What is hair loss?

Hair loss is a common and often distressing side effect of some cancer treatments. For many people, hair loss is one of the toughest aspects of treatment. Some people have mild thinning, while others lose all their hair. Hair loss may occur all over the body. If you do lose hair, it will almost always grow back after your treatment ends. But your hair might grow back a different color or texture. A person who had straight hair before treatment may find that he or she has curly hair afterward.

During your treatment, you may be able to use haircuts to hide hair loss or to make the hair you have left look its best. You may want to wear scarves and hats. Wigs or hairpieces also are an option. Or you may feel more comfortable leaving your head uncovered. Some people switch back and forth, depending on whether they are in public or at home with friends and family members.

When you have hair loss, you lose more than 100 hairs a day. Hair loss may look like bald spots, thinning hair on the top of the head, or patches of hair falling out. Hair may or may not grow back. It depends on what's causing the hair loss.

Your symptoms will depend on what kind of hair loss you have. If your hair is thinning, you may not notice the hairs falling out. If your hair is shedding, then clumps of hair fall out. You may lose hair all over your scalp, or you may lose hair only in one area.

There are many types of hair loss. They include:

• Androgenetic alopecia. This is inherited hair loss. In this type, the hair follicles sprout hairs that are thinner than normal. The hairs become thinner and thinner. Over time, the follicles wither away.
• Alopecia areata. This is hair loss that happens when the immune system mistakenly attacks hair follicles.
• Telogen effluvium. This type is caused by things such as stress, illness, poor nutrition, certain medicines, or hormone changes.
• Trichotillomania. This is a condition in which a person feels an urge to pull hair out of the scalp, eyelashes, or eyebrows.
• Traction alopecia. This hair loss is caused by your method of styling your hair, such as having tight braids or ponytails.

Treatment for hair loss depends on the cause. It also depends on your feelings. You may decide that you need treatment, or you may not be worried about thinning hair or baldness. The choice is up to you.

If hair loss is caused by something that won't last or can be treated, your hair is likely to grow back. For example, if an underactive thyroid is causing the problem, taking thyroid medicine may help. And most hair lost during chemotherapy will grow back after the treatment ends.

Hair loss that runs in the family can be treated with medicines or hair transplant surgery. Some people choose to wear hairpieces, like wigs or toupees. Finding different ways of styling your hair, like dyeing or combing, can help.

If hair loss is caused by something you can control, like stress or medicines, you can treat it by getting rid of the cause.

There are some things you can do that may reduce or prevent hair loss. These include avoiding certain medicines, reducing stress, getting adequate protein and iron in your diet, and using hairstyles that don't damage your hair. Inherited hair loss (androgenetic alopecia) cannot be prevented.

Your doctor will ask you about your past health and examine your scalp and hair loss pattern. Your doctor may gently pull out a few hairs for tests. If it's not clear what's causing your hair loss, your doctor may do a blood test or look at a sample of your hair or scalp.

Home treatment for hair loss includes hair care and hairstyling techniques that may help cover thinning or bald spots on the scalp.

Hair care products

With inherited hair loss, hair care and sometimes using grooming products, hair sprays, hair color, teasing, or frequent washing won't increase hair loss. But if your hair loss is caused by hair care such as perms and dyes, you may want to try:

• Scalp concealers or hair thickeners.
• A hairpiece. These are made from human or synthetic hair that is implanted into a nylon netting.
• Certain hair care products and styling techniques.
• Laser phototherapy combs. These combs use low levels of light to increase hair growth on the scalp.

Skin cancer protection

Hair thinning and baldness increase the risk of sunburn and skin cancer on the scalp. When in the sun, wear a hat or use a sunscreen with an SPF of 30 or more to prevent sun damage to the scalp.

In most cases, hair loss is inherited. That means it's passed down from one or both of your parents. Age, stress, poor diet, certain diseases, and side effects of medicines or medical treatments can also cause hair loss.

Hair loss is hair that is thinning or is falling out of your scalp. It's fairly common. Everyone loses some hair every day. Losing up to 100 hairs a day is normal.

But if hair loss runs in your family, you could lose a lot more hair. With this kind of hair loss, you may end up with bald spots if you're a man. If you're a woman, you may find that the hair on the top of your head is slowly thinning.

• Take good care of your scalp and the hair you have. Use a mild shampoo and a soft hairbrush.
• Air-dry your hair. If you have to use a hair dryer, use the low-heat setting.
• Think about cutting your hair short. A shorter style will make your hair look thicker and fuller. It also will make hair loss easier to manage if it occurs. But do not shave your head while your platelet and white blood cell counts are low. Low platelet and white blood cell counts can increase the risk of bleeding or infection if you cut or nick your head while shaving.
• Sleep on a satin pillowcase. This will reduce friction on your scalp.
• Do not use brush rollers to set your hair.
• Do not dye your hair or get a permanent while you are taking chemotherapy or if you are getting radiation to your scalp.
• Use sunscreen or a hat, scarf, or wig to protect your scalp from the sun.
• If you choose a wig or hairpiece:
  • Shop for your wig or hairpiece before you lose a lot of hair so that you can match your natural color, texture, and style. You may be able to buy a wig or hairpiece at a specialty shop just for people with cancer. Often a salesperson will come to your home to help you. You also can buy a wig or hairpiece through the American Cancer Society’s catalog. You can find other resources through the American Cancer Society’s Look Good, Feel Better program. For more information, call 1-800-ACS-2345 (1-800-227-2345).
  • You may prefer to borrow rather than buy a wig or hairpiece. If so, call your local American Cancer Society or check with the social work department at your treatment center.
  • Remember that a hairpiece that you need because of cancer treatment is tax-deductible and may be at least partly covered by your health insurance. Check your policy, and ask your doctor to write a prescription for a “hair prosthesis.”