head is lost.
Body hair can grow back after chemo. Hair loss from chemo is often temporary, and hair will begin to regrow after the chemo causing hair loss has been discontinued. However, there is a risk that hair loss can be permanent in some people.
Yes, it is possible that pubic hair may fall out because of chemotherapy. This generally happens later than when the hair on the head is lost.
Yes, it is possible that facial hair may fall out because of chemotherapy. This generally happens later than when the hair on the head is lost.
11 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.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;10(4):426-430. doi:10.4103/idoj.IDOJ_471_18Gao Q, Zhou G, Lin S, Paus R, Yue Z.How chemotherapy and radiotherapy damage the tissue: comparative biology lessons from feather and hair models.Exp Dermatol. 2019;28(4):413-418. doi:10.1111/exd.13846American Cancer Society.How chemotherapy drugs work.Rugo HS, Lacouture ME.Alopecia related to systemic cancer therapy.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. 14(1):e0208118. doi:10.1371/journal.pone.0208118American Cancer Society.Coping with hair loss.Trüeb RM.Chemotherapy-induced hair loss.Skin Therapy Lett. 15(7):5-7.National Cancer Insitute.Skin and nail changes during cancer treatment.Kruse M, Abraham J.Management of chemotherapy-induced alopecia with scalp cooling.Journal of Oncology Practice.14(3)149-154. doi:10.1200/JOP.17.00038Kang D, Kim I, Choi E, et al.Permanent chemotherapy‐induced alopecia in patients with breast cancer: a 3‐year prospective cohort study.Oncologist. 2019;24(3):414-420. doi: 10.1634/theoncologist.2018-0184
11 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.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;10(4):426-430. doi:10.4103/idoj.IDOJ_471_18Gao Q, Zhou G, Lin S, Paus R, Yue Z.How chemotherapy and radiotherapy damage the tissue: comparative biology lessons from feather and hair models.Exp Dermatol. 2019;28(4):413-418. doi:10.1111/exd.13846American Cancer Society.How chemotherapy drugs work.Rugo HS, Lacouture ME.Alopecia related to systemic cancer therapy.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. 14(1):e0208118. doi:10.1371/journal.pone.0208118American Cancer Society.Coping with hair loss.Trüeb RM.Chemotherapy-induced hair loss.Skin Therapy Lett. 15(7):5-7.National Cancer Insitute.Skin and nail changes during cancer treatment.Kruse M, Abraham J.Management of chemotherapy-induced alopecia with scalp cooling.Journal of Oncology Practice.14(3)149-154. doi:10.1200/JOP.17.00038Kang D, Kim I, Choi E, et al.Permanent chemotherapy‐induced alopecia in patients with breast cancer: a 3‐year prospective cohort study.Oncologist. 2019;24(3):414-420. doi: 10.1634/theoncologist.2018-0184
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.
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;10(4):426-430. doi:10.4103/idoj.IDOJ_471_18Gao Q, Zhou G, Lin S, Paus R, Yue Z.How chemotherapy and radiotherapy damage the tissue: comparative biology lessons from feather and hair models.Exp Dermatol. 2019;28(4):413-418. doi:10.1111/exd.13846American Cancer Society.How chemotherapy drugs work.Rugo HS, Lacouture ME.Alopecia related to systemic cancer therapy.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. 14(1):e0208118. doi:10.1371/journal.pone.0208118American Cancer Society.Coping with hair loss.Trüeb RM.Chemotherapy-induced hair loss.Skin Therapy Lett. 15(7):5-7.National Cancer Insitute.Skin and nail changes during cancer treatment.Kruse M, Abraham J.Management of chemotherapy-induced alopecia with scalp cooling.Journal of Oncology Practice.14(3)149-154. doi:10.1200/JOP.17.00038Kang D, Kim I, Choi E, et al.Permanent chemotherapy‐induced alopecia in patients with breast cancer: a 3‐year prospective cohort study.Oncologist. 2019;24(3):414-420. doi: 10.1634/theoncologist.2018-0184
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;10(4):426-430. doi:10.4103/idoj.IDOJ_471_18
Gao Q, Zhou G, Lin S, Paus R, Yue Z.How chemotherapy and radiotherapy damage the tissue: comparative biology lessons from feather and hair models.Exp Dermatol. 2019;28(4):413-418. doi:10.1111/exd.13846
American Cancer Society.How chemotherapy drugs work.
Rugo HS, Lacouture ME.Alopecia related to systemic cancer therapy.
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. 14(1):e0208118. doi:10.1371/journal.pone.0208118
American Cancer Society.Coping with hair loss.
Trüeb RM.Chemotherapy-induced hair loss.Skin Therapy Lett. 15(7):5-7.
National Cancer Insitute.Skin and nail changes during cancer treatment.
Kruse M, Abraham J.Management of chemotherapy-induced alopecia with scalp cooling.Journal of Oncology Practice.14(3)149-154. doi:10.1200/JOP.17.00038
Kang D, Kim I, Choi E, et al.Permanent chemotherapy‐induced alopecia in patients with breast cancer: a 3‐year prospective cohort study.Oncologist. 2019;24(3):414-420. doi: 10.1634/theoncologist.2018-0184
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