When preparing for treatment of cancer you may have many concerns on your mind. Hair loss is associated with many cancer treatments and is a natural concern for most people. We are here to help you look good and feel able to cope, should you be affected.
Before we help to introduce you to this topic please be aware of the following - Unlike the type of hair loss caused by chemotherapy (which usually affects the hair on the entire body) hair loss caused by Radiotherapy, if it occurs, is “Area Specific”. In other words hair loss would only occur around the treatment area. For example if you are being treated on the breast area then only this area of your body could be effected and this may not cause you concern where hair loss is concerned. Whereas if you are being treated on your head you may be concerened about hair loss in this area.
So IF you are worried about hair loss on the AREA of your body that is being treated, please continue reading.
We say this because unlike when chemotherapy causes hair loss, with radiotheraphy you simply won’t lose hair on other (untreated) areas of your body. So this piece of information alone may be enough for you.
A guide to understanding Radiotherapy and possible hair loss or thinning
We understand that you may have many concerns about losing hair. First take a look at a few key points:
A few key points:
• Radiotherapy does not always cause hair thinning or hair loss. This depends upon the type, dosage and quantity of treatments
• If hair loss does occur, this is only in the area that is exposed to treatment and not the entire body. This means that your scalp hair may not be affected at all unless you are treated around the head and neck
• The hair commonly grows back again but some people can be left with an area of permanent baldness or thinner hair on the treatment area
• If hair loss or hair thinning does occur there is plenty that can be done to help you feel good about your style
The best person to offer you individual advice is always your radiologist.
This section is written in a logical sequence, starting with finding out if hair loss will affect you then running through various topics that may be helpful. Either read through the entire section or click on the topic of interest to you. A host of ideas, inspiration and support is just a click away. You really won’t have to give up on looking good because it’s all here waiting for you.
Let’s get started to helping you look good and feel better about hair loss during radiotheraphy treatment, knowing facts and making a plan will help you to take control.
Why not make a cuppa and take your time to fully understand if hair loss will happen to you.
There are different types of radiotherapy treatments. Which ones cause hair loss?
Whether or not you will experience hair loss as a side effect of radiotherapy all depends upon the type of radiotherapy treatment (external or internal) you are having as well as the area being treated, dosage and number of treatments.
There are several different types of radiotherapy including external treatments such as X ray and internal treatments including brachytherapy (the placement of solid radioactive material) and radioisotope (a radioactive liquid).
If hair loss or thinning occurs it is external radiotherapy treatment which is more likely to cause the hair loss as a side effect, but this is not always the case. If hair loss does occur, this is only in the area that is exposed to treatment and not the entire body. This means that your scalp hair may not be affected at all unless you are treated around the head and neck.
Internal radiography in the form of brachytherapy very rarely causes hair loss and radioisotope never causes hair loss.
So for clarity:
External radiotherapy -Very likely to cause some hair loss/thinning in area treated
Internal radiotherapy (brachytherapy) - Not likely - very rarely causes hair loss
Radioisotope - Never causes hair loss
For complete assurance you are best advised to discuss this with your radiographer as each case is so very specific to you.
What causes hair loss?
The hair follicle which holds the hair root in place is very sensitive and easily damaged. If the hair follicle is damaged by the radiotherapy the hair can reduce in thickness leading to hair thinning or fall out leading to hair loss. But unlike chemotherapy, which travels around the blood stream and can cause hair loss anywhere on the body, radiotherapy ONLY causes hair loss in the area being treated.
So hair loss is a result of a disruption to your hair’s growth system from the radiotherapy. The disruption is that the skin is often damaged (a bit like serious sun burn to the skin) and this makes the hair fall.
Most of the time hair will grow back. - it may different than before in texture and colour or can be just the same. Sometimes the skin is effected long term so the hair may not grow back, or be thinner than before. Your radiologist is the best person to explain if new hair growth will be affected.
If you are affected there are many ways to help adapt your look.
Will I lose my hair – talking to your radiographer
Radiotherapy ONLY causes hair loss in the area being treated . This area is very specific to you. So it is best recommended that you talk to your medical team about hair loss as normally, your radiologist will be able to tell you before you start your radiotherapy treatment, if hair loss may occur.
For clarity it is important to ask your radiologist (doctor or nurse) if your radiotherapy treatment will cause hair loss and where exactly this is going to happen on the body.
Talking to your radiologist about hair concerns may be something totally new to you, but most cancer doctors and nurses understand that hair loss can be a very emotional, physical and practical concern for you. So don’t feel uncomfortable about discussing your concerns about how you will look with your care team because they are used to it and talk to people about their hair concerns every day
Below are some suggested questions for your radiologist, nurse or specialist care team. It may be a good idea to write down any questions for your care team on a note pad. You can then make a note of their response so that you are clear about hair loss. Please remember that if you are having more than one treatment, such as chemotherapy, you will need to ask questions related to that treatment as well.
Treatment to the head area • Can you give me an indication of the size and location of possible hair loss – for example larger than a 10p piece? You may wish to ask them to draw a diagram to be really clear.
• Should I prepare myself for total hair loss? At what stage in my treatment do you think this will occur and will my hair grow back?
• Will my eye brows, eye lashes or (men facial hair) be affected?
• Is there anything that you can suggest to help minimise hair loss?
• If necessary will I be offered a referral letter for an NHS hair piece or wig
• If hair loss is upsetting me can you make any other suggestions to help me?
Treatment to the body (Not head) • What is my “treatment” area? • Can you please define this for me? • Will my radiology treatment cause hair loss? If yes, will the hair loss be complete hair loss leading to baldness or patchy hair loss or hair thinning? • Will the hair grow back in the area affected? • Can you give me an indication of how long the hair may take to grow back? • If hair loss concerns me can you offer me any advice?
Hopefully your care team will provide you with the answers you need. You can then read the advice topics that are most helpful to your specific needs.
Because your treatment will be so individual there are not really any other ways of finding out information on hair loss other than asking your care team.
IF YOU ARE HAVING A COMBINATION OF TREATMENTS – Remember to read the other relevant sections. Once you know how you may be affected you can read the chapters that appeal to you and your needs
What is the area of treatment?
For exteranl radiotherapy this simply means the specific area being treated.
Your radiologist will define the exact areas. The area being treated is very specific down to a millimetre as to where treatment will start and end.
As the body is a three dimensional mass this is an example of how it is most likely to be effected:
In the area to be treated a radiotherapy ray will enter into one area, pass through this specific area into the body and then exit into a surrounding area. This is the area being treated and if hair loss does happen, it will be in these areas only.
Here are some examples of “External radiotherapy treatment areas”
Breast area If you are being treated in the breast area then a ray may pass in through your breast and exit via your arm pit. So hair loss may occur around these areas (breast, chest and arm pit only) and will not occur on other areas of the body. Hair loss may not occur at all.
Head If you are being treated on your face, for example your jaw, then the rays may pass in through the cheek and jaw area, through your mouth and exit via your head (scalp). Therefore hair loss may occur at these specific areas on your face and scalp. But remember that if hair loss or thinning occurs it may be on a very tiny area that may be unnoticeable or can be easily disguised and may not occur at all.
Best idea is to talk to your radiographer and ensure that YOU understand where you are being treated so you know if hair loss is something that concerns you
Will my hair grow back?
Your radiologist needs to offer you advice which is directly related to your dosage and treatment type as sometimes hair does grow back and other times you may be left with areas of thinning or baldness. Should this happen to you we will offer you lots of help and ideas on looking good.
If told your hair will grow back then it can take a little while. But most hair will grow back between 6 – 12 months. Re-growth is likely after treatment is complete and the skin and surrounding area has healed.
Re-growth does depend on where the hair loss has occurred and the quality of the skin surrounding this area. Hair growth varies but it is common for the hair to be thinner or sometimes patchy after radiotherapy. It may also have a different texture, colour and feel to before.
After a few months you are likely to see a light covering of hair as an indication the hair will grow back. Remember that on the scalp even an inch of hair is enough to have a very short style. There are lots of clever ways to disguise areas of hair loss on the head and we will go into more details in later categories.
But occasionally the hair loss can be permanent which can be upsetting as this means that the hair in the affected area will not grow back at all. However this could be as small as a few millimetres or cover a larger area. We will help you with ideas and options if you need to find a more permanent solution.
Treatment to the head area If permanent hair loss is going to happen, your radiologist will normally inform and advise you prior to treatment. In particular if this is in an area such as the head and scalp, as this is most likely to cause you concern - the exact amount and location of any permanent hair loss should be explained to you.
Remember that there is plenty that can be done to help disguise permanent hair loss. It all depends on how you feel about the area where hair loss has occurred. We will go into permanent hair loss and all of the options available to you in great detail in Wigs & Hair Replacements.
For many people the hair will grow back - take a look in New Hair Growth for more on how to manage new hair.
Is there anything I can do to prevent hair loss?
Unfortunately there is nothing that can prevent hair loss IF it occurs due to radiotherapy.
It is important to know that the “Cold Cap” treatment that can sometimes be used with Chemotherapy to help prevent hair loss simply does not work with radiotherapy.
Remember- because any hair loss or hair thinning is specific to the area being treated it may not give you any cause for concern at all.
Most concern occurs if the area being treated is on the scalp or head area, so you can see how important it is to be clear about the area being treated and if hair loss will happen to you. If effected there are plenty of options available to help you look good through hair loss and sometimes this may mean altering your style for just a short period of time.
It is normal to be anxious about hair loss to the head. When it comes to radiotherapy it is so very specific to your individual treatment. Please be sure that you have talked to your radiographer and be sure to fully understand where you may be effected.
If you are being treated on the scalp, you may experience hair loss on the head – either in a small or larger area dependant on the size being treated. If you are affected and worried about this there is plenty that can be done to help you manage your new look.
You should be clear on the following:
• Understand how large the area of baldness or hair thinning may be and if the hair will grow back
• Been given a time frame on when this is likely to occur
• If necessary offered a referral letter for an NHS hair piece or wig
Changing my hair style to disguise hair loss
Sometimes a clever change of style can help to disguise thinning hair and areas of baldness. You won't have to give up on looking good as there are so many ideas on how to cover up, blend in your style and many more ideas.
You may find that your regular hairdresser can help or that you need to speak to an experienced hair loss specialist.
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Please kindly note that Cancer Hair Care and The Caring Hair Boutique are not designed to provide medical advice. You should always consult with your doctor if you have any medical concerns or queries.