Cancer & Cancer Treatments

Cancer, cancer treatments, and the stress related to cancer can all cause hair loss.

Cancers that Can Cause Hair Loss

Skin cancers can cause extensive and permanent hair loss on the scalp and elsewhere. Merkel cell cancer is one rare but aggressive form of skin cancer that sometimes develops in hair follicles themselves; it affects the very specialized neurosecretory Merkel cells, which seem to play a key role in hair growth.

Lymphoma cells can mass in the skin and destroy hair follicles. And cancers elsewhere in the body, including the breasts, lungs, liver, and kidneys can also metastasize, spreading to the skin and destroying hair follicles. Once hair follicles are destroyed, hair loss is permanent.

Cancer can also cause hair loss indirectly; it can lead to anemia or hormonal imbalances or stress, all of which can cause hair loss. Such hair loss is generally diffuse and temporary.

Hair Loss from Cancer Treatments

Cancer treatments also often cause hair loss. Chemotherapy generally results in temporary hair loss, while radiation therapy can result in temporary or permanent hair loss.

Chemotherapy drugs target fast-growing cancer cells and seek to stop their rapid division and proliferation. Fast-growing normal cells, most often hair follicles, blood cells, and cells lining the gastrointestinal cells, may also be affected. As hair cells stop dividing, hair shafts thin and break off.

Some chemotherapy drugs (including methotrexate, cyclophosphamide, bleomycin, doxorubicin, mitomycin, cytarabine, vinblastine, and vincristine) seem more likely than other drugs to cause hair loss, and some seem more likely to affect scalp hair while others lead to more general loss. But all chemotherapy-related hair loss is highly variable. Some people experience hair loss and others do not, even when they are taking the same drugs in the same dosage.

Hair can be lost gradually or in clumps, and it can happen at any time, but it usually begins one to three weeks after the start of chemotherapy and then worsens after a month or two. Sometimes as much as 90 percent of scalp hair is lost.

While nothing can prevent or stem this loss, but there is good news: once chemotherapy is completed, the hair usually grows back in six months to one year. Sometimes it even begins to grow back prior to the completion of treatment. This regrown hair may be very fine, it may break easily, and it may differ in color and texture from the hair that was originally lost.

It is generally best for chemotherapy patients to plan in advance for some hair loss. If a wig is desired, they might seek to match their original hair color and texture before it is lost. Custom-made wigs and hair prosthetics take up to four months for production and delivery.

Radiation therapy generally causes loss only in the specific area being treated. The dosage of the radiation may determine whether this hair loss is temporary or permanent. As with chemotherapy, if hair returns, it may differ in color and texture from the original hair that was lost.

Information on this page, provided as a service by Peggy Knight Solutions, draws upon information from the following primary sources: the American Academy of Dermatology, the American Cancer Society, the National Cancer Institute, which is one of the National Institutes of Health, and the U.S. National Library of Medicine.

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