Why do some chemotherapy patients lose their hair, not just on the scalp, but also on their eyebrows, eyelashes, and the rest of their bodies?

“Many of the drugs work by attacking the rapidly dividing cells in the body, and tumor cells or cancer cells are rapidly dividing cells, but there are normal cells in the body that are also rapidly dividing, and the chemotherapy drugs affect those normal cells as well, which gives us side effects.”
Terri Ades, DNP, FNP-BC, AOCN, Director of Cancer Information at the American Cancer Society

Because hair follicles divide fast, they’re also susceptible.

Some chemo drugs are more likely than others to cause hair loss, Lacouture says. Ask your doctor about the likelihood of hair loss before you start your treatment, so you are prepared and know what you may expect. After chemotherapy begins, any hair loss usually progresses quickly.

“Generally, patients notice it when they wake up in the morning and they look at their pillow. They’ll see hair on their pillow,” Ades says. “Then they’ll start brushing it and noticing that it comes out in clumps.”

“It’s emotionally challenging for someone who is losing their hair,” she says. Ades adds that once a person takes steps such as wearing a wig or cap to feel more attractive, self-esteem may improve. Ades offers these additional tips on dealing with chemo-related hair loss:

  • If your doctor says that your hair is likely to fall out, decide before you begin chemo whether you want to wear a wig. You may want to shop before treatment to match your hair color.

  • The American Cancer Society can direct women to places that can help them with wigs, and some ACS offices will even provide women with wigs. Sometimes, insurance plans will also help cover the cost of a wig for cancer patients.

  • Hats, turbans, and scarves can also camouflage hair loss, although some people prefer to leave their heads uncovered. If you go bare-headed outdoors, be sure to use sunscreen on your scalp.

  • Cut your hair short. It eases the inconvenience of shedding lots of hair, but it also can reduce the emotional impact of watching your hair fall out.

  • Don’t perm or color your hair during chemotherapy. Those chemical treatments are already damaging to hair and can enhance hair loss. Once your chemo treatments are done and your hair has grown back, it’s OK to resume dyeing or perming hair.

    With chemotherapy, hair loss is almost always temporary. But when it grows back, it may be a different color or texture. In older adults who still had hair color before chemotherapy, the new growth may be completely gray, Ades says. Often, new hair is very fine and soft.

  • Some patients also feel upset about losing eyebrows and eyelashes. The American Cancer Society offers a program called “Look Good, Feel Better,” which teaches women makeup techniques to improve their appearance during cancer treatment, including tips for eyebrows and eyelashes.

  • Can drugs such as minoxidil help with hair loss? The research is lacking, and some medical experts are skeptical. But for patients who are very distressed by hair loss and are motivated to try everything at their disposal, Lacouture has recommended minoxidil, a baldness drug, for the scalp and eyebrows to try to maintain or stimulate hair growth.