Hair loss can be shocking and emotionally draining for some people living with breast cancer. This outward change may draw unwanted attention and lead to feelings of isolation.
The more you know about cancer-related hair loss, the better prepared you can be. Here is what you should know about alopecia (hair loss) in breast cancer — what it’s like, what causes it, and how you can handle or minimize hair loss.
Hair loss is a common side effect of cancer treatments. This change can cause a range of difficult emotions.
Some members of MyBCTeam — the social network for people living with breast cancer — experience anxiety surrounding hair loss. As one member asked, “What did any of you do before learning that you would lose your hair? It is nerve-wracking, and I’m a little anxious about the thought.”
Others find hair loss to be an incredibly challenging aspect of breast cancer. “Hair loss was the scariest thing for me,” wrote one member, “and it’s very traumatic, but once you lose your hair and either wear a wig or just go bald, once you embrace it, it’s so much easier. Many prayers, because this part is hard!”
Some members have been surprised by their strong emotional response to hair loss, even if they had initially felt prepared for this change. One member said: “It is surprising how hard the hair loss is. Especially after all the tests, biopsies, blood draws, port placement, etc. This has been the hardest thing to deal with (other than the original diagnosis).”
For some members, hair loss is particularly difficult because it can serve as a constant reminder of a cancer diagnosis. One member explained: “I am ashamed to admit that I cried when I got into the shower. I think it’s because when you lose your hair and look into the mirror, it is a neon sign for the world to see that you have cancer.”
Hair loss after a breast cancer diagnosis usually occurs because of a treatment for breast cancer. Chemotherapy agents, such as the taxane drugs paclitaxel (sold as Abraxane) and docetaxel (Taxotere), are well known for having hair loss as a side effect. Although hair loss most commonly happens during chemotherapy, it can also happen with radiation therapy, hormonal therapy, immunotherapy, and targeted therapy.
Chemotherapy targets cells that multiply and grow rapidly, which can include both cancer cells and healthy cells. When chemotherapy kills hair cells, it leads to hair loss. Chemotherapy-related hair loss usually stops after treatment is completed, but some drugs are known to cause more permanent hair loss in certain cases. Your hair may also grow back with a different thickness, texture, or color.
Other types of breast cancer treatment cause hair loss for similar reasons. Some cause only hair thinning, which you may not even notice. Others may cause hair to fall out quickly in large clumps. Although hair loss on the scalp is a common side effect of treatment, hair on all parts of the body (such as eyelashes, eyebrows, nose hair, and pubic hair) can also occur.
There are a few ways you can deal with hair loss associated with breast cancer and the difficult emotions that can come along with it.
It’s a good idea to go into treatment knowing that you may experience hair loss and understand that it can bring up many different feelings such as anger, sadness, frustration, or lowered confidence. Being prepared for hair loss and the accompanying emotions can help you to better manage the experience.
One member explained it this way: “Everyone feels differently about losing their hair. Quite honestly, for me, the anticipation of losing my hair was more traumatic and stressful than actually losing my hair. But that was me.”
The emotional aspects of losing your hair are legitimate and deserve care. Ask your doctor to help you add a social worker, therapist, or support group to your breast cancer team to help cope with the side effects of chemotherapy.
For some MyBCTeam members, maintaining a sense of control over their hair loss makes them feel better. Many do this by cutting their hair short or shaving it off entirely before it starts to fall out.
A MyBCTeam member shared, “When I started to lose my hair, my son shaved it off. It made me feel more in control. I would do it that way again.”
Another explained they had their hair cut into a short bob before chemo. “For me, it was simply a step of having control and a chance for a fun, new haircut before I would eventually lose it all,” they shared.
If cutting away all of your hair at once is too hard, you can take it slowly. One member described their process: “So, I shaved my head really short last night, but not bald yet. It’s my third haircut since having my hair long. I’m taking baby steps for my emotions.”
Cutting your hair off can be a relief, reducing the anxiety of waiting for hair loss to happen. A member put it like this: “For me, the hair loss was tough too, but once I shaved my head, it was actually a very freeing feeling!”
Getting a wig (or a scarf, hat, or other head covering that you love) can help you feel more confident when dealing with hair loss. Many of our members like this plan. “I got a wig before I lost my hair,” wrote one member.
Another explained, “I’m meeting with a wig lady next week. I’m trying to be prepared so that it’s not a shocker.”
You may even find that you enjoy being able to change your look whenever you want to. As one member explained, “I’ve grown to LOVE my wigs.”
Another described how realistic their wigs look: “When I wore the wig, people who didn’t know my situation didn’t know that it was a wig.”
When not wearing a wig (or other head covering), make sure to take care of your skin by regularly applying sunscreen to your scalp. One member advised, “During the summer, I wore bandanas and head scarves to protect my head from the sun.”
Some MyBCTeam members discuss their experiences losing hair from all over their bodies, including their eyebrows, eyelashes, nose, and legs. “I’m in my second week of radiation and have noticed that I’ve lost some of my eyebrows”, one member said.
Another described, “I had one dose of taxol and lost all my hair — all nose hair, most of my eyelashes, and some of my eyebrows. It did grow back though … except for the hair under my affected arm. No problem there!”
Hair loss on all parts of the body may be hard for one’s self-image. It also takes away from the functions of these hairs.
Eyebrows collect sweat to prevent it from dripping into the eyes. On hot days, adapt by carrying a handkerchief or sweatband. If you want to, you can explore waterproof eyebrow pencils and consult a stylist about how to draw on natural-looking eyebrows.
You may not notice yourself missing your nose hairs until you experience nosebleeds and nasal dryness. Make sure to use saline spray to moisturize your nose regularly.
Eyelashes are meant to protect your eyes from debris. Without eyelashes, it’s important to wear protective eyewear such as sunglasses. If your eyelashes are thinning but not completely gone, avoid wearing mascara or rubbing your eyes to prevent additional loss.
Many MyBCTeam members try to keep a positive attitude when it comes to facing hair loss. They know that losing their hair means they are fighting their cancer, and they embrace their appearance in all stages of treatment.
One member wrote to another, “Just know that no matter what, who you are as an amazing woman and human being has nothing to do with your hair. You are going to be exactly as beautiful, smart, and strong when the last hair falls out as you are this very minute.”
Another told their friends on MyBCTeam that “The rest of my hair fell out yesterday! No hair, don’t care! I’m embracing my baldness!”
Yet another member reminded everyone that hair is not necessary to look good or feel beautiful: “My hair is going faster than I thought, but it’s OK. I’m cute with or without my hair.”
Although there is no guarantee that you can prevent hair loss while undergoing treatment for breast cancer, there are solutions that work for some people. You’ll need to talk to your doctor, oncology team, or cancer care specialist to determine which (if any) of these options are right for you.
A cooling cap is just what it sounds like: a cap you wear on your head that cools down your scalp. This seems to decrease the amount of chemotherapy drug that builds up in hair follicles, limiting hair loss.
One of our members had great success with a scalp cooling system: “I did the cooling cap, and my hair held up. I’m so happy that I had the opportunity to use the cold cap.”
Rogaine is a hair growth cream containing minoxidil as its active ingredient. Studies have shown that this treatment can help limit the effects of chemo on the hair. One such study looked at women with breast cancer who experienced hair loss as a result of endocrine therapy. Treatment with topical minoxidil improved hair loss in 80 percent of those participating.
Despite the apparent success of this study, the use of Rogaine in cancer-induced hair loss is controversial. A MyBCTeam member explained: “My dermatologist told me to use Rogaine, but the box said it’s only helpful with hereditary baldness. The hair loss specialist I went to said not to use Rogaine.”
Make sure you and your health care provider are certain that Rogaine is a good choice for you before you try it.
Many other medications may be useful in preventing or limiting hair loss. Vitamin C, 5-alpha-reductase, omega-3s, and the CDK4/6 inhibitor palbociclib (Ibrance) may be helpful, depending on your chemotherapy treatment. Ask your oncologist if there are any new treatments or clinical trials for treatments that might help eliminate or make your hair loss less severe if you are interested in trying them.
If you are facing hair loss associated with a breast cancer diagnosis, reach out today. On MyBCTeam, we offer a social network exclusively for those diagnosed with breast cancer, breast cancer survivors, and those who love and care for them.
Reach out to ask your questions, request support, share your story, or join ongoing conversations. Before long, you’ll be connected with a group of more than 58,000 people from around the world who will support you on your journey with breast cancer.