If you need chemotherapy as a part of your cancer treatment, you might have some concerns about losing your hair. Many people lose some or all of their hair if they undergo chemotherapy. Chemotherapy uses powerful medicines that attack fast-growing cancer cells. The medicines also hurt other fast-growing cells in your body. That’s because chemo targets rapidly growing cells, which damages hair follicles and makes the hair fall out. But radiation therapy can sometimes cause hair loss, too, when it’s used to treat head and neck cancers. However, this effect is rarely permanent, and the hair should grow back once treatment is over. This article will explore what to expect regarding hair growth after chemo, including timelines, potential changes in texture and color, and tips for managing hair regrowth.
Chemotherapy may cause hair loss all over your body, not just on your scalp. Sometimes your eyelash, eyebrow, armpit, pubic, and other body hair also falls out. Some chemotherapy medicines are more likely than others to cause hair loss. Not all chemotherapy drugs have hair loss as a possible side effect. Whether your hair thins or you become completely bald will depend on your treatment. It could fall out very quickly in clumps or gradually. You'll likely notice hair on your pillow, in your hairbrush or comb, or in your sink or shower drain. Hair loss typically continues throughout treatment and up to a few weeks afterward. Talk to your healthcare team about the chemotherapy medicines you'll receive.
Both chemotherapy itself and the hair loss it causes can make your scalp feel rough and itchy, too.
The reason chemotherapy can cause hair loss is that it targets all rapidly dividing cells - healthy cells as well as cancer cells. Hair follicles, the structures in the skin from which hair grows, include some of the fastest-growing cells in the body. If you're not in cancer treatment, cells in your hair follicles divide every 23 to 72 hours. But as chemotherapy does its work against cancer cells, it also damages hair follicle cells. Within a few weeks of starting certain chemotherapy medicines, you may lose some or all of your hair. The hair loss can happen gradually or fairly quickly.
After the last treatment, it takes time for chemotherapy drugs to leave the body altogether and stop attacking healthy dividing cells. Therefore, the hair does not start to grow back immediately.
Read also: Regaining Hair After Cancer Treatment
It may take several weeks after treatment for your hair to recover and begin growing again.
Here's a typical timetable for hair regrowth on the head:
It can take several years for hair to return to its previous style, particularly for people who once had very long hair.
A 2019 study involved 1,470 people who underwent chemotherapy as part of their breast cancer treatment. A survey of the participants revealed that:
When your hair starts to grow back, it will probably be slightly different from the hair you lost. The hair on your head may be a different color, texture, or volume when it grows back. If you were dyeing or chemically treating your hair before you started chemotherapy, you might be surprised to see what your natural hair looks like when it grows back.
Read also: Lasting Hair Graft Results
After chemotherapy, hair initially regrows as thin fuzz. It may stick straight up or be difficult to style. Very fine hair may also not be visible from a distance. Some hair follicles may enter the active growth period before others. When this happens, the length of hairs can vary, which may make the hair look patchy overall. It will likely also be more difficult to style. Over time, the hair should settle into a more regular growth pattern. However, its texture might be different than before the treatment.
Some people talk about “chemo curls,” which occur when the hair grows back curlier, more brittle, or less manageable than before. In some cases, the hair may also grow back a different color. Many people who previously had straight hair get "chemo curls," or curly hair that grows after chemo. People with curly hair may notice it grows back straighter. Some people also see changes in hair color - for example, dark hair may come back lighter, or even with a reddish tint.
The 2019 study previously mentioned discovered that:
Doctors still do not fully understand why hair texture sometimes changes after chemotherapy. It could be that the treatment damages hair follicles or affects the genes that control hair growth. Changes in hair texture and color are largely due to the lingering effects of chemotherapy in the body. These medications can temporarily alter the way your hair follicles function, disrupting the normal process of hair strand formation. As a result, your new hair may be finer, more fragile, a different color or grow in uneven patches. Fortunately, like texture changes, hair color changes are usually temporary.
In many cases, hair eventually returns to the way it used to be after the effect of chemotherapy on the hair follicle wears off. But some people have incomplete hair regrowth. Sometimes permanent baldness and loss of eyebrows and eyelashes can occur, particularly in people who received Taxotere.
Read also: Customizing Your Hair Oil Blend
Whether you experience hair thinning or the complete loss of your hair, any hair loss can be traumatic. Like many people, you might feel that the hair on your head is a big part of your identity. Losing it can make you feel self-conscious and exposed.
There are steps you can take to prepare, possibly lessen hair loss, and protect your hair as it grows back. Your new hair growth will be especially fragile. It may be more easily damaged by styling products and heating devices. Hold off on coloring, relaxing, or bleaching your new hair until it grows stronger. Continue gentle hair care.
People can take certain steps to keep their hair healthy as it regrows:
Hair loss and changes in appearance can be among the most emotional side effects of cancer treatment. "If you are feeling distressed, remember that these changes are almost always temporary," says Iheme. For some, hair changes are a symbol of resilience and renewal. For others, the loss of hair or changes in hair texture or color can be emotionally challenging, especially when they serve as a visible reminder of a cancer journey. This can lead to feelings of sadness, anxiety, or isolation, which is why emotional support is important. Whether through counseling, support groups, or loved ones, having a safe space to process your feelings can make a big difference.
Many patients are surprised to find that their hair looks different when it grows back after chemotherapy. Chemotherapy works by targeting cells that divide rapidly. “Chemo can linger in the hair follicles and alter the way hair grows,” says Iheme. Hair growth depends on a process called hair shaft synthesis. When chemotherapy disrupts this process, it can cause new hair to grow differently than before. Along with texture, patients sometimes experience changes in hair color after chemotherapy. The exact reasons for these color changes are not fully understood. Iheme says that genetics, age, and gender may all influence how hair grows back.
Hair loss can be traumatic in part because it’s so visible. You may feel that it reveals to the world that you’re a cancer patient, threatening your privacy. And you may have to deal with it around the same time that you’re facing other unwanted changes to your body and appearance due to treatment.
Of course, not everyone reacts to treatment-related hair loss in the same way. For some, it can be devastating, especially at the beginning. For others, it’s a big inconvenience but it doesn’t affect them as deeply.
It’s important to remember that everyone has a different response.
If you’re worried or upset about hair loss, try not to isolate yourself because you’re embarrassed or fear being judged as superficial. Talk about your feelings with understanding friends and family members, a mental health professional, or a social worker at your local cancer center.
Also, try seeking out an in-person support group or an online community for people with breast cancer. Connecting with others who are going through cancer treatment and experiencing hair loss can be particularly helpful since they understand what you're going through. Visit our online community to connect with others who have experienced hair loss from breast cancer treatment.
If you have young children, you may be concerned about how they’ll react to seeing you lose your hair as a side effect of chemotherapy.
Experts say that no matter the age of your kids, it’s best to prepare them before your hair falls out with honest, age-appropriate information about what to expect.
Since kids often follow your lead, reassure them that though you may look different without your hair, you’ll still be the same you. It can be helpful to remind them that your hair will grow back. It might also make them feel better to participate in some of the things you’re doing to prepare, such as picking out hats, scarves, or other head coverings, or shaving off your hair.
There tends to be a lot less stigma with being open about a cancer diagnosis in the workplace than there was even a generation ago. If you’re planning to continue working or to job hunt during treatment, you’re likely to find that many colleagues are understanding about what you’re going through.
Still, it’s up to you to decide how comfortable you feel telling your colleagues or others you interact with in your job about your diagnosis and treatment. If you’ve lost your hair and you want to maintain your privacy at work, you might choose to wear a wig that looks as close as possible to your natural hair and to otherwise conceal your hair loss (such as by penciling in your eyebrows). If you’re not as concerned about privacy, you might wear a scarf or choose not to hide your hair loss.
How you decide to handle hair loss at work might also depend on your job role and industry. For instance, if you work in a field in which your appearance is front and center more, you might decide that concealing your hair loss on the days you go to work helps you feel more confident.
This article contains personal stories from Anj Oto and Ngozi Onwuchekwa, two individuals who have experienced hair growth after chemo.
Eileen Posner, a cancer survivor who lost all her hair to chemotherapy, kept a year-long photo diary showing her changing appearance as she went through recovery.
A 41-year-old mother of two, Posner had long, flowing locks before she was diagnosed with aggressive breast cancer. She went bald as a result of her life-saving chemotherapy treatment.
In total, she had 6 doses of chemo between January and April 2017, as well as 28 doses of radiation therapy and a double mastectomy to remove a mass on her left breast.
Chemotherapy kills cancer cells but also affects hair root cells. It caused Posner’s head hair, eyelashes, and eyebrows to fall out.
“I was hoping I would be the one and only person that didn’t lose their hair, and it didn’t fall out until after my second dose - but then it fell out in clumps.”
“Losing my hair to chemo was way more traumatic than losing my breasts to cancer,” she says, noting that strangers gave her looks of pity whenever she went out in public.
“When you don’t have hair, everyone knows what you are going through. I got these looks of pity - no one knows how to speak to you anymore. That was the hardest part - to be reduced to my diagnosis,” Posner says.
Six weeks after undergoing her final chemo session, the first tufts of hair began to reappear on her head.
Posner decided to document the progress her hair made during treatment and then recovery.
“I took my first picture one week post-chemo because it was very important for me to document that year and prove to myself that I was getting better - looking better,” she says.
While the growth was slow at first, pictures show her brunette mop becoming fuller as each week goes by. In her final photo, she poses with a full head of hair.
She put the 52 images together in a video montage to show her journey, which she hopes will help others who are also battling the disease.
Eileen was diagnosed with breast cancer in November 2016 after her son, Declan, then 3, rolled onto her breast and she experienced a sharp pain.
“My breasts were there to feed my babies - they were like elbows. I didn’t pay attention to them,” she says.
Posner, who says she’s back to feeling 100 percent, adds: “When I heard the words ‘breast cancer,’ mortality washed over me. All I could think about was leaving my children without a mother and leaving my husband without a wife.”
She tries to instill hope in anyone undergoing treatment or having a hard time with recovery. “I just hope that anyone who is in the middle of treatment can watch this and see that things get better.”
Talking about life post-treatment, she adds, “It’s not going to be the same, but you get better. You are going to get a renewed sense of who you are and maybe even find the new you.”
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