Everything You Should Know About Cancer Hair Loss

When Lucia was diagnosed with a type of Hodgkin lymphoma in her early 20s, she prepared herself to lose her hair. She felt calm when she shaved her head because she knew it was part and parcel of her cancer treatment. It was only when her eyebrows and lashes fell out that the true impact hit her. "I realised that hair is a big part of your identity; your eyebrows and eyelashes too," says Lucia, who finished her treatment last year. "Without them you are well and truly lost."

As Lucia recovers from treatment and her hair grows back thick and curly, she is finding positives and using the opportunity to explore her style. Elsewhere, breast cancer survivor Julie found that colouring her hair for the first time after treatment helped her feel like herself again, while Ediri turned to wigs to regain her confidence as a woman of colour.

Hair loss was one of the many daunting challenges that Lucia, Julie and Ediri faced during their cancer journeys. Fortunately, the charity Cancer Hair Care was there to support them every step of the way. Founded by hairdresser Jasmin Julia Gupta, Cancer Hair Care offers free, expert advice and support on all aspects of hair loss and hair care, before, during and after cancer treatment. This year, Schwarzkopf LIVE Colour has partnered with Cancer Hair Care to pledge support and make even more people aware of the important service the charity provides.

There are many myths and misconceptions surrounding cancer-related hair loss but Cancer Hair Care is a source you can trust for facts and expert advice — whether you’re supporting a loved one with cancer or you’ve been diagnosed yourself. We’ve tackled the key topics below with personal stories from Lucia, Julie and Ediri, and expert input from Cancer Hair Care’s Jasmin, the UK’s leading oncology hair loss specialist. You’ll find lots more information on Cancer Hair Care’s website, too.

Every cancer patient is different and oncologists tailor treatment plans to each individual depending on their age, type of cancer and other factors. While one person might have a combination of surgery, chemotherapy and radiotherapy, another may require only one of the three. The main cause of general hair loss is chemotherapy, which can lead to some or all of the hair falling out, but not all chemotherapy causes hair loss. In contrast, radiotherapy only affects the part of the body being treated — in the case of breast cancer, this might simply mean a hairless armpit or a hairless breast. "With over 200 types of cancer and many different treatments, understanding how your particular type of treatment may affect your normal hair growth cycle is a really good start to taking control of options to deal with hair loss should it happen to you," says Jasmin.

Chemotherapy uses powerful chemicals to destroy fast-growing cells in the body — in other words, cancer. It can’t distinguish between cancer cells and hair follicles, which is why the hair falls out. "Hair loss is usually temporary and so we always plan for new hair to grow post-chemo," Jasmin tells us.

We’re all familiar with the image of the bald-headed cancer patient but chemotherapy often causes all body hair to fall out, which has its pros and cons. On the plus side, loss of leg hair and pubic hair means no shaving or waxing during treatment; on the other hand, the loss of eyebrows and lashes can feel distressing. Fortunately, there are many great options for brow makeup and false lashes that can help return some semblance of familiarity to your face.

"I lost all body hair and eyelashes, and had bald patches on my eyebrows," says Lucia. "The eyelashes and eyebrows fell out a couple of weeks after I finished my final round of chemotherapy. I was more self-conscious about my brows and lashes falling out than my hair." Lucia learned how to pencil and powder in her brows, and use false lashes. "Cancer Hair Care helped me to navigate all of these challenges."

It’s a personal choice but for those with long locks, it can be a real shock to go from all to nothing. When Julie’s hair began to thin from chemotherapy to treat her breast cancer, she went to see Jasmin, who cut her long hair into a bob. "It felt really positive and empowering to make a decision," Julie tells us.

"It is entirely up to you if and when you cut your hair short but for most people, cutting hair short is about taking control," explains Jasmin. "While different brands of chemotherapy treatment will vary, the vast majority of people will find that hair loss starts around 10 to 14 days after your first chemotherapy treatment. For many people, this waiting time can be anxious and distressing and so cutting hair short can help to alleviate anxiety."

Jasmin adds that some people may not want to cut their hair for cultural or religious reasons, in which case Cancer Hair Care can advise on scarves, hats and headwear to cover the head and maintain your style while going through treatment.

"Scalp cooling, also known as cold cap therapy, is one of the options for patients who want to reduce hair loss or thinning," Jasmin explains. Patients wear a chilled cap during chemotherapy sessions, which reduces blood flow to the hair follicles and minimises impact on the hair. However, scalp cooling is not suitable for everyone and will usually only lessen the loss of hair rather than prevent it entirely. Those with afro hair, coils or thick hair may need to wear the cold cap for longer during treatment as the hair is more springy. It’s also important to remove weaves and braids before starting chemotherapy — see Cancer Hair Care’s website for specific guidance.

"I decided to try and minimise my hair loss through scalp cooling," explains Julie, who received her cancer diagnosis in 2018. "Cancer Hair Care had lots of great advice about how to prepare for each session and what to expect. They gave me a simple, fabric hair band to protect my forehead from the cold — although a tissue works too!"

Some patients say their scalp feels more sensitive, sore or itchy when their hair starts to fall out, although this is normal and usually subsides within days. Cancer Hair Care has lots of tips for scalp care and ways to ease any discomfort. Look out for small red spots on the scalp that are intensely itchy as this may be a sign of inflammation of the hair follicle, called folliculitis. Speak to your medical team if in doubt.

When you’ve lost your hair to cancer treatment, no longer needing to wash it might feel like one less thing to worry about. But it’s important to look after your scalp, particularly to protect it from sun damage by wearing a high SPF or appropriate headwear. Cancer Hair Care tips include using a pillowcase made from natural fibres such as cotton or linen instead of man-made materials that can irritate sensitive skin. Jasmin suggests a gentle massage, too, if it feels comfortable on your scalp. "Use the pad of your fingers in a circular motion to ease away tension and keep a good flow of blood to the skin."

People of colour may need to nourish the scalp with hydrating oils and products that aren’t too oily to wear under wigs or headwear. Coconut oil is still great but you’ll need less on your bare scalp than you’d normally use on your hair, as it might stain your headwear or cause your wig to slip.

In addition to physical scalp care, Cancer Hair Care recommends recognising the feelings that come with hair loss. "We all deal with emotions differently and one important thing to remember when dealing with hair loss is that it is not vanity — it is for your sanity and self-esteem and that is quite a natural feeling," Jasmin says. "Everyone cares about how they look (and this doesn't mean that an individual spends hours on their self care, but everyone cares how others see them). It’s not just negative emotions either; some people talk about how much courage they felt or how proud they felt adapting to a new look."

There’s a huge variety of wigs available within the NHS wig supply service and it’s worth taking the time to have a consultation and fitting with Cancer Hair Care before choosing one. A common misconception is that you need to spend hundreds on a wig made from real hair. In fact, synthetic wigs can be easier to manage and look just as natural. Instead of wigs, some people prefer to wear hats with hair, headscarves, traditional African-style wraps or ethnic headwear with batik fabrics, whereas others opt to go hair-free. There’s no one-size-fits-all.

With her 50th birthday approaching, Ediri felt overwhelmed as she had very short, new hair growth after her cancer treatment. With guidance from Jasmin, she decided to spend time preparing for her birthday party by wearing her wig around the home to ensure she’d feel comfortable. "Talking to Cancer Hair Care was a great support," Ediri says. "I had the time and space to really consider how I wanted to look — and feel — for my big celebrations. Once I’d decided on a fabulous, textured purple wig, I felt really happy. Having a wig grip underneath and some headwear to hand were the final confidence boosts I needed."

For many patients, their hair post-treatment will be the same as it was before but for some, the hair can grow back a different colour, or curly when it was previously straight. The shape of the hair follicle determines whether or not a hair will be curly, wavy, afro or straight, and as an expert in new hair growth, Jasmin tells us that "when the hair falls out, the follicle can collapse, causing the straight follicle to become twisted. This can create a coil known as 'chemo curls'." Many people find that this initial curly hair becomes straighter over time.

Most people find their hair starts to regrow within a few weeks of finishing chemotherapy but rates of growth vary. As for when to cut your new hair, this is completely individual. Many patients choose to simply trim and tidy the hair while it grows out.

"Jasmin kindly gave me my first ever haircut post-treatment when I was nervous about going to a normal hairdresser in case they ruined my hair," says Lucia. "My hair came back curly and it used to be a bit wavy and straight." Cancer Hair Care helped Lucia to understand how to care for her new type of hair, as well as giving her confidence and a better understanding of hair regrowth.

There are several considerations for new afro hair growth. For example, it’s important not to saturate hair with oils as this can separate the hair and make it look sparse. New hair needs growth and recovery time so it’s also vital to avoid weaves, extensions, braids and chemical smoothers until the hair has grown about three inches.

"When my new hair started to gain some length, I really wasn’t sure when I could have it cornrowed or add in weaves and extensions," says Ediri. "I was about to head off on holiday and, usually, having my hair cornrowed would be a part of my ritual. Jasmin explained to me how I could check the strength of my hair, to have cornrows but take them out after four weeks to let my hair recover." Check Cancer Hair Care’s website for more afro tips.

As a Cancer Hair Care charity partner, Schwarzkopf LIVE believes in the Power of Colour and the importance of self-expression through hair. Switching colour after treatment can feel like a great way to claim back some of your pre-cancer identity but there are certain rules to follow to use hair dye safely. Together, Cancer Hair Care and LIVE want to bust the myths around hair colouring post-cancer treatment and support patients in this small but impactful step.

"Colouring hair is a great way to add some individuality to shorter styles but many people are very nervous about any possible damage to the new hair," says Jasmin. Cancer Hair Care has put together a six-step Safe Colour Guide, which recommends only colouring new hair growth if you can answer 'yes' to the following:

• ​​Your hair growth is stable, meaning you’re not still shedding hair.
• ​​You have at least one inch of hair growth.
• ​​Your hair is in a good enough condition to colour.
• ​​Your scalp is in a healthy condition.
• ​​You do the manufacturer’s sensitivity test.
• ​​Avoid bleach products until you have at least three inches of good-quality growth.

"My hair has always been a really big part of my look and having that vibrancy always made me feel really good. So having that stripped away really took away a big part of me," says Julie, who has coloured her long hair red since her late teens. After a year of cancer treatment, she asked Jasmin from Cancer Hair Care to colour her hair for the first time, before returning to at-home hair colouring treatments. "It was quite an emotional moment. I wore a hat to hide my roots but I also had lots of new hair coming through that had never been touched by hair dye. It was really great to have Jasmin do it in a way that I felt was safe. Then I could go out and buy the LIVE box and colour my hair in the way I always had done."

Cancer Hair Care has tailored guidance for colouring afro hair, such as waiting for at least an inch of growth for semi-permanent colour or two inches for permanent colour. Avoid bleaching new afro hair as it causes too much damage, and wait to have several inches of growth before using chemical smoothing and hair relaxers. Taking the manufacturer’s sensitivity test is more important than ever — even if you used the same product before treatment.

Cancer hair loss is undoubtedly overwhelming, especially on top of the emotional and physical toll of cancer itself, but you’re not alone. Cancer Hair Care’s website is packed with guides, videos and resources to help you figure out everything from scalp cooling and hair loss prevention to colouring your hair so that you feel ready to face the world again.