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Hair loss
During chemotherapy and radiotherapy
Information for patients
Weston Park Hospital
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Cancer treatments such as chemotherapy and radiotherapy can cause
total hair loss or thinning. If you lose your hair due to cancer treatment
there are many ways of dealing with this. This leaflet gives you
information to help you cope, practically and emotionally, with possible
hair loss during your treatment.
Why does hair loss occur during cancer treatment?
Chemotherapy
Chemotherapy works by attacking cancer cells and stopping them from
growing. Unfortunately it also affects normal cells in the body. Some
chemotherapy drugs can temporarily affect the hair follicles which
causes hair loss, also known as alopecia. Normal cells can recover from
this damage so if you lose hair due to chemotherapy it will almost
always grow back after treatment.
Not all chemotherapy drugs affect hair growth; some cause complete
hair loss, some cause hair thinning while others have no effect on hair
growth. In many cases hair loss is only from the head, but some drugs
cause hair loss in other parts of the body. This includes eyebrows,
eyelashes, facial hair, chest, underarm, leg and pubic hair. Before you
start your chemotherapy your doctor or nurse will discuss with you
whether you will lose any hair due to your treatment.
If you are going to have hair loss it usually happens 2-3 weeks after
chemotherapy has started but very occasionally it can be sooner than
this. If your treatment causes total hair loss it can fall out quickly, over
1-2 days. Your scalp may become itchy and tender and hair that is still
growing may become dull and dry.
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Radiotherapy
Radiotherapy will cause hair loss only in the area that is being treated. It
will start to occur about 2 to 3 weeks after radiotherapy has started. It
often grows back 3 to 4 months after the end of treatment. However,
if it is a high dose of radiotherapy the hair loss could be permanent.
Your doctor or therapy radiographer will discuss hair loss with you if this
can happen with your treatment.
Can anything be done to reduce hair loss?
Some patients having chemotherapy can be offered a procedure called
scalp cooling. This involves wearing a specially designed cap that is
connected to a cooling system. When the cooling system is switched on
it keeps the cap at a low temperature, reducing the amount of
chemotherapy that reaches the hair follicles in the scalp. This provides
some protection to the hair follicles and can reduce the amount of hair
that falls out due to treatment.
The scalp cooling cap needs to be put on about 30 minutes before
chemotherapy is started. It then stays in place during all of the treatment
and for a short while after it has been given. This time varies between
different chemotherapy drugs. Wearing a cold cap can be
uncomfortable and some patients get headaches from the cold
temperature. The nurses on the chemotherapy unit will try to make
scalp cooling as comfortable as possible.
Scalp cooling can only be used with a few chemotherapy drugs and it is
not advisable for certain types of cancer. When it is used its effects can
vary and it is not always possible to know how well it will work for each
person until it has been tried. Your doctor or nurse will discuss with you
whether scalp cooling can be used with your chemotherapy treatment.
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Emotional reactions to hair loss
Losing your hair because of cancer treatment can be very upsetting. For
some people hair loss is one of the hardest parts of cancer treatment. It
can be a visible reminder to you and other people that you have cancer
and you may be worried about how other people will react to you.
These feelings and worries are completely normal. Please talk to the
doctors or nurses about any concerns you may have. There are also
organisations that provide support and advice about hair loss: their
details are at the back of this leaflet.
What can I do to help me cope with hair loss?
Preparing for hair loss
You could think about having your hair cut short before treatment
starts. If it is shorter you might feel as if you are losing less hair if it falls
out. Shorter hair is also easier to manage under a wig if you decide to
have one (see page 7). It can be a good idea to try to choose a wig
before you lose your hair completely as it is much easier to match hair
colour and style with your present head of hair. Patients who lose their
eyelashes may find wearing false eyelashes helpful.
Some people may not want to cut their hair for personal, cultural or
religious reasons and may find alternative headwear helpful instead (see
Headways page 8).
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Looking after your hair
Even if you don’t lose all or some of your hair, it may become dry and
brittle during your cancer treatment. These are some things you can do
to help:
• Only use gentle hair products and non-medicated shampoo
• If you are having radiotherapy to your head, ask the radiotherapy
staff about suitable types of shampoo
• Brush or comb your hair gently, with a non-metal brush or comb
with widely spaced teeth. A baby brush is soft and can be a good
alternative
• Dry your hair naturally or use a hairdryer on the lowest setting and
avoid using heated rollers, curling tongs, or straighteners
• Eat a well-balanced diet with plenty of fruit, vegetables and
protein if your diet allows
• Avoid perming or colouring your hair as this can make it even
more dry and brittle
Looking after your skin
If your hair falls out it is important to look after your skin in the places
where you had hair. Here are some tips:
• Use a gentle unperfumed moisturiser on your scalp if it gets dry,
flaky or itchy. If you are having radiotherapy always check with the
radiotherapy staff before using any creams or lotions
• Cover your head with a hat or scarf on sunny days to prevent
sunburn
• Use a high factor sun cream
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If I need a wig will I have to pay for it?
Your nurse will give you a prescription which will entitle you to choose
from a range of NHS wigs for around £67.75 (2015 prescription fees).
If you prefer to have a non-NHS wig you will have to pay the full cost,
minus the VAT, even if you are exempt from prescription charges. If you
are an inpatient you are eligible for an NHS wig. There are exemptions
for payment if you:
• are under 19 and in full time education
• have a war pension exemption certificate
• are part of the HC2 NHS low income scheme or HC3 NHS help
with health costs
• receive income support, pension credits, income based jobseekers
allowance or tax credits
If you need a hairpiece because of cancer treatment, this is a
tax-deductible expense and may be partially covered by private health
insurance. Westfield Health Scheme, for instance, classes wigs as
surgical appliances and will give an allowance. Be sure to check your
policy and ask your nurse for a wig prosthesis prescription.
Where do I go to get my wig?
There are two local wig suppliers, Millers and Trends. Both are within
walking distance of the hospital and have their own car parks.
Information about other wig suppliers is available at the cancer
information and support centre. You should take your prescription with
you when you go to the wig supplier.
Contact details
Trends: 0114 276 8676, Monday - Friday (Saturday until 2pm)
Millers: 0114 266 5829, Tuesday - Saturday
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What is the Headways service?
You may not want a wig, or if you do have one you may not want to
wear it all of the time. The Headways service provides stylish alternatives
to wigs. They can show you hats, turbans, scarves and hairpieces. They
can also show you how to tie the scarves and give you advice about
suppliers, so that you can look and feel confident during and after your
treatment.
The headways service is based in the Patients’ Library on the 3rd floor of
the hospital and you can pop in anytime Monday to Friday between
9.30am and 4.30pm.
Will I be able to use a deodorant?
If you have lost hair under your arms you should avoid using perfumed
deodorants.
What happens when my hair grows back?
When your hair grows back it may be curlier or finer than it was before.
It may also be a different colour. Gradually your hair will become thicker
and long enough to be styled. We advise you not to perm or colour your
hair for about 3 to 6 months after your treatment finishes – always have
a strand test done before colouring your hair. You need to wait until
your scalp is in a healthy condition and your skin is no longer sore, scaly,
flaky or irritated.
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Other sources of support and information
Macmillan Cancer Support has produced an excellent booklet
‘Coping with Hair Loss’ which is free to patients. To get a copy please
call:
• 0808 808 0000 (freephone) www.macmillan.org.uk
Local organisations
Wig suppliers
Millers
• 0114 266 5829
Trends
• 0114 276 8676
Cavendish Centre for Cancer Care
• 0114 278 4600
• www.cavcare.org
Weston Park Hospital support
Weston Park Cancer Information and Support Centre
The Cancer Support Centre is situated behind the main hospital car
park. The Centre has experienced health care professionals available
without an appointment, to provide reliable information and emotional
support in a friendly relaxed environment. Other services are also
available by appointment, which include welfare and benefits advice,
legal advice on Wills and lasting power of attorney, and the ‘Look Good
Feel Better’ pampering workshop for ladies with a cancer diagnosis.
There are free complementary therapy sessions available for
radiotherapy patients and one of their carers. There is also a regular craft
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afternoon and coffee morning open to all! You can also access courses
for patients and carers and be signposted to other appropriate services
you may require.
Call in to the Centre or telephone our helpline on 0114 226 5666 during
our opening times, Monday to Friday, 9am – 5pm. A warm welcome
awaits you!
Headways (Patients’ Library)
For stylish alternatives to wigs call:
• 0114 226 5390
National organisations
Macmillan Cancer Support
• 0808 808 0000 (freephone) www.macmillan.org.uk
Breast Cancer Care
• 0808 800 6000 (freephone) www.breastcancercare.org.uk
Alopecia Patients Association
Offers support, practical advice and information for people who are
suffering from hair loss, including help with hair loss due to
chemotherapy.
Lyons Court
1668 High Street
Knowle
West Midlands
B93 OLY
• 01564 785 980
• www.hairlineinternational.co.uk
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Produced with support from Sheffield Hospitals Charity
Working hard to fund improvements that make life better
for patients and their families
Please donate to help us do more
www.sheffieldhospitalscharity.org.uk
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Please email: [email protected]
© Sheffield Teaching Hospitals NHS Foundation Trust 2016
Re-use of all or any part of this document is governed by copyright and the “Re-use of Public Sector Information Regulations 2005”
SI 2005 No.1515. Information on re-use can be obtained from the Information Governance Department, Sheffield Teaching Hospitals.
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PD3525-PIL1139 v4
Issue Date: March 2016. Review Date: March 2018