Some of the functions of the PLAIN summaries work best on the desktop version. We are currently working on optimizing the mobile version.
Other PLAIN summaries
- Asymptomatic coronary artery disease
- Bone problems
- Cancer-related fatigue
- Central precocious puberty – CPP
- Chronic pain
- Craniofacial growth problems
- Dental and oral problems
- Dyslipidemia
- Eye problems
- Gastro-intestinal problems
- Hair loss
- Health promotion
- Hearing problems
- Heart problems
- Higher risk groups
- HP axis problems
- Hypertension
- Impaired glucose metabolism and diabetes
- Kidney problems
- Liver problems
- Lower urinary tract problems
- Lung problems
- Male fertility problems, testosterone deficiency and sexual dysfunction
- Mental health problems
- Neurocognitive problems
- Obstetric problems
- Overweight and obesity
- Peripheral neuropathy
- Premature ovarian insufficiency
- Psychosocial problems
- Spine scoliosis and kyphosis
- Spleen problems
- Stroke
- Subsequent neoplasms:
- Thyroid problems
HAIR LOSS (ALOPECIA)
This page is part of the PanCare PLAIN summaries about late effects and recommendations for long-term follow-up care for survivors of childhood, adolescent, and young adult cancer. Click here, for more information on the PLAIN summaries.
This PLAIN summary is based on the PanCareFollowUp guideline about “Alopecia” [1], which is based on the consensus of different national guidelines.
PLAIN version 2.1: 27/05/2024
Hair loss (alopecia)
Hair grows almost everywhere on the human body and is thickest on the head. Each hair is anchored into the skin by a hair follicle which holds the hair root. When the hair falls out, a new hair grows from the same hair follicle. It is normal to lose 50 to 100 hairs each day.
Damage to a hair follicle can cause its hair to fall out and prevent the follicle from growing new hairs. If many hair follicles are damaged, the hair becomes thinner and bald patches may appear. This is called hair loss or alopecia. Sometimes damaged hair follicles can recover and the hair will then grow back.
During cancer treatment, you may have experienced hair loss. Cancer treatment can damage the hair follicles, causing hairs all over the body to fall out within a few days or weeks. Usually this is only temporary and the hair grows back after the end of treatment. The hair might have a different colour, texture or style (curlier or straighter). It might also grow more slowly or become thinner. In some instances the hair follicles are too damaged and cannot recover. This is called permanent hair loss.
The hair
Created with BioRender.com
Hover over the numbers in the figure for more information.
Am I at higher risk of (permanent) hair loss?
Anyone, including people who have never had cancer treatment, may develop (permanent) hair loss. However, there are some cancer treatments that may increase the risk of having (permanent) hair loss. The problems that can occur depend on the type of cancer treatment received.
The following treatments can increase the risk of (permanent) hair loss:
- Radiotherapy can cause hair loss in the area that was treated. Hair loss after radiotherapy can be temporary or permanent. This depends on the dose and the number of treatments.
- Chemotherapy can cause temporary hair loss all over the body. Chemotherapy alone usually does not cause permanent hair loss.
- Stem cell transplantation can cause temporary hair loss as this involves high doses of chemotherapy.
- Treatment with both radiotherapy and chemotherapy can increase the risk of having permanent hair loss.
You can find out if you have received any of these treatments by looking at your treatment summary. If you do not have a treatment summary or if you have any questions, do contact your treating hospital.
If you experience hair loss, it does not always mean that this is caused by your cancer treatment. Hair loss may have other causes.
Stem cell transplantation
Stem cell transplantation means that blood stem cells are taken out of the body of a person and transplanted back into the same person (autologous) or to another person (allogeneic).
This procedure is often used to treat diseases such as leukaemia and lymphoma, and some solid tumours (such as neuroblastoma) as well as certain immune system and genetic disorders.
There are different types of stem cell transplants, including:
- Autologous Transplant: Uses the patient’s own stem cells, which are harvested before treatments like chemotherapy or radiation and then returned to the body to help recover.
- Allogeneic Transplant: Uses stem cells from a donor. The donor can be a relative (often a sibling) or someone unrelated with a matching tissue type.
The blood stem cells can be harvested in different ways. They can either be taken out of the blood stream (peripheral blood stem cell transplantation) or out of the bone marrow (bone marrow transplantation).
During the transplantation process, the patient often undergoes a treatment to kill the diseased bone marrow cells before receiving the new stem cells through an intravenous line, similar to a blood transfusion. After the transplant, it takes time for the new stem cells to grow and start producing healthy blood cells, during which the patient needs close medical care to prevent and manage potential complications, such as infections or graft-versus-host disease (in case of allogeneic transplants).
Other causes
Radiotherapy
Your treatment summary can tell you which areas of your body were irradiated. If you do not have a treatment summary or if you don’t understand what is written about the radiotherapy you received, do contact your treating hospital.
Radiotherapy is a treatment for cancer which uses high-energy radiation to destroy cancer cells and to shrink tumours. The radiation comes from a machine outside the body (external beam radiotherapy) or occasionally from radioactive material that is placed in the body near cancer cells (intracavitary or interstitial radiotherapy). The aim of radiotherapy is to treat only one area of the body, around and near the cancer or where the cancer was before it was removed by surgery and as far as possible to protect unaffected areas. For example, if you have cancer in your lung, you will have radiation only to your chest, not to your whole body.
External beam radiotherapy is painless and takes only a few minutes. It is given once or occasionally twice a day often for several weeks. A radiation beam is like an invisible light beam. The machines which produce the radiation beam can be moved so that the beam enters the body from different directions, ‘spotlighting’ on the area to be treated. This means that the tumour is given a high dose whilst normal areas get either a lower or no dose at all.
Since the early 1980’s computers and other technical advances have improved radiotherapy. Before this there were not many ways to protect normal tissues which were in the path of a radiation beam. Even now, whilst modern techniques allow doctors to target the cancer cells more precisely than older techniques, healthy cells may still get damaged. This can result in some of the late effects covered in the PLAIN summaries. It will help you and your follow up specialist to know what long term effects there might be after your radiotherapy if you and they have your treatment summary.
Your treatment summary can tell you which areas of your body were irradiated. If you do not have a treatment summary or if you don’t understand what is written about the radiotherapy you received, please contact your treating hospital.
What happens if I have (permanent) hair loss?
Hair loss can be very upsetting, especially when the hair loss is permanent. Sadly, there are no lotions or treatments which will help the hair to grow back. But there are several things which can help to make thin hair or bald areas less noticeable.
You can try different hairstyles, hats, scarves, bands, hair pieces or wigs. Another good (but expensive) option is hair weaving, where extra natural or artificial hair is added to the places where the hair is thin. A hairdresser can help if you want to try any of these options.
Hair transplants are generally not recommended when you received radiotherapy. Skin treated with radiotherapy is often thin and does not heal well, which makes transplanting new hair difficult. If you would still like to try having hair transplant, discuss this with your general practitioner or follow-up care specialist.
What else can I do?
Experiencing (permanent) hair loss can be difficult. Talking to friends and family can be helpful as well as specialist counselling and/or contact with support groups, such as patient organisations. For more information on taking care of your mental health, please read: Mental health problems.
Although it may not influence your (permanent) hair loss, it is still important to live a healthy lifestyle. Taking care of your mental health may be beneficial; even small changes to your lifestyle can have a positive impact on both your physical and mental health. For more information on taking up a healthier lifestyle, please read: Health promotion.
If you have any further questions or if the information in this brochure concerns you, please contact your general practitioner or follow-up care specialist.
Healthy lifestyle
- Having a healthy diet
- Drinking less (or no) alcohol
- Exercising regularly
- Quitting smoking (if you smoke)
Your follow-up care specialist or general practitioner may give you additional advice tailored to your individual situation for maintaining a healthy lifestyle. For more information on taking up a healthier lifestyle, please read: Health promotion.
Where can I find more information?
You may find more information about alopecia online. However, it is important to be aware that this information is not always up to date or accurate.
Some sources of further information are:
- Alopecia UK: Here you can find more information and advice for hair loss in adults and children
- Cancer Research UK: Here you can find more information about coping with hair loss
- Macmillan Cancer Support: Here you can find more information about coping with hair loss
- The National Alopecia Areata Foundation (NAAF): Here you can find more information about alopecia areata and about support groups
- Little Princess Trust UK: Here you can find more information about free wigs for everyone younger than 24 years old who lost their own hair through cancer treatment in the UK
On this website, you can also find more information related to this topic:
Please note
This PLAIN summary is based on the PanCareFollowUp guideline about “Alopecia” [1], which is based on the consensus of different national guidelines.
While the PanCare PLAIN information group strives to provide accurate and complete information that is up-to-date as of the date of publication, you can check with your general practitioner or follow-up care specialist if this summary reflects the most up-to-date information available and whether it is relevant for you.
Please do not rely solely on this information. It is best to also seek the advice of a qualified medical practitioner if you have questions regarding a specific medical condition, disease, diagnosis or symptom.
No warranty or representation, expressed or implied, is made concerning the accuracy, reliability, completeness, relevance, or timeliness of this information. PanCare has produced the English version and PanCare is not responsible for the translated versions of this summary.
The PanCare materials are free to use for anyone aiming to inform about late effects and long-term survivorship care. However, no financial advantage may be achieved. All communication should reference PanCare and link to the PanCare website.
[1] van Kalsbeek, R. et al. (2021) European PANCAREFOLLOWUP recommendations for surveillance of late effects of childhood, adolescent, and Young Adult Cancer, European journal of cancer. Available at: https://www.ejcancer.com/article/S0959-8049(21)00368-3/fulltext.