Essential Tips for Managing Hair Loss During Chemotherapy

Hair loss, also known as alopecia, is one of the most visible and often emotionally challenging side effects of chemotherapy, especially for women. To shed light on these questions, we have compiled answers to the 10 most frequently asked questions about hair loss during chemotherapy. Why am I losing my hair? Is it only temporary? When will it grow back? What can I do to prevent or reduce hair loss?

Just a small reminder: the effects of chemotherapy vary from person to person, always consult your doctor for advice tailored to your situation.

1. Why am I losing my hair?

Chemotherapy aims to attack rapidly dividing cells, which includes cancer cells as well as hair follicle cells, affecting your hair, eyelashes, eyebrows, and body hair.

2. Will I lose all my hair?

Not necessarily. Hair loss during chemotherapy is not systematic and varies depending on several factors, such as the type and dose of medication, the duration of treatment, and individual sensitivity. Your doctor will be best able to tell you if you are at risk of losing your hair. Even with the same treatment, some people may lose more hair than others due to the resilience of their hair.

The amount of hair and body hair you lose will depend on the following factors:

type of medication
medication dosage
combination of medications (chemotherapy protocol)
method of medication administration (intravenous, oral, topical)
treatment duration

Is hair loss permanent?
No, it is temporary, except in the particular case of radiation therapy to the scalp. Outside of this case, hair will grow back after the treatment is stopped.

3. When will I lose my hair or body hair?

Alopecia generally begins 2 to 3 weeks after the first chemotherapy session. It can occur gradually or suddenly, sometimes even overnight, and may be accompanied by itching or tingling of the scalp.

4. How can I prevent or slow down my hair loss?

There is currently no miracle cure, but the use of a cold cap can sometimes help reduce hair loss. If you can tolerate intense cold (easier said than done!), the cold cap can in some cases slow or decrease hair loss by irrigating the scalp and reducing blood flow around the hair follicles.

5. How should I take care of my hair during chemotherapy?

During your chemotherapy, it is important to treat your hair gently.

Do not wash them too often. Try to reduce the frequency of washing to twice a week. Ideally, wash your hair the day before your session, and wash them only 3 to 8 days after, until the bulb has regenerated.
Use a non-greasy, gentle shampoo in small quantities and rinse with lukewarm water. Gently massage your scalp – without rubbing. Do not use baby shampoos. They are far too greasy. Pat your hair to dry rather than twisting or rubbing it.
Use a soft-bristled brush or a wide-tooth comb to gently comb your hair. Avoid hard brushes, curling irons, flat irons, hot rollers, and hair dryers. Let your hair air dry.
Sleep on a satin pillowcase or wear a small sleeping cap.
Avoid the sun, coloring, highlights, straightening, and perms.

6. Should I cut or shave my hair before it starts falling out?

It is not mandatory to cut your hair or shave your head, but it is often advised.

Some people choose a short transitional cut to slightly delay hair loss. And when their hair starts to fall out, they shave it. Some find this less traumatic. If you choose to cut your hair, we advise you to make an appointment with the hairdresser before your first chemotherapy session. Others choose to shave their heads before treatment. This gives them a sense of control. It is ideal to leave 1 to 2 centimeters of hair.

Quick tip: If you choose to shave your hair, use a hair trimmer (electric shaver). Do not use a manual razor. This would exacerbate itching and tingling of the scalp. If you are not used to these devices, ask an experienced person to shave your head or make an appointment with a Sibelle’s partner-salon.

7. When will my hair start growing back after chemotherapy?

Hair regrowth can start immediately after treatment or take a few months. It may even occur before or during the last chemotherapy session. Regrowth is about 1 cm per month.

Good to know: wigs, caps, and chemotherapy scarves do not prevent hair growth. Your hair will grow as fast whether your head is covered or not.

While hair grows back, it may become more brittle than before. Continue to take care of your hair. Until they have regained their normal appearance, avoid hair treatments such as perms, colorings, and chemical straighteners.

8. Will my hair be the same after chemotherapy?

Hair that grows back after treatment often has differences. The color may be slightly different, sometimes tending towards a darker shade, and the texture may also change. It is possible that the hair grows back thinner or thicker, straighter or curlier. These variations are usually temporary, but sometimes they can be permanent. It often takes more than a year to get back to your “real” hair.

9. How should I take care of my scalp?

Even in the case of hair loss, it is important to continue washing and moisturizing your scalp. Use a gentle shampoo. After shampooing, moisturize your scalp with a cream or oil to prevent itching. Massage your scalp with your fingertips with sweet almond oil, argan oil, evening primrose oil, wheat germ oil. Massage yourself for a few minutes every day to stimulate blood circulation and promote regrowth.

When you go out, protect the skin on your scalp with a hat, beanie, scarf, or apply a high SPF sunscreen. Try to avoid overheated places or places that are too cold.

10. What should I do if I lose the hair in my nose and eyelashes?

Unfortunately, the loss of certain hairs can lead to some unexpected inconveniences.

My nose runs and bleeds.
Do nasal showers once or twice a day and apply a water-based ointment 1 to 4 times a day (especially before bedtime). Products available over the counter in pharmacies.

My eyes are sensitive.
Buy artificial tears and put them in your eyes at least 4 times a day. Products available over the counter in pharmacies.

Sweat irritates my eyes.
Wear a hat, beanie or scarf to absorb sweat and prevent it from running down your forehead and into your eyes.