Hair Loss and Your Cancer Treatment

This information will help you understand hair loss during cancer treatment and explains medications that you can take to prevent or help hair loss.

Commonly Asked Questions

What are the causes of hair loss?

Many people with cancer lose their hair because of chemotherapy or radiation to the head. However, there are other causes of hair loss, too. These include being low in certain vitamins, having a family history of hair loss, going through hormonal changes, having certain medical conditions, hairstyles, treatments, and medications and being stressed.

It is important to be seen by a dermatologist to determine the reason for your hair loss and if you have any questions about your hair. Your dermatologist will ask about your history of hair loss and look at the areas where you are experiencing hair loss. 

Why will I lose my hair during cancer treatment?

Cancer treatments such as radiation and chemotherapy attack fast-growing cancer cells. These treatments can also affect normal cells that are fast growing, such as hair.

Chemotherapy can cause hair loss on your scalp, pubic area, arms, legs, eyebrows, and eyelashes. Radiation therapy to the head often causes hair loss on the scalp. Sometimes, depending on the dose of radiation to the head, the hair may grow back differently from how it looked before or it may not grow back at all. 

When will I begin to lose my hair?

You may start to see your hair thin or fall out 1 to 4 weeks after your first chemotherapy treatment and 4 weeks after you receive radiation therapy.

How much of your hair falls out or thins depends on the type, dose, and timing of your treatments. The speed at which it falls out also varies from person to person. You may first notice hair on your pillow in the morning or see it when you shower or brush your hair.

Some people will experience hair thinning rather than hair loss. Speak with your nurse about what to expect after your chemotherapy or radiation therapy.

When will my hair grow back?

Once your treatments have stopped, your hair should begin to grow back. Hair regrowth can take 3 to 5 months. Your hair may look or feel different in terms of texture or color. In rare cases, your hair will not grow out as fully as it did before.

There is a very small risk that your hair will not grow back after radiation therapy to the head.

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Caring For Your Hair and Head

Here are suggestions on how to care for your hair and head while you are experiencing hair loss:

  • Wash and condition your hair every 2 to 4 days with a baby shampoo or other mild shampoo and a cream rinse or hair conditioner.
  • Always rinse your hair well and pat it dry with a soft towel.
  • Wash your hair after swimming in a pool.
  • Use shampoos and conditioners that have sunscreen to prevent sun damage to your scalp. Do not expose your scalp to the sun and keep your head covered in the summer.
  • In the winter, cover your head with a hat, scarf, turban, or wig to keep it warm. This can also help to contain falling hair.
  • Sleep on a satin or silk pillowcase because it is smoother than other fabrics and can decrease hair tangles.
  • Brush or comb your hair gently with a soft-bristle brush or comb. Start brushing or combing your hair at the ends and gently work your way up to your scalp. You can also finger-comb your hair by moistening your fingers with water.
  • If your hair is long, you may want to have it cut short before you begin treatment.
  • Tell your hairdresser that you are receiving chemotherapy. He or she may be able to recommend gentle hair products.
  • Try using Bumble and bumbleTM Hair Powder to cover bald spots and thinning areas of your hair. You can buy it at Sephora® or online from various beauty supply websites.

Do not use the following on your hair during treatment because they can be too harsh or pull on your hair:

  • Hair spray, hair dye, bleach, or permanents (perm)
  • Clips, barrettes, bobby pins, pony tail holders, or scrunchies
  • Hair dryers, curlers, curling irons, or a hair straightener
  • Rubber bathing or swimming caps

Do not put your hair in braids, corn rows, or pony tails.

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Wigs, Hairpieces, and Head Coverings

Wigs

If you want to wear a wig, try to get one before your hair falls out because it will be easier to match your hair color and style. If you have already experienced hair loss, bring a photo of your usual hairstyle, and if you can, a lock of your hair. This will help you find a wig that looks like your hair did before your treatment started.

When shopping for a wig, you may want to shop around and compare prices. There is a list of places to buy wigs in the section “Where to Buy Wigs and Hairpieces” at the end of this resource. 

A wig should fit properly, be comfortable, and be easy to care for. You may want to start wearing your wig as soon as your hair begins to thin. As your hair gets thinner, you may need to have your wig adjusted to make it fit better.

There are many types of wigs and hairpieces. Below is a list of the most common. 

Custom-made wigs

Custom-made wigs are made by hand and are usually the most expensive type of wig. These wigs are made using your specific head measurements. To get a custom-made wig, you may need to visit the store that sells it several times, for it to be colored, cut, and cleaned. Custom-made wigs are usually made of human hair, but can be made of synthetic (not human hair) materials.

Customized ready-made wigs

Customized ready-made wigs can be made of human hair, synthetic blends, or a mixture of both. They are made in standard sizes, but can be altered to fit your head. These wigs can be styled and generally cost less than a custom-made wig.

Ready-made or stock wigs

Ready-made or stock wigs are usually made out of a stretchy material and come in 1 size. If you buy a ready-made wig, you can usually take it home the same day that you purchase it. Ready-made wigs are generally the least expensive type of wig.

Hairpieces

If you lose your hair in only 1 area, you may want to consider buying a hairpiece rather than a wig. A hairpiece will blend into your own hair when combed. It can be made in any size, color, or shape.

Head coverings

Scarves, turbans, and hats

  • Scarves, turbans, and hats can help hold hair that is falling out and also hide a bald scalp.
  • Scarves made from silk can easily slide off your head. A scarf made of a cotton blend can be more comfortable.
  • Turbans are sold in many drug stores and come in many different colors and textures.
  • Hats worn with or without scarves can also be attractive and comfortable.
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Financial Support

Your health insurance may cover the cost of your wig or hairpiece. For your wig or hairpiece to be covered by insurance, your doctor must write a prescription with a diagnosis code indicating that your hair loss is due to treatment for cancer. Check with your insurance company to see if they cover the costs of wigs or hairpieces and how much they will pay.

Additional resources for financial support include:

American Cancer Society

www.cancer.org

Some American Cancer Society offices offer free wigs to cancer patients. If you are interested in this service, go to your local American Cancer Society office or call 800-227-2345.

Cancer Care

www.cancercare.org

Cancer care offers free wigs to cancer patients. Call 800-813-4673 and ask to speak with a social worker.

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The Look Good Feel Better Program

The Look Good Feel Better program is designed to help people cope with the effects that cancer treatment can have on their appearance. During weekly sessions, makeup artists teach makeup techniques, skin and nail care, and hair styling and head-covering options. To register for a class, call  the American Cancer Society at 800-227-2345.

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Medications and Supplements for Hair Loss

Medications and supplements for hair loss can slow thinning of hair and increase coverage of the scalp by growing new hair and enlarging existing hairs. Below are frequently asked questions people have about minoxidil, biotin, BioSil™, finasteride, and spironolactone.

Minoxidil

What is minoxidil?

Minoxidil is a topical (applied on the skin) medication that has been used for over 20 years to help regrow hair. It can be purchased over the counter. One common brand name is Rogaine®.

Minoxidil has only been tested on the scalp. However, your doctor may recommend that you use it also on your eyebrows, as an off-label use. Off-label use means that a medication is used in a way that is different from how it is described on the FDA-approved medication label.

Which product do you recommend?

We recommend the 5% product for both men and women.

Should I use the liquid or foam product?

The foam product is easier to apply if you have some hair and it is less likely to drip down your face. To apply:


  1. Dispense ½ capful of foam onto your fingers.

  2. Apply directly to your scalp, parting your hair where it is thinning.

  3. Massage into your scalp.

  4. Wash your hands.

  5. Let the foam dry.

If your nurse or doctor tells you to apply minoxidil to your eyebrows, we recommend that you use the foam as well. Protect your eyes and eyelids by placing a cloth over your eyes when applying.

For more information on minoxidil, including how to apply it, go to www.rogaine.com

How often should I apply it?

Apply it at least once daily, but we recommend applying it twice daily. Using minoxidil more often than this will not make your hair grow faster. Add minoxidil to your daily routine.

Do not use minoxidil if you are using any other topical medication. Wait until you finish the course of your other topical medication, and then start using minoxidil. 

When should I expect to see results?

It may take up to 4 months to see results.

During the first few weeks of use, some of your hair may shed. This is to make room for the new hairs to grow. 

What are the side effects?

Uncommon side effects include scalp irritation and itchy or dry scalp. If you experience these side effects, stop applying the medication and call your doctor’s office.

Rare side effects include increased hair growth on the face. If this happens to you, use threading to get rid of the unwanted hair.

You may experience changes in the color or texture of your hair.

If you have history of heart disease, let your cardiologist (heart doctor) know you are applying this medication. 

I am getting some facial hair as a side effect of my cancer treatment. Will the minoxidil increase this growth if I am only applying it to my scalp?

Unwanted hair growth on the face and other parts of the body has been reported from the use of minoxidil, but these reports have been rare. The hair growth may be caused by the transfer of minoxidil to areas other than your scalp, or by low levels of it being absorbed into your body.

Are there any alternatives to minoxidil?

There are no alternative topical medications that we recommended.

Can I use minoxidil if I am pregnant or nursing?

No. Do not use this product if you are pregnant or nursing.

Biotin

What is biotin?

Biotin is a supplement that can strengthen hair and nails.

How much should I take daily?

We recommend taking 2,500 mcg (2.5 mg) orally (by mouth) daily.

Are there any side effects?

Biotin is usually well tolerated when taken as directed.

BioSil™

What is BioSil™?

BioSil™ is a supplement that allows your body to make and increase the production of collagen.

Why do I need collagen?

Collagen is a protein that we need for healthy hair, skin, nails, healthy bones, and joints. It makes your skin more elastic, your hair thicker and stronger, and your nails harder. 

How long should I take BioSil™?

You can take it as long as you want, or until you feel your hair and nails have returned to normal after your treatment.

Can I take BioSil™ with other supplements (i.e, biotin)?

Yes. There are no contraindications between BioSil™ and any other supplement.

Are there any side effects?

Rare side effects include leg swelling and rashes.

Finasteride

What is finasteride?

Finasteride is a prescription medication that has shown approved by the FDA to treat male pattern baldness. It can also be prescribed to women for off-label use.

How does finasteride work on hair growth?

Finasteride works by lowering a hormone called dihydrotestosterone (DHT) which is present in both men and women. High levels of DHT shrink hair follicles resulting in hair loss. Reducing DHT stops the progression of hair loss in many men.

What are some side effects?

Some of the side effects are listed below. Please see the package insert for all side effects.

Some of the common side effects of finasteride include an inability to have an erection, low blood pressure, dizziness, weakness, and decreased interest in sexual intercourse.

Rare side effects include an allergic reaction, enlarged breasts, fluid retention, and decreased semen upon ejaculation.

Do not start this medication if you are planning to be pregnant or are pregnant.

Call your doctor if you experience new or worsening side effects after taking this medication such as swelling, rash, depression, confusion, genital pain, or difficulty urinating. 

Spironolactone (Aldactone®)

What is spironolactone?

Spironolactone is a prescription medication used to treat conditions including high blood pressure, and low levels of potassium. It can also slow the production of hormones which are present in hair follicles. This has shown to stop the progression of hair loss.

What are some side effects?

Some of the side effects are listed below. Please see the package insert for all side effects.

Some of the common side effects include stomach irritation, mild nausea, breast tenderness, headache, and difficulty with erections.

Rare side effects include an allergic reaction and high potassium in the blood.

If you develop any new side effects when taking this drug, call your doctors office immediately.

Will I need to have special tests done while taking spironolactone?

Your doctor will monitor your potassium, kidney function, and blood pressure while on this medication.

If you take this medication, tell all your doctors (including your oncologist, primary care doctor, and your cardiologist). Tell your doctor if you have liver, heart disease, if you take other water pills, salt substitutes, or other blood pressure medications.

What should I avoid while taking this medication?

Do not start this medication if you are:

  • Pregnant
  • Planning to get pregnant
  • Have high potassium blood levels
  • Have an allergy to this medication
  • Not able to urinate
  • Have kidney disease

Do not eat foods with potassium such as:

  • Bananas
  • Beans
  • Dark, leafy greens such as spinach
  • Potatoes
  • Squash
  • Yogurt
  • Fish
  • Avocados
  • Mushrooms

Do not drink alcohol because it may cause dizziness and low blood pressure.

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Where to Buy Wigs and Hairpieces

Manhattan

   
Angels of New York Nicholas Piazza Nina Larsen*
161 East 61st Street 16 West 56th Street 26 East 63rd Street
New York, NY 10021 2nd Floor New York, NY 10065
212-838-7888 New York, NY 10019 646-301-9087
www.angelsofny.com 212-838-6190 917-517-4544 (cell)
    Call to make an appointment
   
Top Priority Prosthetics for Hair Loss  
174 Fifth Avenue  
New York, NY 10010  
212-206-6785  
   
   

Brooklyn 

 
Claire Accuhair* Yaffa Wigs*
1611 Cedar Street 4118 13th Street
Brooklyn, NY 11230 Brooklyn, NY 11218
718-998-6043 718-436-4280
www.claireaccuhair.com www.yaffawigs.com
   

Queens

Ginza Wigs*
116-01 Queens Boulevard
Forest Hills, NY 11375
718-544-1848
www.ginzawig.com
 

Long Island

 
Jacki’s Wig Works The Wig Salon
3381 Merrick Road 1008 West Jericho Turnpike
Wantagh, NY 11793 Smithtown, NY 11787
516-679-4633 631-864-7560
www.jackiswigworks.com www.thewigsalonli.com
   

Westchester County

 
Oggi, Adam & Eve Tiffany Wigs
770 Central Avenue 100 Triangle Shopping Center
Scarsdale, NY 10583 Yorktown Heights, NY 10598
586-985-0576 800-427-9447
www.oggiadameve.com www.tiffanywigs.com
   

New Jersey

   
AAA Wigs Just For You* Lillian Lee Salon and Spa*
682 Morris Turnpike 37 Mt. Pleasant Avenue 947 Teaneck Road
Short Hills, NJ 07078 East Hanover, NJ 07936 Teaneck, NJ 07666
973-376-8050 973-887-5930 201-837-6770
www.angelsofny.com www.justforyoucenter.com  
     

Connecticut 

 
Allura Salon & Day Spa Anthony’s Wigs
23 West Putnam Avenue Hawley Lane Mall
Greenwich, CT 06830 Trumbull, CT 06611
203-869-1234 800-421-9447
www.allurasalon.com www.anthonyshairstylists.com

 

* For women only.

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If you have any questions or concerns, talk with a member of your healthcare team. You can reach them Monday through Friday from 9:00 am to 5:00 pm at ____________________. After 5:00 pm, during the weekend, and on holidays, please call____________________. If there’s no number listed, or you’re not sure, call 212-639-2000.

Hair Loss and Your Cancer Treatment
Printed on May 29, 2015, 3:03 am