Chemotherapy, while effective in treating cancer, often brings about side effects, one of the most distressing being hair loss. This article explores the process of hair regrowth after chemotherapy, offering a timeline, insights into potential changes in hair texture and color, and tips for promoting healthy regrowth. It also shares personal stories to provide hope and encouragement.
Chemotherapy targets rapidly dividing cells, including cancerous cells and healthy cells like those in hair follicles. Damage to these follicles can lead to hair loss on the head, eyelashes, eyebrows, and other body parts. Hair loss typically begins within 1 to 3 weeks of starting treatment and becomes more pronounced after 1 to 2 months. The extent of hair loss varies depending on the chemotherapy type and dosage.
After the last chemotherapy treatment, the drugs need time to leave the body and stop affecting healthy cells. Therefore, hair doesn't grow back immediately. Here's a general timeline of what to expect:
It's important to remember that this is just a general guideline. A 2019 study of 1,470 people undergoing chemotherapy for breast cancer revealed that hair started growing back, on average, 3.3 months after stopping treatment. In about 13% of people, hair started regrowing before treatment ended. Less than 0.5% of cases saw no hair regrowth 6 months after treatment ended. It can take several years for hair to return to its previous style, particularly for people who once had very long hair.
Hair often grows back differently after chemotherapy. This can include changes in texture, color, and thickness. Usually, these changes are temporary, but in rare cases, they may be permanent.
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 people experience "chemo curls," where the hair grows back curlier, more brittle, or less manageable than before. In some cases, the hair may also grow back a different color.
The 2019 study mentioned earlier found that:
Doctors are still researching 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.
People can take certain steps to keep their hair healthy as it regrows:
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Some drugs encourage hair regrowth after chemotherapy, but the results vary. Most hair regrowth drugs aim to treat hair loss from causes other than chemotherapy. Minoxidil (Rogaine) may accelerate hair growth or decrease hair loss in individuals undergoing chemotherapy.
Doctors may, for example, recommend Rogaine for people who have had tamoxifen therapy for breast cancer. However, it can be messy and expensive. Pharmacies usually offer other forms of minoxidil that are cheaper. Minoxidil is thought to stimulate hair growth by improving blood flow in the scalp and prolonging the growth phase of each hair follicle.
They are exploring other therapies, such as platelet-rich plasma, Spironolactone, and photobiomodulation. However, more studies need to be conducted to confirm their effectiveness in helping hair growth.
A person should discuss the risks and benefits of hair regrowth treatments with their doctor before using them.
The Food and Drug Administration (FDA) has approved the DigniCap Cooling System, a cooling cap that may help prevent hair loss during chemotherapy. Cooling caps are rubberized caps cooled with water until they reach a temperature just above freezing (around 37 degrees Fahrenheit). The cold from the cap makes the blood vessels in the scalp tighten. This can reduce the amount of chemo that reaches the hair follicles and help prevent hair loss. The time patients spend wearing the cooling cap varies based on their chemotherapy.
Read also: Achieve Voluminous Hair
It works by cooling the scalp to reduce the likelihood of alopecia in people undergoing cancer treatment. Some studies have shown that cooling caps might not work well on hair with tight curls and coils. This type of hair is more common in Black people. Tight curls and coils might prevent the cap from getting the scalp cold enough.
Losing hair while receiving chemotherapy can be upsetting, but the loss is usually only temporary. 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.
Finding a suitable wig or hairpiece can help as an individual waits for their hair to regrow. Trying to maintain some sense of normalcy is important to many people with cancer. So, it makes sense that some people find the hair loss that often comes with chemotherapy treatments upsetting.
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.
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.”
Many people find that wearing a wig is a good solution for them if they experience hair loss from breast cancer treatment. A wig can provide a sense of normalcy, consistency, and privacy during cancer treatment. Experimenting with different wig styles and colors can also be quite fun!
Many people find that scarves, hats, and turbans are the easiest, most comfortable, and versatile solutions for managing hair loss from breast cancer treatment. They can hide your hair loss, help keep you warm, protect you from the sun, and they can be stylish and fun to wear.
If you’re concerned that your hair isn’t growing back or is noticeably thinner than in the past, it’s a good idea to see a dermatologist. If possible, seek out one who specializes in hair loss or an onco-dermatologist who focuses on problems with the hair, skin, and nails that can develop during cancer treatment. The dermatologist will order blood tests to check whether there are other reasons for your hair loss besides the effects of breast cancer treatments. Thyroid problems, nutritional deficiencies, and other factors can play a role in hair loss.
For mild to moderate hair loss, dermatologists often recommend Rogaine (chemical name: minoxidil), an over-the-counter medication that promotes hair growth. It’s safe for people with a history of breast cancer and moderately effective. But check with your oncologist before you start using minoxidil. In most cases, you can use it while you take hormonal therapy or targeted therapy, but not during chemotherapy treatment.
Some dermatologists may recommend certain nutritional supplements to help speed up hair growth, such as Nutrafol and Viviscal Hair Growth supplements. Always check with your oncologist before you start taking a nutritional supplement. Biotin supplements should be avoided because they can cause you to have incorrect results from lab tests, such as cardiovascular diagnostic tests and hormone tests.
Some of the other products you might want to try for mild to moderate hair loss include:
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.
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.
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.
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