What is chemotherapy-related hair loss in children?

Hair loss is a common side effect of chemotherapy. It can affect hair on the head, arms, legs, face, and underarms. It can also affect eyebrows, eyelashes, and pubic hair. Not all chemotherapy causes hair loss. And not all children lose hair in the same way. Your child's cancer specialist (oncologist) can tell you what to expect with your child's chemotherapy treatment.

What causes chemotherapy-related hair loss in a child?

Chemotherapy kills cells that grow fast, such as cancer cells. Hair also grows fast, so some chemotherapy medicines damage the hair follicle (the root of the hair). This causes the hair to fall out.

What are the symptoms of chemotherapy-related hair loss in a child?

Hair loss from chemotherapy may start 7 to 10 days after your child's first chemotherapy treatment. Sometimes it starts later. Hair loss often starts slowly. Your child's hair may first begin to thin before falling out in larger amounts. Sometimes all the hair doesn't fall out, but it gets thin, dry, and dull.

Your child may lose hair only on the head. Or they may lose hair on other parts of the body, including eyelashes. Your child's scalp may become sensitive, dry, and itchy.

Hair usually begins to grow again about 2 to 3 months after your child's last treatment. The new hair may easily break at first. When hair grows back after chemo, it may be a different color or texture. It usually goes back to normal in a year or so.

How is chemotherapy-related hair loss diagnosed in a child?

Your child's doctor will ask about your child's chemotherapy treatment and hair loss symptoms. They may examine your child’s scalp and hair.

How is chemotherapy-related hair loss treated in a child?

You will need to make sure your child's head is protected from sun, heat, and cold. You can use sunscreen on your child's scalp. And your child can wear a hat or a scarf.

For dryness or itchiness, you can use a moisturizing shampoo and conditioner. You can also put cream or lotion on your child's scalp.

What are possible complications of chemotherapy-related hair loss in a child?

Your child's reaction to hair loss depends on your child's age and personality. A young child may not be bothered by hair loss. But a school-age child or teen likely will be.

Many children find hair loss to be the most upsetting part of chemotherapy. It makes them look sick and it makes them look different from their family and their peers. Hair loss can cause emotional trauma, social isolation, and problems with self-image. It may help your child to talk to a counselor, social worker, child life specialist, or another member of their care team.

How can you help your child with chemotherapy-related hair loss?

You can help your child cope with hair loss and prepare them for it. You and your child may want to try the following:

• Make sure your child understands that their hair will grow back after treatment.

• Consider cutting the hair or shaving the head before the hair falls out.

• Wash hair less often than normal. Use a gentle moisturizing shampoo.

• Try not to pull on hair. Brush gently. Use a wide-toothed comb.

• Don’t use harsh chemicals on the hair, such as hair colors or straighteners.

• Don’t use curling irons, blow dryers, flat irons, or curlers.

Help your child decide what they want to do about hair loss. Your child's care team can give you ideas, too. Talk about getting a wig or wearing hats or scarves. Insurance may partially or fully cover a wig for your child. Ask your child's care team if they can help you order a wig. Also ask for help checking your insurance coverage.

What can you do to prevent chemotherapy-related hair loss in your child?

Unfortunately, chemotherapy-related hair loss can’t be prevented.

When to contact your child’s doctor

Contact your child's oncologist if you have any questions about your child's hair loss.

Key points about chemotherapy-related hair loss in children

• Hair loss is a common side effect of many chemotherapy medicines.

• Hair loss may start a week or so after your child's first chemotherapy treatment. Sometimes it takes longer for hair to start falling out. Or the hair may thin and not all fall out.

• You will need to make sure your child's head is protected from sun, heat, and cold. 

• Hair loss can be very upsetting to a child, depending on their age. 

• Hair usually starts to grow back about 2 to 3 months after your child's last treatment. 

• You and your child can work together to prepare for and cope with hair loss.

Next steps

Tips to help you get the most from a visit to your child’s doctor:

• Know the reason for the visit and what you want to happen.

• Before your visit, write down questions you want answered.

• At the visit, write down the name of a new diagnosis and any new medicines, treatments, or tests. Also write down any new instructions the doctor gives you for your child.

• Know why a new medicine or treatment is prescribed and how it will help your child. Also know what the side effects are and when they should be reported.

• Ask if your child’s condition can be treated in other ways.

• Know why a test or procedure is recommended and what the results could mean.

• Know what to expect if your child does not take the medicine or have the test or procedure.

• If your child has a follow-up appointment, write down the date, time, and purpose for that visit.

• Know how you can contact your child’s doctor after office hours. This is important if your child becomes ill and you have questions or need advice.