Chemotherapy-Related Hair Loss (Alopecia) in Children
What is chemotherapy-related hair loss?
Hair loss is a common side effect of chemotherapy. It can affect the hair on the head,
and also the eyebrows, eyelashes, and facial and pubic hair. Not all chemotherapy
causes hair loss. And not all children lose hair in the same way. A child may lose
his or her hair with a medicine and another child taking the same medicine may not.
Your child's cancer specialist (oncologist) can tell you what to expect with your
child's chemotherapy medicines.
What causes chemotherapy-related hair loss?
Chemotherapy kills cells that grow fast, such as cancer. Hair also grows fast, so
some chemotherapy may also damage the hair. The medicine harms the tissue around the
root of the hair (hair follicle). This causes the hair to fall out.
What are the symptoms of chemotherapy-related hair loss?
Hair loss from chemotherapy may start 2 or 3 or more weeks after your child's first
or second chemotherapy treatment. Your child's hair may first begin to thin before
falling out in larger amounts. Your child may lose hair only on the head. Or, he or
she may lose hair on other parts of the body. Your child's scalp may also be 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
chemotherapy, it may be a different color or texture.
How is chemotherapy-related hair loss diagnosed?
The healthcare provider will ask about your child's chemotherapy treatment and hair
loss symptoms. He or she will examine your child’s scalp and hair. In some cases,
the healthcare provider may do a pull test. He or she will grasp 20 to 60 hairs and
pull gently but firmly. This is done to see how many hairs pull out. More than 10%
of the hairs pulling out is a common sign of hair loss caused by chemotherapy. The
roots of the hairs may be checked under a microscope. This is to see what stage of
growth they are in.
How is chemotherapy-related hair loss treated?
You will need to make sure your child's head is protected from sun and cold. You can
apply sunscreen to your child's scalp or he or she can wear a hat or scarf. For dryness
or itchiness, you can use a moisturizing shampoo and conditioner. You can also apply
cream or lotion to your child's scalp.
What are possible complications of chemotherapy-related hair loss?
Depending on your child's age and personality, hair loss can be very upsetting. A
young child may not be bothered by hair loss. But a school age child or teen may be
How is chemotherapy-related hair loss managed?
You can help to manage your child's hair loss. You and your child may want to try
- Make sure your child understands that his or her hair will grow back.
- Help your child decide what he or she wants to do about hair loss. Consider cutting
the hair before if falls out, shaving the head, getting a wig, or wearing hats or
- Wash hair less often than normal. Use a gentle moisturizing shampoo.
- For teens, don’t use harsh chemicals on the hair, such as hair colors.
- Don’t use curling irons, blow dryers, flat irons, or curlers.
Can chemotherapy-related hair loss be prevented?
Chemotherapy-related hair loss can’t be prevented.
When should I call my child’s healthcare provider?
Call your child's cancer oncologist if you have any questions about your child's hair
Key points about chemotherapy-related hair loss
- Hair loss is a common side effect of many chemotherapy medicines.
- Hair loss may start 2 or 3 or more weeks after your child's first or second chemotherapy
- You will need to make sure your child's head is protected from sun and cold.
- Hair loss can be very upsetting to a child, depending on age.
- Hair usually begins to grow again about 2 to 3 months after your child's last treatment.
- You and your child can work together to help manage hair loss.
Tips to help you get the most from a visit to your child’s health care provider:
- Before your visit, write down questions you want answered.
- At the visit, write down the names of new medicines, treatments, or tests, and any
new instructions your provider gives you for your child.
- 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 provider after office hours. This is important
if your child becomes ill and you have questions or need advice.