Chemotherapy consists of the administration of drugs that
destroy rapidly reproducing cancer cells. Cancer cells are
some of the most rapidly reproducing cells in the body, but
other cells, such as those which contribute to the formation
of hair shafts and nails, are also rapidly reproducing. Unfortunately,
while chemotherapy drugs preferentially destroy cancer cells,
the drugs also can destroy those cells responsible for normal
growth of hair and nails. Cancer patients sometimes shed
the hair and nails during treatment. Chemotherapy drugs are
poisonous to the cells of the hair root responsible for hair
shaft formation. Usually, the hair is lost rapidly in large
quantities during treatment.
NO HAIR GROWTH STIMULANTS, SHAMPOOS,
CONDITIONERS OR OTHER COSMETIC TREATMENTS CAN PREVENT OR
RETARD THE HAIR LOSS.
NEWS, however, is that once
chemotherapy is completed, the hair usually grows back.
HOW AND WHEN HAIR GROWTH OCCURS
Adequate hair growth may take six months to one year.
• Returning hair may be different from the hair that was lost. Due to the
absence or alteration of pigment the hair may grow back white, gray or a different
color. Eventually, as the pigment cells return to normal, the original color
• It is common for the new hair returning to be finer in texture initially,
but like color, the texture should return to its original thickness. It is sometimes
difficult to be patient, but as the body is returning to normal and getting
over the significant insult, time is a necessary ingredient.
HAIR CARE TIPS FOR NEW HAIR GROWTH
1. Shampoo hair twice weekly with a mild shampoo such as those intended for
dry or damaged hair.
2. The scalp should also be thoroughly massaged to remove any scale.
3. Follow shampoo with a conditioner for fine or limp hair.
4. Avoid high heat from blow dryers to the hair and skin.
5. Keep hairstyling to a minimum due to the new hair being prone to breakage.
Brushing, combing, hair pins and curling should all be minimized. Curling appliances
should be avoided as the scalp is very tender following chemotherapy.
6. Hair styling aids such as mousse, hair spray, hair spritz, styling gel and
sculpturing gel may be used in moderation. It is best to select products
with normal to light holding ability as the high hold products may not be completely
removed with mild shampoos. Hair styling aids can build up on the hair shaft
resulting in dullness and possibly scalp disease.
CHEMICAL CURLING OR PERMANENT WAVING
Chemical treatment of the hair is best
avoided until the hair is at least three inches long. It
is difficult to get nice curls if the hair is much shorter
even with a healthy head of hair. For best results use a
mild body wave with short processing time.
The hair should be wrapped loosely on the largest size curling
rod possible. Looser curls will be less damaging to the recovering
hair shaft, and will thus minimize hair shaft breakage.
WARNING! Many patients cannot tolerate the permanent wave
solution on their scalp for some times up to one year following
chemotherapy. This extreme sensitivity of the scalp is not
unusual during the regrowth period. In such cases permanents
should not be attempted.
Hair coloring may also be
irritating to the sensitive scalp and should be avoided until
the scalp sensation returns to normal. Once the scalp is
healed, the hair may be colored.
PERMANENT HAIR COLORINGS ARE THE MOST
DAMAGING TO THE HAIR SHAFT and should be minimized in favor of semi-permanent
hair colorings which are gradually washed away with four
to six shampooings.
BLEACHING to lighten the hair color should not be attempted
at this time. Additionally, the hair should be altered only
3 shades from its regrowth color as more drastic color changes
could increase hair shaft breakage.
The period of time following chemotherapy treatment
is a time of healing and rebuilding for the body. Hair growth
will gradually return, and with time most patients regain
a healthy head of hair. Following some of the enclosed hair
care tips will insure that the regrown hair looks and feels
its very best!
A word of caution to parents with
chemotherapy. The absence of hair can be used in a positive
manner. It can signal to others “handle with care.” While
undergoing chemotherapy the child has a low blood count
and can be bruised easily.
The insistence of parents, although well meaning, for a
child to wear a wig or prosthesis can signal the message “YOU’RE
NOT O.K. THE WAY YOU ARE!” A child should have all
of the options but the choice should be his or hers. Hugs
and tender loving care along with your physician’s
suggestions for care are all that is necessary from
Prepared for the American Hair Loss Council by Zoe Draelos,
M.D. and Mike Mahoney, AHLC Executive Director.