Radiotherapy hair loss
External radiotherapy can cause hair loss in the area where you are having treatment. You might also have some hair loss on the opposite side, where the radiation beam leaves the body. This is called the exit site.
You might start to lose your hair about 2 or 3 weeks after you begin treatment. It usually starts to grow back once you finish your course of radiotherapy. But it might not be quite as thick as before and in some people can be patchy.
For some people, the hair doesn’t grow back. Permanent hair loss is more likely after high doses of radiotherapy. Your doctor will talk to you before you start radiotherapy about what to expect and if permanent hair loss is likely.
Hair loss after radiotherapy to the brain or head and neck
Radiotherapy to the brain will cause some hair loss. If you have radiotherapy to a particular part of your head, your hair only falls out in that area. Whether or not your hair grows back depends on the type of radiotherapy you're having. For example, if you have whole brain radiotherapy to treat your symptoms it's likely that your hair will grow back. But treatment to try to cure a brain tumour uses a high dose of radiation, so permanent hair loss is more common.
Radiotherapy to the head and neck can cause hair loss, including facial hair. This may be permanent. It depends on the position of the radiotherapy beams and the treatment dose.
This video shows people affected by cancer talking about hair loss as a side effect of radiotherapy. The video is around 1 and a half minutes long.
Transcript
Voice over: When having radiotherapy to your head and neck, you can experience many different side effects. One of these might be hair loss.
Tasha: My hair loss from radiotherapy, you could see it weeks and months later, it slowly and gradually started to sort of go bald at the top.
Louise: Hair loss is common, but only in the area exposed to the radiation beam.
Charlie: Every hair in the treatment area, whether it was on the back of my neck or the front of my throat/neck area, had just fallen out.
Louise: The majority of hair does grow back, but we can't always guarantee that it definitely will. And it doesn't always grow back in quite the same way that it used to.
Tasha: I try to embrace it because it's part of my cancer story, but I like having my fringe and I just think I'll probably keep it.
Voice over: For information on other head and neck radiotherapy side effects, visit the Cancer Research UK website.
Head coverings or wigs
You might like to cover your head with a soft hat or scarf to protect the exposed skin and keep your head warm.
The video shows you the different types of hats and scarves you can wear when you have hair loss. It is about 7 and a half minutes long.
Transcript
Ann: Sheena who lost her hair during her chemotherapy will now show you some of the different types of headwear. Hello Sheena.
Sheena: Hello, I wore wigs as well as lots of alternatives. There are many different alternatives to wigs. The stretchy tube is simple, easy and quick to put on. It’s comfortable, light and breathable and there are no uncomfortable seams. And it’s easy to wash. They come in lots and lots of different colours which is really nice so you can match different outfits very easily. You can get them from lots of different high street stores which is very useful.
I use to keep one of these by my front door. So if anyone rang on my front doorbell and I didn’t have my wig on or have my headscarf on I could just pick this up very quickly and just pop it on. It is important to just make sure you adjust it so that it follows your natural hairline. And then that was it. I was ready to go and answer the door. If I then wanted to go out I could then just tuck it in at the back and if I wanted to I could just put an ordinary outdoor hat on top and that would be me ready to go. The other nice thing about that is that if you perhaps were out and somebody invites you in for a coffee, you don’t want to go in wearing an outdoor hat you, so can just slip the outdoor hat off. Make sure you hold your fingers to keep it in place and you have got head covering.
Depending on the shape of your face you might want to create a bit more width and one of the ways to do that is to add another one of these stretchy tubes on top. They are quite versatile. And actually just pop it on, very simple. You can do a little bit of adjusting if you want to, and then it’s created a little bit more width. If you want to create a bit more height if you just un tuck the back bit you can just rearrange it... and tuck the front part under there and that creates a bit more height.
The other thing you can do is to add different scarves and accessories. You can even take... you know this would be quite a good scarf you could just wrap it... around... and it gives you quite a nice elegant look, so you can change it to whatever suits your personality, your wardrobe and what you are doing.
The other important thing if you are talking about scarves is looking at the size um and texture of what they are. This one is a bit too small... that sort of size. It won’t provide enough coverage so when you tie it you’ll find you’ve got sort of gaps and won’t be a good size. The sort of size you are looking for is this sort of one, you can see it’s quite big that’s the sort ideal size of head scarf. This is cotton so it’s got a little bit of grip it’s not going to slide. The problem is this is a really beautiful scarf but this is silk. The trouble with silk is that if you tie it, you think it is secure it tends to slip so it is much better to choose a fabric with just that little bit of grip.
If you want to tie a headscarf it is important to start with something quite simple. You don’t want to start with anything too complicated. You form it into a triangle first, if you create a little turn over it gives you a little bit more height which is quite nice because what you are trying to re create is that sort of volume around your face and that’s what the scarves and the tubes do.
And then it goes round the back and use one of these stretchy bands but without any metal because otherwise it might catch your headscarf and ruin the fabric. Treat it a bit like tying a ponytail. Double the elastic over and you can pull out as much of the fabric as you like at the back. And again with all these scarves the other thing you can do of course is accessorise them. So we can choose something perhaps to just add a little bit of extra... this would work, this would work again. And again you can either tie bows or you can wrap the ends in whatever you feel comfortable doing. If you just lose the ends behind.
So the other thing you can think about is perhaps putting a nice summer hat on top. And again you have got the layer underneath so if you want to stop anywhere you can take the hat off but you can just add another. Quite an elegant look. Also another thing is it is quite important sometimes to avoid the sun and this provides you with a nice shade over your face.
The other option are these crinkle cotton ones. Now these are quite nice, they are quite long. And because it is crinkle cotton it will grip quite nicely. So again what you are doing is off- setting this, so we have got one end longer than the other. So if you just scrumple the ends, cross them over at the back and then that’s secured it. Then if you give it a little bit of a twist and go over the top. And then secure it. If you can try and tie a reef knot at the side it gives a flatter knot which is a nicer look. And then what you can do is either leave the ties loose or you can tie a bow and again you can lose the ends... and wrap the one round the back there. And they do these in a wide range of different colours and designs. So if you are trying to co-ordinate an outfit it is quite easy to find something that will actually work for that.
If you want to go for hats, one of the things you might need to do is to measure your head to get your hat size. It is a very simple way of measuring. You just need to take tape measure, the middle of your forehead, round the back and there is a little bump on the back of your head. You are measuring over that little bump. And then you just take the measurement and mine is 55, I think 55 to 56 is about a standard size. That’s centimetres. In old money it’s 21 to 21 1/2 inches.
The high street tend to sell them as standard sort of sizes. So, if you have a smaller head or a larger head you might need to look elsewhere. If it is too big you’ll tend to look swamped in it. If it is too small you’ll feel it is quite insecure and you’ll feel like it is slipping off all the time. So it is important to get the right sort of size. Something like this would be good because you are looking at... something that provides enough coverage. So you need to have something that is going to cover...to the sides and also down to the nape of the neck. And you can see here it has quite pretty detail on this one. And another one... I quite like this one, this is another... nice breathable fabric, no sort of seams to be uncomfortable and again you can see it has got quite a nice detail to the side.
Whatever you choose to wear remember you can experiment with different colours and patterns depending on your outfit and what you will be doing that particular day.
Some people prefer to wear a wig until their hair grows back. You can get a wig on the NHS or buy one privately. Speak to your radiotherapy team who can advise you on any wigs, hats or scarves they sell in the hospital.
You might want to cut your hair short before the treatment starts. This can make the change less dramatic and easier to cope with. But speak to your doctor beforehand to check how much hair you might lose.
Sometimes you can have small patches of no hair or thinning hair. To cover these small patches up you might want to use extensions clips. Or you may want to change your hairstyle to help cover these areas better.
Worries about treatment side effects
You may feel anxious about radiotherapy side effects and this is normal. It can help to talk through any worries you have with your doctor, nurse or radiographer.
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