Hair loss due to cytotoxic chemotherapy treatment and radiotherapy treatment

Chemotherapy treatment

Chemotherapy drugs are used to destroy cancer cells by interfering with the cells rapid growth and division.

Chemotherapy drugs can also damage normal body cells that divide and grow, such as the hair follicles. The hair may thin or be lost completely.

Hair loss

Some chemotherapy drugs do not cause hair loss or so little it is hardly noticeable. Others, however, can cause partial or complete hair loss. The amount of hair loss will depend on the type and combination of chemotherapy drugs used. Your doctor will tell you the amount of hair loss to expect, before you start your treatment. Hair loss usually starts within 2 to 3 weeks of starting your treatment. You will lose hair from your head and you may lose some facial and body hair.

If you do lose your hair due to the chemotherapy treatment, it will grow back again when you have completed your treatment. Usually, you can expect to see some hair regrowth starting about 3 weeks following your last chemotherapy treatment.

Radiotherapy treatment

Hair loss due to radiotherapy treatment only happens if the radiation is directed at an area where hair is growing, such as the scalp. Ask your radiographers to show you exactly where hair is likely to fall out.

Hair regrowth usually begins a few weeks after treatment finishes but can take some months to regrow. Sometimes, new hair can be different in colour or texture than it was before.

Occasionally, hair loss can be permanent if you have a high dose of radiotherapy. Your radiographer will be able to advise you further.

Specialist help for hair loss

Some people who lose their hair due to chemotherapy or radiotherapy choose to wear a wig. A wig consultancy service is offered once a week in the FOCUS Support Centre, which is located in the Oncology Outpatients waiting room. Please contact the FOCUS Support Centre for an appointment or further advice; the details are at the end of this page.

The FOCUS Support Centre can also provide a list of NHS approved wig consultants. All wig consultants should make an assessment of your own hair texture, colour, and style. This will allow them to recommend wigs that are as similar to your own hair as possible. If you have already lost your hair before your wig consultancy appointment, it is a good idea to take along some photographs of yourself, showing how your hair normally looks.

NHS wigs

Wigs supplied via the NHS, require a completed wig form (WF10304). These are available from the FOCUS Support Centre.

There is a prescription charge payable for NHS wigs. If you have a valid exemption (these are listed on the WF1 form) you will not be charged but proof of exemption will be needed. The FOCUS Support Team will advise you the fees and the centre can accept payments by card, cash, or cheque. You will then receive a wig release form. Take this form to your chosen wig consultant appointment.

Scalp cooling

Scalp cooling or ‘cold capping’ is a technique used to lessen hair loss. It involves wearing a closely fitting cap which will lower the temperature of the scalp. The cap is worn for a period before chemotherapy, during chemotherapy and for a period after chemotherapy. It can be uncomfortable for the first 20 minutes or so, due to the rapid cooling of the scalp. This improves when you get used to the temperature change. Gloucestershire Oncology Centre offers a scalp cooling service which will be available to some patient’s, depending on their treatment plans. Your Oncology doctor will tell you if you are able to have scalp cooling with your course of treatment.

Hats, scarves and turbans

Some patients may feel more comfortable wearing a hat, scarf, or a turban. If you do wear a wig, you could also use hats, cotton scarves or turbans as an alternative, particularly during hot weather.

The FOCUS Support Team will be able to show you the many different ways of wearing headscarves. There is a selection of hats and scarves available to buy in the FOCUS Support Centre.

The Maggie’s Centre in Cheltenham runs a ‘Talking Heads’ session once a month. At this session, hair loss will be explained and some practical advice about hats, scarf tying and wigs will be given.

Hair loss advice

• To minimise hair loss, use a mild shampoo and conditioner. Do not stop washing your hair just treat it with great care.
• Avoid heated hair styling. If possible, allow your hair to dry naturally.
• Brush and comb your hair gently, supporting the roots of the hair as you do so.
• Avoid chemical hair treatments such as colours and perms during chemotherapy treatment. Once chemotherapy treatment is completed, there is no set time limit before you can start to use chemical hairdressing products but this should be assessed on the health of your scalp. A patch and strand test should always be done before applying any chemicals.
• It is advisable to have long hair cut or layered, to stop the weight of the hair pulling on the scalp. Some people prefer to do this before they start chemotherapy.
• Following hair loss, your scalp may feel dry or itchy. A simple moisturising cream may soothe your scalp and reduce the itching.
• During hot weather, you should protect your scalp with a hat or a high factor sun cream (at least factor 30). In cold weather, protect your scalp with a hat, scarf, or turban.

Contact information

If you need further information about hair loss due or would like to make an appointment to see a wig consultant please contact the:

FOCUS Support Centre

Tel: 0300 422 4414 or

Tel: 0300 422 3226

Monday to Friday, 8:30am to 4:30pm

Email: ghn-tr.focus.supportcentre@nhs.net