Minimizing Hair Loss During Chemotherapy: Is It Possible?

Hair cells are vulnerable to chemo drugs, but you have options.

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Hair loss is commonly associated with having cancer, but it’s actually a side effect of chemotherapy, not the cancer itself. Still, losing your hair during chemotherapy is an emotional topic for many patients, who may feel like their hair loss is a visible marker of their cancer to the rest of the world.

“Hair loss can be very anxiety-provoking for patients,” says Ashish Saxena, MD, oncologist at Weill Cornell Medicine and NewYork-Presbyterian. “It’s something that everyone sees. It also has a lot to do with how a person feels about themselves.”

Understanding that the hair loss is temporary can help you cope with those feelings, according to the American Cancer Society (ACS). It can also help if you understand exactly why hair falls out during chemotherapy.

Chemotherapy is a class of drugs that attacks all rapidly dividing cells in the body, which includes cancer cells. Unfortunately, some normal, healthy cells also divide quickly, making them targets of chemotherapy drugs as well. When chemo damages these cells, it results in side effects. (Learn more about chemotherapy side effects here.)

Hair cells reproduce quickly to support hair growth, so they one of the normal cells that are vulnerable to chemotherapy drugs. The hair loss usually begins a couple weeks after the chemotherapy begins, and it will typically get worse after a couple months. Luckily, the hair loss is temporary and usually comes back within months of ending chemotherapy sessions. The hair may grow back with a slightly different color or texture.

Can You Prevent Hair Loss from Chemotherapy?

Most people assume hair loss from chemotherapy is a sure thing, but that’s not the case. “Not all chemotherapy is likely to give you hair loss,” says Dr. Saxena. “Some chemotherapies have a high likelihood to do so, and some have a very small chance.”

Unfortunately, there are no sure-fire ways to guarantee no hair loss will occur. However, there are some methods that can reduce the amount of hair loss for certain individuals.

Cooling caps are one of the most effective ways that have been studied to minimize hair loss during chemotherapy. These caps are worn before, during, and after chemotherapy sessions.

Here’s how cooling caps work: They constrict blood vessels near the scalp to reduce how much chemo reaches the hair follicles (since chemo drugs travel through the bloodstream). Additionally, the coldness slows the activity of the hair cells, so they’re less attractive to chemo drugs.

But cooling caps aren’t guaranteed to prevent hair loss completely. Overall studies have shown mixed results; however, newer studies have been generally more positive, and one study found that women who used cooling caps lost less than half of their hair, according to ACS.

Your hair care can also play a role. The following tips help reduce hair loss among all individuals with or without chemotherapy, so they are especially important tips to follow when hair growth is under attack. It’s best to avoid:

  • Excessive brushing

  • Making braids or ponytails, which pull the hair

  • Using rollers

  • Dyeing and bleaching

  • Perming

  • Or using heat (e.g., blow drying, curling, flat ironing).

If hair loss occurs and you’re not comfortable letting others see it, you still have options. Most patients turn to wigs, scarves, or turbans. You might be surprised to know that many insurance companies cover the cost of wigs for patients undergoing chemotherapy.

“There are a lot of options available,” says Dr. Saxena. “There’s a lot of support for [people with hair loss] in the community and the medical field for helping deal with this issue.”