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Will I lose my hair during chemotherapy treatment?

Medically reviewed by Kristianne Hannemann, PharmD. Last updated on May 28, 2025.

Official Answer by Drugs.com

Chemotherapy is a powerful tool in the fight against cancer, but it often comes with side effects—one of the most visible and emotionally challenging being hair loss. Not everyone experiences hair loss from chemotherapy. For those who do, it is usually temporary and begins to reverse after treatment ends. Here’s what you need to know about why it happens, what to expect, and how to cope.

Why Chemotherapy Causes Hair Loss

Chemotherapy drugs are designed to target rapidly dividing cancer cells. This means they also affect other rapidly dividing cells in the body, including those in the hair follicles. This damage disrupts the normal hair growth cycle, leading to hair loss (a condition called chemotherapy-induced alopecia or CIA).

The most common mechanism of hair loss from chemotherapy is called anagen effluvium, where hair falls out during its active growth phase. Unlike telogen effluvium, the hairs are not shed and are instead broken. Other cancer treatments may cause hair loss as well, such as radiotherapy, hormonal treatments, immunotherapy, and targeted cancer drugs.

When and How Hair Loss Happens

Hair loss from chemotherapy usually begins within a few weeks after starting treatment. It often starts as thinning and can progress to complete baldness on the scalp and sometimes other parts of the body, such as eyebrows, eyelashes, and body hair.

The process of hair loss is typically acute and diffuse, meaning hair falls out quickly and affects the whole scalp. You may notice hair coming out in clumps when you are showering or brushing your hair. Some patients experience symptoms before losing their hair, such as scalp tenderness. After the hair falls out, the area might feel itchy.

In most cases, hair loss is temporary. Regrowth usually begins a few weeks to months after treatment ends, though the new hair may differ in color or texture.

Which Chemotherapy Drugs Are Most Likely to Cause Hair Loss

Not all chemotherapy drugs cause hair loss, but some are more likely to do so. Drugs with a higher risk of causing significant hair loss include:

Drugs with a lower risk of causing significant hair loss include:

Keep in mind that some patients may not experience hair loss even with high-risk drugs, and some may experience significant hair loss with lower-risk drugs. Some regimens, especially those combining several of these drugs, can increase the risk and severity of hair loss. In rare cases, certain chemotherapy protocols can lead to permanent hair loss, particularly with high-dose or prolonged use of drugs like taxanes and busulfan.

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Can Hair Loss Be Prevented or Reduced?

While there is no guaranteed way to prevent chemotherapy-induced hair loss, some strategies may help reduce its severity:

Emotional Impact and Support

Hair loss can have a profound emotional and psychological impact. Many patients report that losing their hair is one of the most distressing aspects of cancer treatment, affecting self-image, confidence, and social interactions. Support from family, friends, and healthcare providers can significantly benefit patients who are experiencing CIA. Some strategies to cope include:

What Happens After Treatment?

In most cases, hair begins to regrow within a few weeks to months after chemotherapy ends. However, the new hair may be different in color, texture, or thickness—commonly referred to as “chemo curls.”. In rare instances, especially after certain drug regimens, hair loss may be permanent or regrowth may be incomplete. Some treatments may help stimulate hair regrowth.

Summary

Chemotherapy-induced hair loss is common and usually temporary, caused by the drugs targeting rapidly dividing hair follicle cells. Hair loss typically starts a few weeks after treatment begins and regrows a few months after it ends. The likelihood and severity depend on the specific drugs used, with taxanes, anthracyclines, and alkylating agents posing the highest risk. Scalp cooling is the most effective preventive measure, while minoxidil may help with regrowth. Most patients will see hair return, though it may look or feel different. Permanent loss is rare, but possible with certain drugs. Ask your healthcare team about your specific regimen and expectations.

References
  1. American Cancer Society. 2024. Hair Loss (Alopecia). Accessed on May 27. 2025 at https://www.cancer.org/cancer/managing-cancer/side-effects/hair-skin-nails/hair-loss/coping-with-hair-loss.html
  2. Breast Cancer Now. Capecitabine (Xeloda). Accessed on May 28, 2025 at https://breastcancernow.org/about-breast-cancer/treatment/chemotherapy/chemotherapy-drugs/capecitabine-xeloda
  3. Cancer Research UK. 2023. About hair loss and thinning due to cancer treatment. Accessed on May 27, 2025 at https://www.cancerresearchuk.org/about-cancer/coping/physically/changes-appearance/hair-loss/treatment
  4. Etoposide injection [package insert]. Updated June 2022. Fresenius Kabi USA, LLC. Accessed on May 28, 2025 at https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=fe870629-104d-4d67-a7c6-f53bc588121e
  5. Fluorouracil injection [package insert]. Updated May 2024. Accord Healthcare, Inc. Accessed on May 28, 2025 at https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=66d451fe-2436-494c-80c5-4528c8e34369
  6. Gangireddy, M, et. al. Updated 2024. Ifosfamide. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK542169/
  7. Gaumond, S. I., et. al. 2025. Chemotherapy-Induced Alopecia in Ovarian Cancer: Incidence, Mechanisms, and Impact Across Treatment Regimens. Cancers, 17(3), 411. https://doi.org/10.3390/cancers17030411
  8. InformedHealth.org [Internet]. Updated 2023.Overview: Hair loss in chemotherapy. Cologne, Germany: Institute for Quality and Efficiency in Health Care (IQWiG). Accessed on May 27, 2025 at https://www.ncbi.nlm.nih.gov/books/NBK547552/
  9. Perez, A. M., et. al. 2024. Chemotherapy-Induced Alopecia by Docetaxel: Prevalence, Treatment and Prevention. Current oncology (Toronto, Ont.), 31(9), 5709–5721. https://doi.org/10.3390/curroncol31090423
  10. Rossi, A., et. al. 2017. Chemotherapy-induced alopecia management: Clinical experience and practical advice. Journal of cosmetic dermatology, 16(4), 537–541. https://doi.org/10.1111/jocd.12308
  11. Saleh, D., et. al. Updated 2024. Anagen Effluvium. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan-. Accessed on May 27, 2025 at https://www.ncbi.nlm.nih.gov/books/NBK482293/
  12. You, J. S., et. al. 2019. The effect and mechanism of YH0618 granule on chemotherapy- induced hair loss in patients with breast cancer: study protocol for a randomized, double-blind, multi-center clinical trial. Trials, 20(1), 719. https://doi.org/10.1186/s13063-019-3893-3

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