What to expect if you lose your hair

Hair loss will usually begin gradually within 2 or 3 weeks of starting chemotherapy. For some people, it may be sooner and more sudden.

You may lose all or some of your hair. Your scalp might feel tender as the hair thins and falls out.

Other breast cancer treatments may cause hair loss and this may happen at different times. 

The first signs that you are losing your hair may be finding hair on the pillow in the morning or extra hair in your hairbrush. This can still be a shock and very distressing even when you’re prepared for it to happen. Wearing a soft hat or turban in bed to collect loose hairs might help.

Cancer Hair Care has useful information on their website explaining the hair loss and regrowth cycle in more detail.

Some people find that being prepared for hair loss before it occurs helps them cope better when it happens. You might want to think about:

1. Having your hair cut short
2. Shaving your head with clippers before treatment starts
3. Whether you want to use a cold cap during chemotherapy to try to prevent hair loss
4. Choosing a wig
5. Trying out other headwear and wig alternatives
6. Finding out how to care for your hair and scalp
7. Learning how to recreate eyelashes and eyebrows
8. Finding support from other people with experience of hair loss

For many people these are ways of taking back control rather than waiting for hair loss to happen.

Some people donate their hair if they have it cut off. You can donate your hair to organisations such as Little Princess Trust.

If you're considering wearing a wig, it can be useful to choose a wig before you lose your hair. Some people want to match their wig to your hair type, colour and style. Some people may decide to have a complete change.

If you haven’t yet lost your hair the wig should be quite tight when fitted so that it gives a good fit later on. This can be adjusted later if needed.

Some hospitals and local organisations offer hair loss services. These provide practical support and information about hair loss for people who are likely to lose their hair, or have already lost it. They may give you:

1. Tips on caring for your hair and scalp before, during and after your treatment
2. Information about cold caps  
3. The opportunity to try on different types of headwear, providing an alternative to wearing a wig
4. Advice on feeling more confident about your appearance
5. Information on hats, headscarves and fringe hairpieces and where to get them
6. Practical tips on using makeup to give the illusion of eyelashes and eyebrows

You can ask your treatment team or local cancer information centre for more information about services available in your area.

The charity Cancer Hair Care has lots of information to help people understand and prepare for hair loss.

It may also be useful to talk to other people who have experience of hair loss.

How you may feel

Hair loss is a visible side effect of treatment and can change how you view yourself.

For many of us, the way we feel about ourselves is closely linked to the way we look, and losing your hair can be devastating. You may feel anxious at the thought of losing your hair, or angry and unhappy that this has happened in addition to your cancer diagnosis and treatment.

Hair loss may also make you feel vulnerable and exposed. You may see it as a constant reminder of your treatment, labelling you as a ‘cancer patient’ or feel that hair loss has prevented you keeping your diagnosis private.

Some people feel guilty about being upset when they lose their hair as they feel there are other, more important things to worry about.

There’s no right or wrong way to feel and whether you lose some or all of your hair, the experience can be very distressing.

Some people describe hair loss as the most difficult side effect to deal with. Others find that losing their hair isn’t as upsetting as they thought it would be. While some people adjust quickly to hair loss, others find that it takes longer, or is more difficult to accept and adapt to than they imagined.

In some cultures and religions hair has a particular significance. If hair has a special significance for you, losing it may affect your cultural or religious identity as well as your body image and self-esteem. This can make it even more difficult to come to terms with. If you are finding these feelings overwhelming you may wish to speak to your breast care nurse or treatment team.  

Scroll down to section 7 of this page for information on where you can get support if you lose your hair.

Friends and family

You may feel that losing your hair means you will need to tell people about your diagnosis when you would prefer not to, however, it’s up to you who you tell.

Some people tell just their family and close friends, while others are happy to let everyone know.

People will respond to you losing your hair in different ways, and you may find some reactions difficult to understand.

A change in appearance may make you feel less confident about socialising with friends and family. However, withdrawing from your social life may make you feel more isolated or that your diagnosis is preventing you from doing the things you enjoy. Many people find continuing to meet up with others is a useful distraction and helps to keep some normality.

You may feel anxious about other people’s reactions at first, but these feelings should gradually improve over time. It might help to talk to others who have experienced hair loss.

Children

Your children may find it upsetting to see you without any hair and it might help if you prepare them for the fact that this may happen. You could let them know that hair loss is not usually permanent and what, if anything, you are going to wear on your head.

Many children are more accepting of physical changes than adults can be. They might want to help you select wigs, scarves or different headwear.

There are organisations that can support your child. You can order free activity packs and hair loss dollies to help children understand what is going to happen from Cancer Hair Care. The Fruitfly Collective also has resources to support families affected by cancer.

You may lose some or all of your body hair after starting chemotherapy, including eyebrows, eyelashes, nose hair, underarm and pubic hair, and chest hair for men. This can be a shock, especially if you’re not prepared for it.

Find out more about losing your eyelashes, eyebrows and body hair during chemotherapy.

Looking after your scalp if you experience hair loss is important as this area may feel tender and the skin may be sensitive.

It’s important to protect your scalp from the sun. Cover your head when in the sun or use a high protection factor sun cream at all times, as the scalp is particularly sensitive.

We lose a lot of heat from our heads so cover your scalp in colder weather.

If your scalp is dry, flaky or itchy you can use unperfumed moisturiser or natural oils such as almond or coconut oil to help with this. Some people use aromatherapy oils, but it is best to consult a trained aromatherapist as the oils can be very strong.

Continue to wash your scalp regularly. If you are wearing a wig, head scarf or hat wash these regularly to keep them clean and avoid irritation to your scalp.

If you are having radiotherapy to treat breast cancer that has spread to the brain, your treatment team may discuss what skincare products you can use on your scalp.

Find out more about headwear, wigs and scarves after hair loss.

Losing your hair can be a particularly distressing side effect of treatment. Finding ways to feel more confident in your new appearance can help you to accept and adjust to what has happened, and feel more like yourself again.

Everyone’s experience of hair loss is different and there’s no right or wrong way to feel. It’s important you find your own way of dealing with it, but it can be helpful to talk to others and find out what worked for them.

You can chat to other people going through breast cancer on our online discussion forum or through our Someone Like Me service - see below.

You can also ask your breast care nurse, treatment team and local cancer information centre for more information about hair loss services in your area.

Breast Cancer Now’s Moving Forward courses - see below - and Moving Forward booklet are for anyone who's had a diagnosis of primary breast cancer, helping you approach life after treatment with more confidence.

If you have secondary breast cancer, see below to register for our Living with Secondary Breast Cancer meet-ups and online course. The course contains videos and support for secondary breast cancer and hair loss.

Hair usually starts to grow back once treatment has finished.