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Hair Loss During Chemo

Updated: Dec 15, 2022

Woman with braid facing hair loss
Photo by Tamara Bellis on Unsplash

When I found out I needed chemo one of my first questions was ‘will I lose my hair?’.

This is often one of the biggest concerns among women who receive chemotherapy. In fact research has shown that women are so traumatised at the thought of losing their hair that 8% choose not to undergo the recommended treatment.

I thought I was being very shallow being worried about my hair when I was facing a cancer diagnosis, so I want you to know that if this is one of your big concerns you are not alone.

I surveyed a group of women who had recently completed or who were still undergoing treatment and asked if they struggled mentally with changes to their appearance.

80% answered that they did and the most common thing they struggled with was hair loss. I’ve included some of their comments to let you know it is totally OK to be concerned about losing your hair.

What change in appearance did you struggle with most?

  • How I looked losing my hair

  • Hairless, eyelashes & eyebrow loss, weight gain

  • Hair loss. I spent 3 weeks of wages on a wig that itches my sensitive scalp like crazy!

  • My hair mostly! Although very grateful to retain around 30%, the grey regrowth is hard!

  • Hair patches seeing so much hair on ground / cleaning up daily hard to get through

  • Loss of eyebrows and eyelashes. I’m kind of vain ;)

  • Losing eyebrows and lashes. It is so hard for me to make brows that look good and out on fake lashes…why? I have no idea!

  • Losing my hair

  • Hair loss was very difficult at first...lots of tears

  • Thought hair loss wouldn’t worry me, but it hurt!

When I expressed concerns around losing my hair I got told a lot "it is only hair, it will grow back’"and "just shave it, you will look good bald".

Every single person who said something along these lines meant well, but it minimized my feelings and made me feel silly for being so worried about it.

It isn’t only hair and it is 100% OK to be worried about losing it - your feelings on this are valid.

I was determined not to lose my but I also accepted it might happen and I knew there was no point having beautiful hair if the cancer killed me.

I never considered not doing treatment but as I am a stubborn MF I knew there must be a way to do both! This is how I came to find cold capping (more on this here).

Not all chemotherapy drugs will cause you to lose your hair. Some drugs will have no impact on your hair, some will cause thinning and of course some will cause total hair loss. The amount of hair you lose also depends on the drug, dose and timing of treatment.

If your treatment includes a drug that causes hair loss it can be anywhere on your body. This includes the head (scalp, eyelashes & eyebrows), the chest, legs, underarms, face and pubic area.

I experienced total hair loss except my head hair as I did manage to cold cap. My hair started coming out in the shower around 3 weeks after my first session and I continued to shed for roughly another 4 weeks. I retained my eyelashes and eyebrows a bit longer but eventually everything went. You might start to notice hair on your pillow, or when you wash and brush it. Some people choose to cut their hair short in preparation for treatment so the shedding hair isn’t so noticable and is therefore less traumatic. You may experience some tingling or itchiness on your scalp just before it starts to shed.

Although I was very worried about losing my hair I was surprised at the impact on others around me. Those close to me found it very hard as it was the first visual sign that I was unwell.

I did a lot of research and knew I wanted to cold cap to try to retain my hair. I spoke with my oncologist and he was happy for me to proceed (some types of cancer aren’t suitable for this so do check with your team), unfortunately I wasn’t offered cold capping through the public health care system so I found a company that provides portable cold caps.

To use the portable system you freeze individual caps at home and take them along with you to your infusion, I had success with these but they do take a lot of preparation. I would freeze them at home in the lead up to chemo day and take an Esky with me to keep the additional caps cold. It was a bit of a faff and extra stuff to take to chemo but I was happy to do it if it meant keeping my hair.

To successfully cold cap you need to have the cap on 30 minutes before your session starts, for the duration of the session then for 30 - 90 minutes after you complete treatment (timings vary depending on your drug). Each portable cap remains cold for approximately 45 minutes so you must change the caps during your treatment, and it must be done quickly to avoid your head warming up.

After a few weeks I came across a fantastic Facebook group with other people who were cold capping with a company called Paxman. Paxman’s website has the following information to explain the process:

Cold caps or scalp cooling may help reduce the amount of hair loss for some individuals. They work by narrowing the blood vessels and reducing the amount of chemotherapy reaching the scalp.

Clinical studies have successfully demonstrated the effectiveness of the Paxman Scalp Cooling System in the prevention of chemotherapy-induced alopecia, or hair loss, with widely used chemotherapy dosages and regimens for breast cancer.

I am very grateful that I came across Paxman as I was able to get a machine into the hospital for treatment and it stopped my hair loss. I even started to grow some hair back before I finished treatment!

I have no affiliation with Paxman I just really am thankful to the system and so glad I did it.

I lost around 50% of my hair and it is still a bit of a mess, but 3 months on from my final chemo I have full coverage and when my hair is up you wouldn’t guess I’d had chemo unless you knew my hair before.

Cold cappin isn’t a walk in the park and some people aren’t able to tolerate the cold, but I didn’t find it too bad at all. I would take a panadol before heading to my appointment to take the edge off the first 15 minutes, then I didn’t feel any pain. I did use a lot of blankets and a hot water bottle to keep me warm during winter. In the height of a QLD summer it was actually quite nice to have the cap on!

If you are able to access a Paxman machine at your treatment centre I would highly recommend it, with the Arctic Heat caps as a great second option.

If you aren’t able to access a cold capping machine or decide it isn’t for you there are other options to help you navigate the loss of your hair.

Everyone will feel different about losing their hair; some will embrace it as part of the process and have fun experimenting with wigs, whereas others may feel angry, self conscious or anxious.

There is no right way to feel or deal with it and it may take you some time to adjust.

There are some things you might want to consider to help you to navigate this part of your treatment:

  • Even though I kept a lot of my hair I still needed hair coverings so I made this into a fun shopping experience with my partner and friends. We played around with scarfs and wigs until I found a look I was comfortable with.

  • You may want to cut your hair before treatment starts to allow you to get used to seeing yourself with shorter hair. This may help with the transition to no hair.

  • You may even choose to shave your head at the start of the hair loss so you don’t have to deal with the stress of the hair falling out. This can be made into a bonding event with friends or family members who wish to support you.

  • If you have children you may want to talk to them about what might happen with your hair and even include them if the process if you decide to shave.

  • Learn how to apply makeup and eyelashes to allow you to feel comfortable in public when you have lost these.

  • If you do lose your hair or if you are using cold capping you will have to adjust your beauty routine considerably. There are new processes for caring for your scalp and new makeup skills you will need to learn.

Looking after your scalp if you have lost your hair or it has thinned considerable:

  • ALWAYS protect your head from the sun when you are out of the house. Wear sunscreen, a hat or a scarf. I learnt this the hard way when my hair started thinning and believe me a sunburnt scalp isn’t fun!

  • To help reduce flaky skin on your scalp gentle massage when you are in the shower using a shampoo for sensitive skin.

  • If you are cold capping do not use any harsh shampoos or conditioners on your hair. Use products for sensitive skin.

  • Do not wash your hair any more than necessary when cold capping.

  • Use a pillowcase made from silk to avoid unnecessary friction on your scalp or pulling on remaining hair.

  • Brush any remaining hair daily to dislodge fallen hairs and avoid matting.

  • Do not use a hair dryer, let your hair dry naturally.

  • Avoid avoid curlers and straighteners.

  • Use silk hair ties to avoid pulling on remaining hair.

  • Hair colouring is out for the next little while. Avoid it until a few months post final chemo as any remaining hair will be extra delicate.

  • You may want to purchase wigs, hats or scarves to cover your head when you are out in public.

  • Avoid perfumed deodorants if you have lost the hair under your arms.

And the good bits:

  • Enjoy the ultra smooth legs you are going to have for the next few months.

  • Use the money you are saving on waxing & hair products to treat yourself to something nice for being such a bad arse, cancer fighting hero!

Chemo induced alopecia is usually temporary and your hair will start to re-grow once you have finished treatment. You may be surprised at how quickly the first bit of ‘peach fuzz’ starts appearing.

As I was cold capping I actually had regrowth during chemo and am now the proud owner of around 6cm of fluffy hairs sticking straight out from my head. It makes styling it or wearing it down next to impossible but I love my baby hairs! It is coming in thick and fast which I’m thrilled about. I’m using some hair growth products to give it as much help as possible.

Hair usually grows about 1cm every 28 days so within a few months you’ll be able to ditch the wigs and scarves for a cute pixie cut.

It hasn’t happened to me but hair can grow back differently to your pre-chemo hair. Your new hair may be curly or a different texture to what it was before. It can also grow back a totally different colour.

Cold cap helps to protect your follicles so even if you lose your hair when using one it may help to ensure it comes back the same texture.

Some people embrace their chemo curls whereas others want to keep a style as close as possible to their pre-chemo look. A good hairdresser will be able to help you manage your re-growth and help cover any partial hair loss through styling or toppers.

Finally, I'm sorry you are going through this. It is awful and you are entitled to feel sad, angry, scared, self conscious or any other of the emotions that come up for you.

If you find yourself needing to talk to someone after reading this article you can call Lifeline on 13 11 14 or The Cancer Council on 13 11 20


Top Hair Loss Choices

I tried so many products and spent so much money trying to find things to manage my hairloss so I’m recommending these to save you time and money.

These are the products that helped me navigate hair loss during my cancer treatment.

Cold-Pressed 100% Pure Castor Oil.

Cold pressed castor oil can help with hair growth on your eyebrow and eyelashes. It helps to moisturise the hairs as they grow to minimise breakage.

As a bonus I see improvements in the skin around my eyes as well.

Click to purchase

The Ordinary Multi Peptide Serum for Hair Density

This hair growth serum is is designed to support hair health so that it looks thicker, denser, fuller and healthier.

Be aware that it contains caffeine to stimulate the follicles so keep this for when you have finished chemo as it can actually have the opposite effect you are going for if you use it whilst undergoing treatment.

Click to purchase

Miracle Spray Hair Treatment

I LOVE this product and was using it before chemo on recommendation from a friend. It is great to leave in after washing when you can't blow dry to help contain fluffiness from dried out chemo hair!

Click to purchase

DermaVeen Daily Nourish Oatmeal Shampoo & Conditioner

Whilst I was cold capping DermaVeen Shampoo and conditioner were the only products I would wash my hair with as they are so gentle on the hair.

Click to purchase Shampoo

Click to purchase Conditioner

Philip Kingsley Body Building Shampoo & Conditioner

Now that I'm done with chemo I'm using this shampoo and conditioner to give my hair the best chance of coming back thick and strong. With a combination of this, the hair growth serum and my follicles being protected I do have great re-growth.

Click to purchase Shampoo

Click to purchase Conditioner

TOPPIK Hair Building Fibers

Toppik Hair Building Fibers, are made of colored keratin protein and it blends with existing hair strands to instantly create the appearance of naturally thick, full hair. I used this when my bald spot was at it's worse and I didn't want to wear a wig. I was skeptical about this product but it is honestly amazing how it works. I wouldn't use it everyday but occasionally to give you a break from hats and wigs it is perfect.

Click to purchase

Support Resources

Cancer Council Australia

CCA an organisation to support all Australians affected by cancer through support, research and prevention programs.

Ovarian Cancer Australia

OCA is an independent national not-for-profit organisation, supporting women diagnosed with ovarian cancer. Our focus is to provide care and support for those affected by ovarian cancer; and represent them by leading change. Our vision is to save lives and ensure no woman with ovarian cancer walks alone.

Breast Cancer Network Australia

BCNA Breast Cancer Network Australia (BCNA) is Australia’s leading breast cancer consumer organisation. We have worked tirelessly to ensure that all Australians who are affected by breast cancer receive the very best care, treatment and support.

Bowel Cancer Australia

BCA Peer-to-Peer Support Network connects patient’s and loved ones on a one-to-one buddy basis that enables members to give and receive advice about their bowel cancer experience in an informal and mutually beneficial way.

Leukaemia Foundation

LF is a support service for patients and supporters dealing with blood cancers.

*FU Cancer is supported by its audience. If you choose to purchase through the links on our site we may receive an affiliate commission. This goes towards paying our expenses plus a percentage of our monthly profit goes towards directly helping people with cancer. If you know someone who could do with a boost during their cancer treatment please let us know here.

*FU Cancer is supported by its audience. If you choose to purchase through the links on our site we may receive an affiliate commission. This goes towards paying our expenses plus a percentage of our monthly profit goes towards directly helping people with cancer. If you know someone who could do with a boost during their cancer treatment please let us know here.

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